Adult Hydrocele Repair

Adult Hydrocele Surgery

Hydrocelectomy is performed here at The Urology Place in San Antonio, Texas. 

Treatment is considered when the hydrocele interferes with normal activity. In some cases, hydroceles can become infected or even interfere with normal sperm production. Two options exist for treatment.

Option one: A needle can be used to aspirate the fluid and drain the fluid pocket. This method is office-based, quick and covered by insuranace. Our in-office procedure is relatively painless with local anesthetic. We even offer nitrous gas, which is a safe inhalant used in dentist offices. Unfortunately, hydroceles can often return after this method.

Option two: This method is preferred. The hydrocele sac is opened and then sutured closed in a way to prevent recollection of the fluid. Return of a hydrocele is very unlikely. Insurance covers the procedure in the hospital.

What is a hydrocele?

A hydrocele is a membranous sack of fluid that surrounds the testicle and can cause swelling of the scrotum. Any swelling of the scrotum needs to be examined by a doctor to distinguish between serious and benign conditions. A hydrocele is a benign condition, but testicular cancer can mimic a hydrocele.

A small incision is made on the scrotum and the hydrocele is opened and drained of the fluid. The hydrocele is then everted around the testicle and secured. In essence it is turned inside out. This keeps the fluid from re-accumulating.

Cost of Hydrocelectomy

If you do not want to use insurance, we can do the procedure for select patients in the office. The procedure is relatively painless and we offer nitrous gas to help with anxiety and discomfort. The procedure in the office is approximately $1850. This represents a significant savings for patients compared to the cost of having the procedure in the hospital. Nitrous gas is available to ease anxiety and discomfort. It is very safe. Many other urologists will refer you to a surgery center for your hydrocele procedure, which can increase your cost dramatically. In a surgery center, you typically pay separate fees for the surgery center, the urologist, the anesthesia doctor, and your supplies. 

Hydrocele Procedure Overview

The hydrocele procedure can take 30 minutes to an hour depending on the patient. If the procedure is performed in the operating room, the patient can be asleep. An operating room procedure is more expensive than an office procedure and is done when insurance covers the procedure.

A scalpel is used to open the scrotal skin. The hydrocele is entered and drained. The sac is then closed in such a way to prevent the fluid from reaccumulating. Sometimes, a temporary rubber drain is placed. The scrotum is then closed in layers.

In the office, local anesthetic is given. Nitrous gas is also available.

Patients experience minimal pain after their hydrocele, and typically only take Tylenol and an anti-inflammatory during recovery. Swelling can last for a few weeks after the procedure. The drain is usually removed in 48-72 hours.


Any surgical procedure has risks. Hydrocele repair’s major risks are testicle injury or loss, infection, bleeding and recurrence of hydrocele.

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  • A surgical procedure removing the foreskin
  • Usually repaired if it is painful or interfering with normal activity
  • Insurance coverage if performed in the hospital
  • In office option available for those not using insurance

Post Hydrocele Activity and Care

First 48-72 hours

Tylenol or Advil is usually all that is needed. We recommend ice packs and compressive shorts to minimize jostling.  Use the ice pack for 10-20 minutes the first 24 hours. Try to do this 2-3 times. You can return to desk work in 24-48 hours.

You can eat whatever you want.

You can resume blood thinners in 48 hours but clear it with the doctor.

You can shower after 24 hours.

Remove any dressing after 24 hours. If there is any spotting, you can replace the dressing.

Expect swelling for a few weeks after the procedure.

Sex after Hydrocele repair

Usually wait 3 weeks. Wait for the sutures to dissolve.

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Frequently Asked Questions

Yes. Hospital repair of a hydrocele is covered. Drainage in the office is covered. Surgery in the office is not covered by insurance but is a less expensive option for many patients.

We offer a cost effective in-office hydrocele procedure to patients without an insurance-covered benefit. Instead of general anesthesia we use a lidocaine block, which makes the procedure essentially painless. Patients usually listen to music during the procedure. We can prescribe nitrous gas for patients who are anxious. Nitrous is safe and reduces pain and anxiety. You can still drive home after nitrous gas.

Patients should avoid physical activity for about a two weeks after their hydrocele procedure. Patients can travel the day of the procedure. Desk work can be resumed after 24-48 hours. Sexual activity can resume once the sutures dissolve, which typically takes 2-3 weeks.

Pain is amazingly minimal during your hydrocele surgery and afterwards. Tylenol and anti-inflammatories are usually enough.

For elective procedures not covered by insurance, the age is 18.

Patients will be in the office for all sorts of urological issues. Urology is a discrete practice. No one should know what you are here for. In addition, we have a male assistant for the procedure if desired as well.

Hydrocele is one of the more common procedures done in urology. Skill is needed to minimize complications and ensure good outcomes. We have performed hundreds of hydrocele repairs. The key is to have a consultation prior to your procedure.

Avoid aspirin or blood thinners for at least 1 week prior to your surgery. Use clippers to cut away any scrotal hair. Do not use a razor. Bring some frozen peas and tight compressive shorts for after the procedure.

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