HYDROCELECTOMY

WHAT IS A HYDROCELE, A SPERMATOCELE, AND AN EPIDIDYMAL CYST?

A hydrocele is an abnormal fluid collection between the outer tissue layers of the testicle. These tissue layers naturally secrete fluid and when this fluid is not reabsorbed, as it usually would be, a fluid collection or hydrocele forms. The cause of most hydroceles is unknown, although some may be related to trauma, infection, or past surgery.

A spermatocele is a cyst-like sac that is usually attached to the epididymis, the tube that sits behind the testicle and stores sperm. The sac of a spermatocele is filled with sperm. The exact cause of a spermatocele is unknown but it is thought that injury and obstruction may play a part in their formation.

An epididymal cyst is much the same as a spermatocele. However, the sac attached to the epididymis is a true cyst and is filled with cystic fluid and not sperm.

WHAT IS A HYDROCELECTOMY, SPERMATOCELECTOMY AND AN EPIDIDYMAL CYSTECTOMY?

A hydrocelectomy is an operation to treat a hydrocele. An incision is made in the scrotum and the testicle containing the hydrocele is lifted out. The sac is then removed and the remaining tissue edges are stitched back. The tissue edges then heal onto themselves and the surrounding vessels naturally reabsorb any fluid produced.

A spermatocelectomy is an operation to remove a spermatocele from the epididymis of a testicle. An incision is made in the scrotum and the testicle with its attached spermatocele is lifted out. The spermatocele is then removed from the epididymis and any bleeding areas are sealed off.

An epididymal cystectomy is an operation to remove the cyst from the epididymis. The operation is performed in exactly the same way as a spermatocelectomy.

After all three types of surgery, once the operation is complete, the wounds are stitched closed with dissolving stitches that dissolve slowing in the weeks following surgery. No wound drains are usually required.

Hydrocelectomy, spermatocelectomy and epididymal cystectomy are usually not performed unless the hydrocele, spermatocele or epididymal cyst are causing pain or social embarrassment. All three operations are usually simple day stay procedures and complications are rare. Haematoma (blood clot collection), wound infection, abscess, and recurrence, are all very uncommon complications and success rates for surgery usually approach 100%.

YOUR CONSENT

We need your permission for your operation to go ahead. Before you sign the consent form it is important that you understand the risks and effects of the operation and anaesthetic. These will be discussed with you by Dr. B C Shah and the nurse, should you have any questions, Dr.B C Shah would be happy to answer these.

If you would like any testicle tissue returned to you for personal reasons, please discuss this with your family and inform Dr. B C Shah before your operation.

ABOUT YOUR ANAESTHETIC

You will NOT be allowed to eat or drink anything for at least six hours before your surgery. This includes chewing gum and sweets.

Before your operation you will be able to discuss the type of anaesthetic with your anaesthetist, who will see you prior to your operation.

There are two main types of anaesthetic used for this surgery; • General Anaesthetic: You will be asleep throughout the operation and remember nothing of it.

Regional Anaesthetic e.g. Spinal, Epidural or Caudal: A needle is placed into your back and a solution is injected that will numb your body from the waist down. You will be awake but you maybe sleepy and you will not feel the operation.

Feel free to discuss these options and your questions with the anaesthetist.

You must not drive any vehicle or operate any machinery for 24 hours after having an anaesthetic. You will have to arrange for someone to drive you home if you go home within 24 hours of your surgery.

YOUR OPERATION

On admission you will be informed of your approximate time of surgery and prepared for theatre by your nurse.

Any shave of the surgical site is done in theatre once you are asleep.

You may be given some tablets before theatre. These are charted by your anaesthetist and may include tablets for tension, nausea and pain prevention.

You will be escorted to theatre where you will be transferred to the theatre table. Anaesthetic staff will then insert a drip in your arm and will attach various monitoring devices.

Once you have been completely prepared and given your anaesthetic, surgery will begin. The operation usually takes about 30 minutes to perform.

When the operation is completed you will go to the recovery room for a short while where you will be cared for until you are ready to be transferred to the ward.

AFTER SURGERY

Dr. B C Shah will check your blood pressure, pulse and your wound routinely.

You may still have the drip in your arm so you get enough fluid until you are drinking. You can usually eat and drink when you return to the ward.

You may have a scrotal support in place, which is a special pair of underpants that support the scrotum. These underpants help prevent bleeding and keep you comfortable.

Once you have recovered from your anaesthetic you will be able to be up and about, but you must take things very quietly in order to avoid causing any bleeding or bruising at the operation site.

Our aim is to keep you as comfortable as possible, so please tell Dr. B C shah if you have any pain or discomfort so you can be given the appropriate care. At all times, your nurse is there to help you, please ring your bell if you need assistance and your nurse is not nearby.

GOING HOME

Once you are up and about, eating and drinking and you have passed urine you will be able to return home. This may be later on your operation day or the following morning.

Before leaving the ward you will be given a discharge information letter which contains helpful information for when you get home.

Dr. B C Shah will give specific instructions about caring for your wound. You can shower daily to wash your wound but avoid soap and powders directly on the wound until it has healed. The area should be kept clean and dry and you will be given some dressings to take home that are to be placed over the wound to collect any slight ooze.

You will be given appointment to return to see Dr.B C Shah. The appointment is usually about 6 weeks after your operation.

ONCE HOME

If you were a daystay patient, it is important to take things quietly for the rest of the day as the anaesthetic can still have some effects on your body.

You should wear your scrotal support or your own supportive underpants for as long as you need for comfort after your surgery.

Your wound should heal within about 3 to 5 days. During this time your wound may ooze very slightly. However, if your wound continues to ooze or you have any signs of an infection such as a red, hot, swollen, or painful wound please contact Dr. B C Shah as soon as possible.

You should avoid any heavy lifting, straining or strenuous activity for 2 to 3 weeks after your surgery. This includes things such as any digging and strenuous sports as these activities can cause the stitches below the skin to pull apart.

Before discharge Dr. B C Shah will inform you about taking mild pain relievers, should you have any pain or discomfort after you return home.

This is routinely a straightforward operation, after which most patients have a speedy recovery and experience little pain.

While you are in hospital we will do everything we can to make your stay as comfortable as possible. The nursing and medical staff are always available to help with whatever needs you have. If you are worried about anything before or after your surgery, or if you have any further questions or would like more information, please do not hesitate to ask Dr. B C Shah who will be more than happy to help.