What are the potential complications of surgical treatment of hydroceles?

Updated: Oct 28, 2020
  • Author: Jacob C Parke, MD; Chief Editor: Edward David Kim, MD, FACS  more...
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Answer

Complications are largely avoided with meticulous dissection and gentle tissue handling. In addition, extensive dissection should be avoided, as it increases the risk for nerve damage, vascular damage leading to testicular atrophy, and postoperative hematomas.

  • Injury to spermatic cord structures: The vas or testicular vessels may be injured in 1-3% of inguinal approaches. Some testicular shrinkage has been described in nearly 10% of children undergoing inguinal hernia repair.

  • Recurrence: Recurrence of the hydrocele after inguinal approaches is most often reactive in nature and usually resolves within several months. Rarely, aspiration or scrotal surgery is warranted.

  • Bleeding/scrotal hematoma: Either poor intraoperative hemostasis or excessive cord dissection (with inguinal approaches) may result in postoperative bleeding. Hematomas typically resolve over time. If the patient has evidence of ongoing bleeding or is extremely symptomatic, exploration and hematoma evacuation is warranted.

  • Ilioinguinal/genitofemoral nerve injury: These nerves may be entrapped or divided during inguinal approaches. The injury may be temporary or permanent.

  • Wound infection: Postoperative wound infections are quite uncommon, particularly in children. Wound infections should be managed with antibiotics and, if necessary, opening the wound.


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