Hydrocelectomy
A hydrocelectomy drains the fluid that has built up around a testicle (a hydrocele) and removes or folds the thin sac that made it, so the fluid is unlikely to come back.
Also called Hydrocele repair, Hydrocele surgery, Scrotal hydrocelectomy, Hydrocele excision, Jaboulay procedure, Lord's procedure, Water on the testicle, Fluid around the testicle surgery
- Where
- Outpatient surgery center or hospital operating room
- Anesthesia
- General or spinal anesthesia; sometimes local numbing with sedation
- Time in the room
- 45 minutes to 1 hour
- Hospital stay
- Same day
- Going home with
- Sometimes a small drain from the scrotum for 1 to 2 days
- Back to normal
- 2 to 3 weeks; swelling can take 1 to 3 months to settle fully
- Back to work
- Desk work in 3 to 7 days; heavy physical work after 2 to 4 weeks
Overview
A hydrocele is a buildup of fluid inside the thin sac that surrounds each testicle. It causes a smooth, usually painless swelling on one side of the scrotum (the pouch of skin that holds the testicles). Some stay small. Others grow to the size of a grapefruit or larger and feel heavy, rub on clothing, and get in the way of walking, sports or sex.
In adults, the cause is often unknown. A hydrocele can also follow an injury, an infection, or surgery in the groin or scrotum. Because fluid can hide the testicle from the examining hand, an ultrasound is usually done first to make sure the testicle itself is healthy.
A hydrocele is not dangerous and does not turn into cancer, so surgery is for comfort and appearance. Draining the fluid with a needle helps only briefly, because the sac usually refills. In a hydrocelectomy, your surgeon opens the scrotum, drains the fluid, and removes or folds the sac so it can no longer collect fluid.
Recovery takes patience. The scrotum is often swollen and bruised for weeks, and can look nearly as large as before for a while. Most of the swelling settles over 4 to 6 weeks, and the final result is clear by about 2 to 3 months. Hydroceles in babies and young children are different and are covered in the questions below.
The parts of your body involved
Each testicle sits inside a thin, two-layered sac called the tunica vaginalis. Normally, a few drops of fluid let the testicle move smoothly inside it. In a hydrocele, the sac makes fluid faster than it can absorb it, and the space fills up. The fluid is usually clear and straw colored. The epididymis, where sperm mature, sits on the back of the testicle, and the vas deferens runs up from it in the spermatic cord. Your surgeon works carefully around both, because they are pressed against the sac.
- Testicle
The oval gland that makes sperm and testosterone. It is usually normal in a hydrocele.
- Tunica vaginalis
The thin sac around the testicle. This is the lining that fills with fluid, and it is what the surgeon removes or folds.
- Epididymis
A soft, coiled tube on the back of the testicle that stores sperm. It is protected during surgery.
- Spermatic cord
The bundle containing the vas deferens, blood vessels and nerves that holds the testicle up.
- Scrotal wall
The skin and a thin muscle layer underneath that wrinkles and tightens with cold.
Why it’s done
Small hydroceles that do not bother you can be left alone. Surgery is chosen when the size or feel of the hydrocele affects daily life.
- Size and heaviness
A large hydrocele can feel like a heavy weight and cause a dragging ache, especially by the end of the day.
- Daily activities
Trouble fitting into clothes, sitting comfortably, walking, cycling, playing sports or having sex.
- Appearance
Many men feel self-conscious about the swelling.
- It keeps coming back
Fluid that returns after needle drainage is a common reason to choose surgery.
- Skin problems
A very large hydrocele can stretch the skin and cause chafing or irritation.
Other options
- Watching
A hydrocele is not harmful. If it does not bother you, leaving it alone is reasonable. Have any new lump or change checked.
- Support underwear
Snug briefs or an athletic supporter can ease heaviness and aching.
- Needle drainage
Fluid is drawn off through a needle in the office. Relief is quick, but the fluid usually returns within weeks to months, and each needle has a small risk of infection or bleeding.
- Drainage with sclerotherapy
After draining, a medicine is injected to make the sac scar shut. It can work, but often needs repeating and can be painful. Many urologists avoid it in men who may want children, because the medicine can scar nearby tubes.
Getting ready
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Weeks before
The week before
The day before
The morning of surgery
In the operating room, step by step
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1. Going to sleep
You lie on your back on the operating table. The anesthesia team puts you to sleep or numbs you from the waist down. The scrotum is cleaned and draped.
After the operation
Right afterward
- Recovery room
You wake up with a snug dressing and support. The scrotum feels full and sore.
- Ice
Ice packs are often started in recovery.
- Passing urine
The team checks that you can pass urine before you leave, especially after spinal anesthesia.
- A drain, if you have one
You will be shown how to care for it. It is usually removed in the office or at home after 1 to 2 days.
- Going home
Most men go home 1 to 3 hours after surgery with a driver, a pain plan and written instructions.
At home
- Pain
Soreness is worst for the first 2 to 4 days. Acetaminophen and, when allowed, ibuprofen usually control it. A few doses of stronger medicine may be prescribed.
- Ice and support
Use ice on and off for 48 to 72 hours. Wear snug support day and night for 1 to 2 weeks, then during activity until the swelling settles.
- Swelling
Expect the scrotum to stay swollen for several weeks, sometimes as large as before surgery at first. Lying back with the scrotum raised on a folded towel helps.
- The wound
A little oozing onto the dressing is normal for a day or two. Stitches dissolve on their own over 1 to 3 weeks.
- Showering
Most surgeons allow a shower after 24 to 48 hours, or once a drain is out. No baths, hot tubs or swimming for 2 weeks.
- Activity
Walk around the house from the first day. Rest with your feet up often during the first week.
- Lifting and exercise
Avoid lifting more than about 20 pounds and hard exercise for 2 to 4 weeks.
- Sex
Usually after about 2 weeks, once it is comfortable.
- Driving
Once you are off strong pain medicine and can sit and brake comfortably, usually after a few days.
- Work
Desk work in 3 to 7 days. Physical jobs usually need 2 to 4 weeks.
Recovery timeline
- Day 0Home the same day
You go home a few hours after surgery with a snug dressing and support.
- Days 1 to 3Peak swelling
Soreness and swelling are at their worst. A drain, if placed, is usually removed.
- Week 1Moving more
Pain eases. Many men return to desk work. Bruising may spread and change color.
- Weeks 2 to 4Back to activity
Most men return to exercise, lifting and sex. The scrotum is still somewhat swollen.
- Weeks 4 to 6Shrinking
Most of the swelling has gone. A firm area where the sac was may still be felt.
- Months 2 to 3Final result
The scrotum is close to its final size and feel. Any firmness from healing softens.
- Long termFluid stays away
In most men, the hydrocele does not return. Have any new swelling checked.
What it feels like
Most men are glad they had it done, but the weeks after surgery can test your patience because the swelling takes a while to go down. Knowing that ahead of time helps.
Before surgery
Many men feel embarrassed by the swelling and have put off seeing a doctor. Some worry it is cancer.
What helpsHydroceles are very common and urologists see them every week. A normal ultrasound usually brings real relief.
Waking up
The scrotum feels full, tight and sore under a bulky dressing.
What helpsIce, pain medicine on a schedule for the first day, and lying back with your knees slightly bent.
The first week
Swelling and bruising can make the scrotum look as big as before, or bigger. This can be disheartening.
What helpsIt is normal and expected. Keep the support on, keep the scrotum raised when you rest, and call if one side is tense and growing quickly.
Living with a drain
The tube feels odd and the dressing may get damp with pink fluid.
What helpsIt is usually out in a day or two. Change the gauze as you were shown.
Walking and sitting
Moving feels awkward and tight, and clothes may not fit well.
What helpsLoose pants, snug support underneath, and short walks rather than long ones at first.
A month or two later
Most men notice the scrotum is smaller and lighter than it has been in years.
What helpsGive it the full 2 to 3 months before judging the result. Mention any remaining lump at your follow-up visit.
How well it works
Success means a scrotum of normal size once healing is complete, with the fluid staying away.
- Lasting result
After the sac is removed or folded, the hydrocele comes back in only a small number of men.
- When to judge
Swelling from surgery hides the result for several weeks. The final size and feel are usually clear by 2 to 3 months.
- Follow-up
Most surgeons see you once, 2 to 6 weeks after surgery, to check healing.
- Fertility and hormones
Testosterone is not affected. Fertility is rarely affected, because the surgeon protects the epididymis and vas.
Risks
Every operation has risks. These are the ones people ask about most, with honest odds where good numbers exist. Your surgeon’s own results matter more than averages.
Common
Swelling that lasts weeks, and sometimes up to 2 to 3 months, is common and settles on its own.
Purple bruising of the scrotum, and sometimes the base of the penis, is common and fades over 2 to 3 weeks.
Aching for several days, usually controlled with simple pain medicine and ice.
Less common
A collection of blood can make the scrotum tense, very swollen and painful. Most settle with rest and support; some need a return to the operating room to drain them.
Redness, warmth, drainage or fever. Usually treated with antibiotics; rarely needs draining.
Fluid builds up again in a small number of men and may need another operation.
Scar tissue where the sac was can feel like a lump for some months.
Rare
Damage to the sperm-carrying tubes could lower fertility on that side.
Ongoing pain in the scrotum after healing is rare.
Damage to the vessels can cause the testicle to shrink. This is rare.
Call your care team or go to the emergency room if
- Fever of 101°F (38.3°C) or higher, or shaking chills
- Swelling that gets rapidly larger, tense and very painful over a few hours
- Bleeding that soaks through the dressing and does not stop after 10 minutes of firm pressure
- Redness spreading across the scrotum, pus, or a bad smell from the wound
- Pain that keeps getting worse, or is not controlled by your medicine
- You cannot pass urine for 8 hours after surgery, or your bladder feels full and you cannot empty it
Questions to ask your surgeon
- Has an ultrasound confirmed the testicle is normal?
- Do I also have a hernia?
- Will you remove the sac or fold it, and why?
- Will I have a drain?
- Could surgery affect my fertility, and how do you protect the sperm tubes?
- How often do your patients have a bleeding problem or the hydrocele come back?
- How long should I expect the swelling to last?
- How long should I avoid lifting, exercise and sex?
- When can I go back to work?
- Is needle drainage or sclerotherapy a reasonable choice for me?
Words you may hear
- Hydrocele
- A buildup of fluid in the sac around a testicle.
- Hydrocelectomy
- Surgery to drain a hydrocele and remove or fold its sac.
- Tunica vaginalis
- The thin, two-layered sac that surrounds the testicle.
- Epididymis
- A coiled tube on the back of the testicle where sperm mature.
- Vas deferens
- The tube that carries sperm up from the epididymis.
- Transillumination
- Shining a light through the scrotum. Fluid glows; a solid lump does not.
- Hematoma
- A collection of blood under the skin that causes swelling and bruising.
- Sclerotherapy
- Injecting a medicine into a drained space to make its walls scar together.
- Aspiration
- Drawing fluid out through a needle.
- Drain
- A thin soft tube that lets fluid or blood leave the surgical area for a day or two.
- Communicating hydrocele
- A hydrocele in children where fluid moves back and forth from the belly through a small open channel.
Common questions
Is a hydrocele dangerous? Can it turn into cancer?
No. A hydrocele is a collection of fluid and does not become cancer. An ultrasound is still done to make sure there is no separate problem in the testicle hidden behind the fluid.
Why not just drain it with a needle?
Needle drainage brings quick relief, but the sac usually refills over weeks to months. Surgery removes or folds the sac so the fluid has nowhere to collect.
How long will the swelling last?
Expect obvious swelling for 2 to 4 weeks and some for up to 2 to 3 months. It is normal for the scrotum to look large for a while before it shrinks.
Can a hydrocele come back after surgery?
It can, but this is uncommon after the sac has been removed or folded.
Will this affect my fertility or testosterone?
Testosterone is not affected. The tubes that carry sperm sit close to the sac, so there is a small risk to fertility on that side. Tell your surgeon if you might want children.
My baby has a hydrocele. Is it the same thing?
Not quite. Many babies are born with fluid around a testicle, and most of these go away on their own by age 1 to 2. If the swelling changes size during the day, the fluid is moving through an open channel from the belly, called a communicating hydrocele. That kind is usually repaired through a small groin cut, like a hernia repair, if it does not close on its own.
Sources this page draws on
- Urology Care Foundation, Hydroceles
- MedlinePlus (U.S. National Library of Medicine), Hydrocele repair
- European Association of Urology, EAU Guidelines on Paediatric Urology
- MedlinePlus (U.S. National Library of Medicine), Hydrocele
Written November 2026. This page explains what usually happens. It is not medical advice and does not replace a conversation with your own surgeon, whose plan for you comes first.