Hydrocele should be treated if it causes complaints and grows, otherwise only regular follow-up is recommended. The therapy is surgical: under local or general anesthesia, after preparation of the testicular tunica, the pouch of hydrocele is opened, its content is let down, and the testis is turned out while the spermatic cord is carefully spared. The wall of the hydrocele’s pouch is resected (according to Bergmann), or sutured together (according to Winkelmann), in order to prevent its closure and the recurrence of the disease.
After this the testis is placed back to the scrotum followed by subcutaneous and cutaneous sutures. Contrary to the above, during the surgery of congenital hydrocele that occurs in childhood, closure of the vaginal process is primary. Complications of the surgery include bleeding, infection and, due to injury or torsion of the spermatic cord, disordered circulation and consequent necrosis or atrophy of the testis. Earlier in the outpatient clinics puncture of the hydrocele and aspiration of its content were performed instead of open surgery. This method is not recommended, while bleeding and infection may occur, and the hydrocele may recur, as the mucous membrane surfaces which produce the serous discharge are left in place.
