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Testicular swellings - How are they treated?

Hydrocele

There are two treatment options. The first is to aspirate the fluid. This means injecting local anaesthetic into the skin and then inserting a needle to suck the fluid off. Unfortunately it only provides temporary relief and the fluid normally reaccumulates in about 3 months. This may be quite satisfactory treatment though for patients who are not keen on surgery or where an operation would be hazardous.

Long-term cure is achieved by surgery. The operation is usually performed under general anaesthesia and a cut about 5 cms long is made in the scrotum. The fluid is then release and the membrane in which the fluid collets is either removed or turned inside out so that the fluid can no longer accumulate. Your surgeon will normally use stitches that dissolve. After the operation you can expect some swelling and bruising and occasionally this can be complicated by internal oozing of blood or infections, which delay recovery.

Typically there is discomfort for about a week and after that the swelling slowly settles down. The testis feels quite firm for maybe 6-8 weeks afterwards before it softens up.

Epididymal cysts

Treatment options include aspiration, which again is not a permanent solution or an operation to remove the cyst. This is typically done under a general anaesthetic with a cut in the scrotum. The cyst then is removed and occasionally there are multiple cysts present. Although great care is taken because these cysts originate in the epididymis, damage can occur to the microscopic tubes and therefore prevent the natural movement of sperm. Your surgeon will close the skin with dissolving stitches.

After the operation there is swelling with some bruising which will gradually fade. Although this operation will have treated the cyst you have, other ones can grow as the years go by.