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Hydrocele
A hydrocele is a collection of fluid in the sac around the testicle. The scrotum on that side is enlarged and heavier, usually without pain.
What concerns does it address?
When should you get in touch?
An enlarged scrotum should be examined even when it does not hurt — an ultrasound distinguishes a collection of fluid from other causes.
→ Urology: examination and diagnostics
When is surgery needed, and when monitoring?
A hydrocele is not dangerous in itself. It is monitored while it is small, painless and not bothersome. It is operated on when it is large, heavy or growing, when it interferes with walking, sitting or intercourse, when it hurts or when, because of it, the testicle cannot be examined properly by ultrasound.
How is it done?
Through an incision in the scrotum, the sac in which the fluid collects is opened, the fluid drained, and the sac removed or turned inside out and stitched so that fluid can no longer collect. In the first days supportive underwear is worn; swelling of the scrotum after the procedure is expected and goes down over weeks.
When is the procedure not suitable?
The procedure is not done until an ultrasound confirms that a collection of fluid is all that is in the scrotum, because a hydrocele sometimes accompanies a lump in the testicle or inflammation, and that requires a different approach. It is postponed if there is active inflammation of the testicle or epididymis. A small hydrocele that is not bothersome does not need surgery and is monitored. The procedure is done in adults.
General reasons for postponing a procedure (inflammation, a clotting disorder, smoking): When is a procedure postponed?
Anaesthesia
Before a procedure under general or regional anaesthesia, you are seen by the anaesthetist, who works full time at the clinic; the same doctor is also present during the procedure. The anaesthetic assessment and the anaesthesia for larger operations are included in the price of the procedure. What happens before, during and after anaesthesia is described on the Anaesthesia page.
Risks
Expected, and rare but serious → Risks and complications: what is the course of healing, and what is a complication?
Specialist and team
Specialty: urology — examinations, diagnostics and procedures.
When the procedure is done under sedation or general anaesthesia, the anaesthesia is led by a specialist in anaesthesiology, resuscitation and intensive care who works full time at the clinic.
In the operating theatre, the surgeon is assisted by head nurse Martina Šereg, with the help of nurses Kristina Jurešić and Mateja Tomorad, and in recovery the care assistant Mirjana Kovačić is with you. Martina also looks after preparation, scheduling and contact after the procedure.
Who will operate is decided at the examination, based on the findings and the type of procedure. You know the name of the surgeon before the procedure and meet them at the examination.
What happens at the examination?
A urological examination has two parts: a conversation about your symptoms, past illnesses and medicines, and a clinical examination. Depending on the findings, an ultrasound is done straight away, in the same visit, if needed. You receive the findings at the examination.
What if the result is not as agreed?
The result of a procedure is assessed at a follow-up visit, once the swelling has gone down and the scar has matured, not in the first weeks. If it differs from what was agreed at the examination, the same surgeon carries out the correction.
→ Poliklinika Barbel's correction policy
In the same visit
- Hernia surgery — an inguinal hernia and a hydrocele in men are operated on in the same procedure.
Frequently asked questions
Does a hydrocele come back after surgery? Rarely, when the sac is removed or turned inside out; on average in fewer than five in a hundred patients operated on. After aspiration alone it almost always comes back.
Why is aspiration not a permanent solution? Aspiration empties the fluid, but the sac that produces it remains and fills it again, most often within a few weeks or months. In addition, every aspiration carries a risk of infection and of bleeding into the scrotum.
Is a drain left in? With a larger hydrocele a thin drain is sometimes left for one to two days so that blood and fluid do not collect. It is removed at the follow-up visit and does not hurt.
Does it affect fertility and potency? No. The testicle is not touched, only the sac around it. Potency and sperm production stay as they were.
What does the scrotum look like after recovery? After the swelling goes down, on average after one to two months, the scrotum returns to normal size. The scar is hidden in a skin fold.
How much does the result depend on care after the procedure? The larger the procedure, the more it depends on it, but it always does. Healing takes weeks and months and happens almost entirely at home, so the instructions you receive when you go home, about the wound, physical activity and the scar, are part of the procedure, not a recommendation.
Medical review: doctors of Poliklinika Barbel · October 2026.