Surgery For Benign Scrotal Lumps

Procedure Information

Surgery For Benign Scrotal Lumps

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Epididymal Cyst

Hydrocele Treatment
What Is A Benign Scrotal Lump?

A benign scrotal lump is a lump in your scrotum that is not caused by a cancer.
Dr Vasudevan has recommended an operation to remove the lump in your scrotum. However, it is your decision to go ahead with the operation or not.
This document will give you information about the benefits and risks to help you to make an informed decision. If you have any questions that this document does not answer, ask Dr Vasudevan.

How Does A Benign Scrotal Lump Happen?

There are two types of benign scrotal lumps.
A hydrocele is a build-up of fluid around a testicle (see figure 1). There is a sheath around your testicle that contains a small amount of fluid. Fluid can build up because of an injury or inflammation. In some tropical climates, infection can cause a hydrocele.
An epididymal cyst (spermatocele) is a collection of fluid in the epididymis (a tube-like structure that stores sperm) (see figure 2). Sperm drains out of small ducts and some of these can get blocked, causing a build-up of fluid. The sperm count is not affected as there are lots of other ducts.

What Are The Benefits Of Surgery?

If the lump is large, surgery will ease any discomfort you may have and make it easier for you to walk. If you want to have children, it is best to leave an epididymal cyst alone. Surgery in the area of the epididymis can cause scarring which reduces your fertility.

Are There Any Alternatives To Surgery?

The fluid can be removed using a needle but the fluid usually builds up again. It is possible to inject a drug that prevents the fluid from coming back.

What Will Happen If I Decide Not To Have The Operation?

The lump will not usually settle without treatment. If the lump is small and is not tender, it can be left alone. A large lump can be tender, cause discomfort or pain, and make it difficult to walk. A hydrocele can get infected. If antibiotics do not effectively treat the infection, you will need another operation to remove the infected tissue.

What Does The Operation Involve?

The healthcare team will carry out a number of checks to make sure you have the operation you came in for. You can help by confirming to Dr Vasudevan and the healthcare team your name and the operation you are having.
The operation is usually performed under a general anaesthetic. Sometimes a spinal anaesthetic is used. Your anaesthetist will discuss the options with you and recommend the best form of anaesthesia for you. You may be given antibiotics during the operation to reduce the risk of infection. The operation usually takes 20 to 50 minutes.
Dr Vasudevan will make a small cut on your scrotum. For a hydrocele, Dr Vasudevan will remove the fluid from the sheath. To prevent to the fluid from coming back, Dr Vasudevan will either remove the sheath or stitch it together.
Dr Vasudevan will remove an epididymal cyst.
This will usually involve removing part of or all the epididymis.
Dr Vasudevan will close the small cut with stitches.

What Should I Do About Medication?

Let Dr Vasudevan know about all the medication you take and follow his advice. This includes all blood-thinning medication as well as herbal and complementary remedies, dietary supplements, and medication you can buy over the counter.

What Can I Do To Help Make The Operation A Success?

If you smoke, stopping smoking several weeks or more before the operation may reduce your risk of developing complication and will improve your long-term health. Try to maintain a healthy weight. You have a higher risk of developing complication if you are overweight.
Regular exercise should help to prepare you for the operation, help you to recover and improve your long-term health.

You can reduce your risk of infection in a surgical wound.

Part of your scrotum may need to be shaved before the operation. You will either be asked to do this yourself when you are in hospital or the healthcare team will do it for you.

Try to have a bath or shower either the day before or on the day of the operation and make sure your scrotum is clean.

Keep warm around the time of the operation.

What Complications Can Happen?

Dr Vasudevan will try to make the operation as safe as possible but complications can happen. Some of these can be serious and can even cause death (risk: 1 in 400). You should ask Dr Vasudevan if there is anything you do not understand. Dr Vasudevan may be able to tell you if the risk of a complication is higher or lower for you.

Complications of anaesthesia

Your anaesthetist will be able to discuss with you the possible complication of having an anaesthetic.

General complications of any operation

Pain is usually only mild and easily controlled with simple painkillers such as paracetamol. If you have severe pain, let Dr Vasudevan know.

Bleeding during or after the operation (risk: 1 in 6). It is common for your scrotum to be bruised. If Dr Vasudevan is concerned that the bleeding is heavy, they may insert a drain (tube) in your wound. Heavy bleeding can cause a large clot and swelling in your scrotum.

Specific complications of this operation

Difficulty passing urine. You may need a catheter (tube) in your bladder for one to two days.

Infection of the surgical site (wound) (risk: 1 in 10). This is usually mild. It is usually safe to shower after two days. Let Dr Vasudevan know if you get a high temperature, notice pus in your wound, or if your wound becomes red, sore or painful. An infection usually settles with antibiotics but you may need another operation.

Reduced fertility if the surgery is to treat an epididymal cyst. Surgery in the area of the epididymis can cause scarring which reduces fertility.

How Soon Will I Recover?

In Hospital

After the operation you will be transferred to the recovery area and then to the ward. You should be able to go home the next day. However, Dr Vasudevan may recommend that you stay a little longer.
If you do go home the same day, a responsible adult should take you home in a car or taxi and be able to stay with you for at least 24 hours. Be near a telephone in case of an emergency.
Wearing a scrotal support or firm underwear will help ease any discomfort, and minimise bruising and swelling.
If you are worried about anything, in hospital or at home, contact Dr Vasudevan. He will be able to reassure you or identify and treat any complications.

Returning to normal activities

Do not drive, operate machinery (this includes cooking) or do any potentially dangerous activities for at least 24 hours and not until you have fully recovered feeling, movement and co-ordination.
If you had a general anaesthetic or sedation, you should also not sign legal documents or drink alcohol for at least 24 hours.
Do not do strenuous exercise, like running and riding a bicycle, for five to seven days. Most men can return to normal activities after two to four weeks. If you notice swelling or have a discharge from your wounds, or still have pain after four weeks, contact Dr Vasudevan.
Regular exercise should help you to return to normal activities as soon as possible.
Do not drive until you are confident about controlling your vehicle and always check your insurance policy.

The future

Most men make a good recovery. Sometimes the lump comes back. There is usually more than one epididymal cyst and surgery can only treat the larger ones. If the small ones get larger, the problem will come back. For a hydrocele, surgery usually cures the problem but fluid can build up again and you may need another operation (risk: 1 in 20).

Summary

A benign scrotal lump is a lump in your scrotum that is not caused by a cancer. Most of them can be left alone but some cause problems and can be treated by surgery. Surgery is usually safe and effective but complications can happen. You need to know about them to help you to make an informed decision about surgery. Knowing about them will also help to detect and treat any problems early.