What is Hydrocele or Water Hernia?

In a boy, if the opening of the abdominal membrane forming the hernia sac is not too wide and is too narrow to allow the organs to come out, the fluid in the abdomen can enter. This fluid can be trapped around the testicle (hydrocele: water sac), or it can enter and exit the abdomen and its amount can increase. The decrease and increase of the soft swelling (amount of fluid) in the groin/testicular area is commonly referred to as water hernia. The swelling can sometimes be felt as hard and tense.

Is Hydrocele or Water Hernia Surgery Necessary?

It can be expected that the small amount of fluid (hydrocele) around the testicle will regress and disappear on its own within the first 2 years of age. Since there is no organ in hydrocele, there is no risk of strangulation and it does not cause any complications. Therefore, it is waited until the age of 2 unless an adverse situation develops. However, Water Hernia can turn into Inguinal Hernia. The family should be informed about this.

Are There Different Types of Hydrocele?

There are 2 types of hydrocele observed in the newborn age;

1. Communicating – Connecting Hydrocele: The abdominal membrane descending to the scrotum is completely open.
2. Non-Communicating – Non-Connected Hydrocele: The abnormal closure of the abdominal part of this membrane to the scrotum and the trapping of peritoneal fluid in the scrotum.
3. Acquired – Hydrocele seen in adults or occurring in children due to trauma etc.

 

Figure: Hydrocele in Children

What are the Symptoms of Hydrocele?

The important finding in this disorder, that is, the suspicious situation, is the swellings that appear in the groin area of ​​the baby or child. It is possible to see it on the right, left or both sides of the groin area. This swelling gives a highlight when the light is held. It may decrease in size when sleeping at night.

How is Water Hernia Diagnosed?

It is established with the history and physical examination. However, sometimes it may be necessary to perform Ultrasonography

What is Water Hernia Most Commonly Confused with?

It can be confused with Inguinal Hernia in boys and Nuck Canal cysts in girls. It can be confused with strangulated hernia in particular, caution should be exercised. It can also be confused with Scrotal edema and Testicular Torsion.

Who is Water Hernia More Commonly Seen in?

It is more common in male babies, babies born with low birth weight, premature babies and children with some congenital connective tissue diseases. According to figures, approximately 3-4 out of every 100 male children have an inguinal hernia.

Is Water Hernia Familial?

If it is present in the father and siblings, the frequency of occurrence in other siblings is higher than normal. However, we cannot definitely say that it is familial or genetic.

Does Water Hernia Go Away On Its Own?

Yes, it can be fixed. Some of it can go away on its own by the age of 2. Since there is no organ inside, there is no risk of strangulation. Therefore, there is no need to rush for surgery. However, if it does not go away by the age of 2, it should not be waited any longer because it can disrupt the functional structure of the testicles.

What Kind of Problems Can Be Encountered When Water Hernia Is Not Surgery?

However, if it does not go away by the age of 2, it should not be waited any longer because it can disrupt the functional structure of the testicles. In addition, there is a possibility that Water Hernia may turn into a Normal Hernia, and the family should be informed in this regard.

How is Water Hernia Surgery Performed?

It can be performed with an open method or laparoscopic (closed) method. The procedure is performed in the operating room under general anesthesia.

What is done before the Water Hernia Surgery?

First of all, a good history should be taken and a general physical examination should be performed, and only the groin area examination should not be sufficient. Then, the family (mother and father) is well informed about the process, that is, before the surgery, the surgery process and after. If the child is older, the child is also included in this. A number of tests are performed, these tests are not general and are determined according to the patient. The patient is also seen by the anesthesiologist, the family and the child are informed about the anesthesia process to be experienced. The patient is left hungry for 4 hours before the surgery.

What is the Recovery Period After the Water Hernia Surgery?

The patient is fed in accordance with the doctor and/or nurse's instructions 2 hours after the surgery. Babies over the age of 2 can be sent home after 4-6 hours. After the surgery, the patient only takes painkillers in accordance with the doctor's recommendations, there is no need to take additional medication. The patient is seen by the doctor after 48-72 hours, there is no need for dressing during this time, the stitches dissolve on their own and do not need to be removed. The patient continues his/her normal active life in accordance with the doctor's recommendations after the surgery.

What Kind of Complications Can Be Encountered After Water Hernia Surgery?

Injury or rupture of the testicular veins. Rupture of the spermatic cord. Re-opening of the connected inguinal canal or failure to connect the canal. Formation of hematoma at the surgery site and in the scrotum. Recurrence of hydrocele

Is There Pain After Hydrocele Surgery?

Painkillers are definitely administered during hydrocele surgery and if painkillers are used for 3-4 days after the surgery in accordance with the doctor's recommendations, there will be absolutely no pain.

Can Circumcision Be Performed at the Same Time as Hydrocele Surgery?

As long as the surgery does not take longer, circumcision can also be performed. The process is the same, it does not impose an additional burden on the patient.

***The information provided here and the content of the website are arranged for the purpose of informing visitors, especially families. No information should be considered as advice by visitors and should not lead to any decision or action. Families should definitely have their patients examined by a pediatric surgeon and make a decision based on their personal knowledge and experience.