Hydrocele and Varicocele Excisions | Sentara Healthcare
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Hydrocele and Varicocele Excisions 

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Testicles of fetuses develop near kidneys in the abdomen and descend from that location to their normal position in the scrotum towards the end of pregnancy. In order for the testicles to leave the abdomen, a muscle ring in the groin on each side opens and allows the testicles to drop down to the scrotum.

As the testicle descends, the lining of the abdomen also drops to line the scrotum. This channel closes in most boys. If that channel remains open, or reopens, a small amount of fluid can go from the abdomen to the scrotum through this passage. This results in hydrocele.

Possible signs of hydrocele include: 
     Increase in size of scrotum. 
     Discomfort due to increased size of scrotum.

Types of treatment for hydrocele include: 

Hydroceles may require surgical repair if the symptoms grow or size changes significantly throughout the day. For an uncomplicated hydrocele, a small scrotal incision is made and abnormal excess tissues compromising the hydrocele are excised.

A varicocele is an abnormal enlargement of the veins along the spermatic cord, which is the structure supporting the testis in the scrotum.  When valves inside the veins along the spermatic cord malfunction and prevent blood from flowing properly, a varicocele --  essentially a varicose vein of the testicular veins -- is formed. This causes the blood to backup, which leads to swelling and widening of the veins.

There are usually no symptoms. However, varicoceles may cause infertility and testicular shrinkage. Pain is rare. When pain is present, it can vary from a dull, heavy discomfort to a sharp pain. Symptoms may increase with sitting, standing or physical exertion, particularly when an activity occurs over long periods of time.

Diagnostic tools for varicocele include: 

    Mass in the scrotum that may look and feel like a bag of worms.

     Physical exam
    Detects abnormal enlargements or increased fullness of the pampiniform plexus of veins.

     Scrotal ultrasound
    When a physical exam is inconclusive, an ultrasound is used to help diagnose varicoceles.

Types of treatment for varicocele include: 

     Scrotal support
    Support with a jock strap or snug underwear provides some relief of the pain or discomfort. However, if pain continues or other symptoms occur, further treatment may be needed. 

    The urologist will make a cut, usually in the lower abdomen, and tie off the abnormally enlarged veins. Blood will now flow around the area, into normal veins. Following surgery, the patient should keep an ice pack on the area for the first 24 hours after surgery to reduce swelling. 

     Varicocele embolization
    A small hollow tube called a catheter is placed into a vein in your groin or neck area. Using X-rays as a guide, the health care provider moves the tube into the varicocele. A tiny coil passes through the tube, into the varicocele. The coil blocks blood flow to the bad vein and sends it to normal veins.


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