Hydrocele repair (Surgical repair of a scrotal hydrocele (hydrocelectomy))
An operation to treat a hydrocele — a build-up of fluid around the testicle that causes a soft, usually not painful scrotal swelling — by draining the fluid and stitching or removing the sac so it does not refill.
✓ Medically reviewed by a GMC-registered consultant · last reviewed September 2026 · next review September 2027 · how we review
In short
- A hydrocele is a usually harmless, usually not painful build-up of fluid around the testicle; it only needs surgery if it is large, uncomfortable or bothersome.
- Any new or changing scrotal swelling should be checked by a doctor first, as some lumps have other causes that need different treatment.
- Draining the fluid with a needle alone is not a lasting fix — it refills and risks infection — so surgery to repair or remove the sac is the usual treatment.
- Swelling and bruising for days to a couple of weeks are normal, the testicle stays a little 'bulkier' afterwards, and the hydrocele can occasionally return.
A plain-English summary. The detail — including risks and recovery — is below.
At a glance
A general guide. Your surgeon will give you advice for your situation.
Removes the fluid and the swelling, relieving heaviness and discomfort
The hydrocele is small and not causing symptoms, so observation is more sensible than surgery.
Expect swelling, bruising and discomfort. Wear the scrotal support, use simple painkillers such as paracetamol or ibuprofen, and apply ice packs (not...
Clear written advice on swelling, scrotal support, wound care and pain relief, with a named contact.
Expect swelling, bruising and discomfort. Wear the scrotal support, use simple painkillers such as paracetamol or...
Swelling and bruising gradually settle. Many people take about 1–2 weeks off work depending on their job. The...
Avoid heavy lifting and strenuous exercise until about four weeks. By now most swelling has settled, though the...
Return to normal activity and exercise as comfort allows. A follow-up appointment is not always needed. The...
What is a hydrocele repair?
A hydrocele is a collection of fluid in the sac that surrounds the testicle, making the scrotum look swollen and feel like a balloon filled with water. It is usually usually not painful and not dangerous. In adults it often develops without an obvious cause, but can follow minor injury, infection or other scrotal problems.
A hydrocele does not need treatment if it is small or causes no significant symptoms. A repair is considered when it becomes large, heavy, uncomfortable or bothersome. Importantly, any new or changing scrotal swelling should be checked by a doctor first, because some lumps have other causes that need different management.
During a repair, the surgeon makes a small cut in the scrotum, drains the fluid, and then either bunches up and stitches the sac so it cannot refill, or removes it completely, especially if its wall is thick. Draining a hydrocele with a needle alone (aspiration) is not a standard treatment, because the fluid almost always comes back and the needle can introduce infection.
The operation usually settles the swelling well. However, the testicle on that side will always feel a little bulkier than the other afterwards, there is normal swelling and bruising for some days, and a hydrocele can occasionally come back.
Types & techniques
There isn't one single operation. The right approach depends on you — which is something to discuss with your surgeon.
Options at a glance
These are the main approaches described in this guide. The right option depends on the diagnosis, your goals and what your clinician thinks is safe.
Repair of the sac (plication)
The fluid is drained and the sac is 'bunched up' with absorbable stitches or closed behind the testicle so the fluid cannot re-form. A common approach for thinner-walled sacs.
Excision of the sac
The sac is removed completely, particularly when it has a very thick wall. This may cause a little more bruising and swelling but reduces the chance of recurrence.
Needle aspiration (not standard treatment)
Drawing the fluid off with a needle. Worth knowing about, but the fluid almost always returns quickly and it can introduce infection, so it is not recommended as a cure; it...
Observation (an alternative to surgery)
Doing nothing if the hydrocele is small or not bothersome. Many hydroceles never need treatment; surgery is for symptoms, not appearance alone.
Preparing for your surgery
- See the surgeon, who will confirm the diagnosis (sometimes with an ultrasound scan) and check the swelling is a hydrocele.
- Mention all medicines, especially blood thinners such as warfarin, aspirin or rivaroxaban, and any allergies.
- Tell the team about any implanted devices, previous MRSA, or other health conditions.
- Arrange a lift home and someone with you for the first night, as you will usually have an anaesthetic.
- Get supportive underwear or a scrotal support ready, plus loose, comfortable clothing.
- Plan time off work — often about 1–2 weeks — and avoid heavy lifting for around 4 weeks.
- You may be given anti-clot stockings and a blood-thinning injection around the time of surgery to prevent clots.
What happens
The operation is usually done under general anaesthetic or a spinal anaesthetic (which numbs you from the waist down); occasionally a local anaesthetic is used. You may be given an injection of antibiotics after checking for allergies.
The surgeon makes a small cut in the scrotum and drains the fluid from around the testicle. They then either 'bunch up' the sac with absorbable stitches, or remove it completely if its wall is thick, so the fluid cannot re-form. The skin is closed with dissolvable stitches that disappear over about two to three weeks, and a scrotal support is usually provided.
The procedure normally takes around half an hour and is usually done as a day case, so most people go home the same day. Your testicle on that side will feel bulkier than the other afterwards because of the repaired sac.
Is this operation right for me?
A good consultation should explore whether it's the right choice for you now — including reasons to wait or consider something else.
May not be suitable if…
- The hydrocele is small and not causing symptoms, so observation is more sensible than surgery.
- A scrotal swelling has not yet been properly assessed, as some lumps have other causes needing different treatment.
- You are not fit enough for an anaesthetic, when observation or, occasionally, aspiration may be considered instead.
- An active infection or skin problem in the area makes surgery unwise until treated.
Delay surgery if…
- There is an active infection in the scrotum or elsewhere.
- Blood-thinning medicines need to be managed before surgery.
- The diagnosis is uncertain and an ultrasound or further assessment is needed first.
- You are generally unwell and need to recover before an anaesthetic.
- There is broken or infected skin over the operation site.
Alternatives to discuss
- Observation, with no treatment, if the hydrocele is small or not bothersome.
- Needle aspiration (drawing off the fluid), though it usually refills and is not a cure.
- Treating an underlying cause, such as infection, where one is found.
- Supportive underwear for comfort while deciding whether to have surgery.
- Assessment and different management if the swelling turns out not to be a simple hydrocele.
Before you decide
Use this as a shared-decision checklist. The aim is not just “can this be done?”, but whether it is right for you, now, with the risks and alternatives clearly understood.
What matters most to me?
Think about symptoms, daily life, work, caring responsibilities, sport, fertility, travel, appearance and anxiety — the right choice depends on your priorities, not just the medical facts.
What are all my options?
Ask about waiting, monitoring, medicines, rehabilitation, a smaller or larger procedure, a different test, NHS referral, or a second opinion where that would help.
What would make me pause?
Active infection, pregnancy, unstable medical problems, smoking, medicines that increase bleeding, poor support at home, or feeling pressured are all reasons to slow down and get tailored advice.
What happens if I do nothing today?
For some problems, waiting is safe; for others, delay can make treatment harder. A good consultation should explain the trade-off in plain English.
Anaesthetic choices
The safest option depends on the operation, your health, the facility and your surgeon/anaesthetist. Ask what is planned and why.
Benefits
- Removes the fluid and the swelling, relieving heaviness and discomfort
- Treats the sac so the fluid is much less likely to come back than with needle drainage
- Can make clothing and activity more comfortable
- Usually a short, day-case operation with a quick return to light activity
- Allows the testicle to be examined and the diagnosis confirmed during surgery
Risks & complications
- Swelling, discomfort and bruising of the scrotum lasting from several days to a few weeks (almost all patients)
- A bulky feeling around the testicle from the repaired sac (almost all patients)
- Soreness needing simple painkillers for the first few days
- A blood collection (haematoma) around the testicle or wound, which resolves slowly or occasionally needs surgical removal (between 1 in 10 and 1 in 50)
- Infection in the wound or testicle needing antibiotics or drainage (between 1 in 10 and 1 in 50)
- A hospital-acquired infection, including MRSA or C. difficile (around 4–6% overall, higher in high-risk patients)
- Recurrence of the hydrocele (between 1 in 50 and 1 in 250)
- Injury to the epididymis, the vas deferens or the blood supply of the testicle (between 1 in 50 and 1 in 250)
- Chronic (long-lasting) pain in the testicle or scrotum (between 1 in 50 and 1 in 250)
- Anaesthetic or heart and circulation problems, including clots, very rarely serious (between 1 in 50 and 1 in 250)
The most important things to know are that swelling, bruising and a bulkier-feeling testicle are normal and expected, while a hydrocele can occasionally come back. Less commonly, a blood collection or infection can develop. Rarely, the delicate structures behind the testicle (the epididymis, the vas deferens that carries sperm, or the blood supply) can be injured, and a small number of men develop lasting scrotal pain. Tell your surgeon about blood thinners and any health conditions, and ask about their own results and which technique they plan to use.
Published figures to discuss
Hydrocele repair is generally a low-risk, day-case operation, and the British Association of Urological Surgeons (BAUS) publishes typical frequency bands for its after-effects. Almost all men get some swelling, bruising and a bulkier-feeling testicle. The ranges below are from BAUS patient information; individual risk depends on the size of the hydrocele, the technique, and your general health, and your surgeon can give a more personal estimate.
| Figure | Reported range | How to interpret it | Source / confidence |
|---|---|---|---|
| Blood collection (haematoma) or wound/testicle infection | Between 1 in 10 and 1 in 50 patients (each) | A haematoma may resolve slowly or occasionally need surgical drainage; infection may need antibiotics. | NHS — Testicle lumps and swellingsnhs.ukPublished figure |
| Recurrence of the hydrocele | Between 1 in 50 and 1 in 250 patients | Removing a thick-walled sac rather than bunching it may reduce the chance in some cases. | NHS — Testicle lumps and swellingsnhs.ukPublished figure |
| Injury to epididymis/vas deferens/testicular blood supply, or chronic scrotal pain | Each between 1 in 50 and 1 in 250 patients | Uncommon but important; discuss fertility concerns beforehand if relevant. | NHS — Testicle lumps and swellingsnhs.ukPublished figure |
These are literature figures, not a personalised prediction. Your own risks and likely benefits depend on your circumstances, your health, and how your care is carried out and followed up.
Recovery — what to expect, and when
Recovery is usually straightforward but the scrotum is swollen, bruised and sore for some days. A scrotal support helps comfort, and you should avoid heavy lifting and strenuous activity for about four weeks. Bruising and swelling that are slowly improving are normal; swelling that gets worse day by day should be checked.
- Scrotal swelling, bruising and discomfort that slowly improve over days to a couple of weeks
- A bulkier feeling on the side that was repaired, which is permanent
- Needing simple painkillers for the first few days
- Dissolvable stitches disappearing over about two to three weeks
- Gradual return to lifting and exercise over about four weeks
Aftercare
- Wear the scrotal support or tight, supportive underwear to ease discomfort and reduce swelling.
- Keep the wound clean and dry for the first 24 hours, then you can wash the area gently.
- Use simple painkillers and ice packs (not directly on skin) for pain and swelling in the first days.
- Avoid heavy lifting and strenuous exercise for about four weeks.
- Watch for bruising, swelling or pain that gets progressively worse day by day, and seek advice if it does.
- There is usually no need to remove stitches, as they are dissolvable.
- Know who to contact if you develop signs of infection or worsening swelling.
- Scrotal support or supportive underwear ready
- Simple painkillers (paracetamol or ibuprofen) at home
- Ice packs and a cloth to wrap them in
- A lift home and help for the first night
- Time off work arranged (about 1–2 weeks)
- Loose, comfortable clothing
- The surgical team's contact number saved
Scars and how they heal
There is a small scar in the scrotum, closed with dissolvable stitches that disappear over about two to three weeks. Scrotal skin generally heals well and the scar usually becomes discreet. Bruising and swelling around it in the first days are normal.
⚠ Get urgent help if…
- Bruising, swelling or pain in the scrotum that is getting progressively worse day by day
- Increasing redness, heat or discharge from the wound, or a fever — possible infection
- A rapidly enlarging, very painful or hard swelling
- Difficulty passing urine
- Calf pain or swelling, or sudden breathlessness or chest pain — possible clot, call 999 if breathless
- A new lump in the testicle that feels firm or different — get it checked
Who to contact: your surgeon or clinic first (keep their number to hand). For urgent advice when you can't reach them, call NHS 111. In an emergency, call 999.
General guidance — it doesn't replace the specific advice your surgeon gives you.
Results & realistic expectations
A good result is a scrotum that is no longer swollen with fluid and is more comfortable, with the repaired side feeling a little bulkier than before because of the treated sac. Most men are pleased with the outcome once the early swelling and bruising have settled.
Surgery cannot guarantee that fluid will never return, and a hydrocele can occasionally come back. A small number of men are left with lasting scrotal discomfort. The operation treats the fluid collection but does not change the underlying tendency that caused it, so your surgeon should set realistic expectations.
For most men the repair is lasting and the hydrocele does not return. When recurrence does happen it is uncommon (reported between 1 in 50 and 1 in 250). Removing a thick-walled sac, rather than just bunching it up, may reduce the chance of recurrence in some cases. The permanent 'bulkier' feel of the repaired side is expected and does not indicate a problem.
Combining with other procedures
A hydrocele repair is sometimes done alongside treatment of another scrotal problem found at the same time, such as a cyst of the epididymis. If an ultrasound or examination suggests another cause for the swelling, that is assessed and managed separately, as not all scrotal swellings are simple hydroceles.
Follow-up & long-term care
A follow-up appointment is not always needed after a straightforward hydrocele repair, and you will be given advice on what to expect and who to contact. You will usually receive a copy of your discharge summary, and a copy is sent to your GP. Signs of infection or worsening swelling should be reported promptly rather than waited out.
Revision and secondary surgery reality
- If the hydrocele recurs, a further repair, sometimes removing the sac, may be considered.
- A significant haematoma occasionally needs a return to theatre to drain it.
- An infection may need antibiotics or, rarely, surgical drainage.
- Persistent scrotal pain is uncommon but can be difficult to treat and may need specialist review.
Ask your surgeon for their own revision rate, what counts as a revision, and what is included in the written aftercare policy.
What good aftercare looks like
- Clear written advice on swelling, scrotal support, wound care and pain relief, with a named contact.
- Guidance on the difference between normal settling and worsening swelling that needs review.
- A discharge summary for you and your GP, and a route back to the team if problems arise.
- Honest discussion of recurrence and, where relevant, fertility considerations.
- Clear warning signs for infection and clots, and who to contact.
What affects the cost
Costs vary a great deal between people and providers, and we don't publish prices. What matters is understanding what drives the cost and making sure your quote is complete. The main things that affect it:
- Whether the sac is repaired or fully removed, and the complexity of the hydrocele
- The anaesthetic used (general, spinal or local)
- The surgeon's fee and the anaesthetist's fee
- The hospital or theatre and facility fee
- Any ultrasound scan needed to confirm the diagnosis
- Follow-up appointments, if needed
- Whether one or both sides are treated
- The surgeon's and anaesthetist's fees
- The hospital or theatre and facility fee
- Whether any pre-operative ultrasound is included
- Whether a scrotal support and dressings are included
- Follow-up arrangements and what is included
- What happens, and what it costs, if the hydrocele recurs or a complication such as infection occurs
- The cancellation policy
On the NHS? Hydrocele repair is available on the NHS when the swelling is large, uncomfortable or bothersome; private treatment is usually chosen for shorter waits or choice of surgeon rather than because it is unavailable.
You're entitled to your total cost in writing — including aftercare and any revision — before you decide.
Consent traps and marketing red flags
These are not small details. They are often where patients lose choice, time to reflect, or realistic expectations.
Consent traps
- Not being told that the treated testicle will always feel bulkier afterwards.
- No mention that the hydrocele can recur.
- No discussion of the small risk to the vas deferens, epididymis and blood supply, and any fertility implications.
- Being offered needle aspiration as a 'cure' without explaining it usually refills and risks infection.
- No clear advice on normal versus worsening swelling and who to contact.
Marketing red flags
- Promising a guaranteed, recurrence-free result.
- Offering repeated needle aspirations as a definitive treatment.
- Downplaying normal post-operative swelling and bruising.
- Not assessing a scrotal swelling properly before offering surgery.
Choosing a surgeon safely
- Check your surgeon is on the GMC Specialist Register for this area.
- Make sure they practise at a CQC-registered location, and look for membership of bodies like BAAPS or BAPRAS.
- You're entitled to a two-stage consent process with time to reflect (a cooling-off period). The surgeon who will operate must consent you — not a salesperson.
- Be wary of pressure: time-limited offers, discounts or deposits taken before you've had time to think are red flags, not bargains.
- You're entitled to your total cost in writing — including aftercare and any revision — before you decide.
Questions to ask your medical professional
Take this to your consultation. A good surgeon will welcome every one of these.
- Are you sure this swelling is a hydrocele, and do I need a scan to confirm it?
- Will you repair the sac or remove it, and why?
- What are my chances of the hydrocele coming back?
- What are the risks to the structures behind the testicle, such as the tube that carries sperm?
- How long should I take off work and avoid heavy lifting?
- What signs of infection or problems should I watch for, and who do I contact?
- Are you on the GMC Specialist Register for this area, and which Royal College or professional body are you a member of?
- Will you be the surgeon who carries out my operation, and who looks after me afterwards?
- What are the risks for someone like me, and how often do your own patients have a problem or need it repeated or redone?
- What does a realistic result look like — and what can this operation not achieve?
- What are my options, including waiting, doing nothing for now, or choosing a different approach?
- Can I have written information, results and aftercare instructions in a format I can use, including any accessibility or communication support I need?
- What is the total cost in writing, including any follow-ups, and how much time do I have to decide?
Frequently asked questions
Do I need surgery for a hydrocele?
Can the fluid just be drained with a needle?
Will my testicle feel normal afterwards?
How long is the recovery?
Can a hydrocele come back?
Will it affect my fertility?
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How we made this page
Medically reviewed by a GMC-registered consultant. Written in plain English, checked against NHS, NICE, GMC and relevant Royal College / specialist-society guidance, and kept under review. No clinic paid to appear on this page, and we publish no pricing. This is general information to help you prepare — it is not a substitute for advice from your own clinician. How we review our guides →
Source hierarchy: UK regulator and NHS/NICE guidance first, then relevant Royal College or specialist-society guidance, then peer-reviewed evidence for procedure-specific figures where available.
Sources & standards: BAUS — Hydrocele repair (patient leaflet) NHS — Testicle lumps and swellings Cambridge University Hospitals NHS — Repair of hydrocele Royal United Hospitals Bath NHS — Hydrocele repair
Reviews reflect patients' experience of care, not clinical outcomes. For procedure volumes and outcome data see PHIN.
Last medically reviewed 2026-09-21. Spotted something wrong or out of date? Report an error in this guide.
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