Hydrocele - Lessons Learned & Progress of 2nd Surgery

Men's health
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I had left side hydrocele surgery 2 years ago, after a year first noticing something was wrong, lots of being scared/depressed/embarrased after it started growing out of control.

Quick details - maximum growth about the size of an orange, with the largest growth doubling/tripling of size in 3 months (months 5->8 since taking notice of it.  I had it aspirated in month 9 and in month 10.  Surgery in month 11.  Like a self healing water balloon, aspirating was only temporary relief & not a cure - the stretch balloon only refilled & continued to grow.

Biggest mistake post-op... too much movement & not enough support, leading to much longer recovery time & a lot of unneeded excruiating pain.

I am now 15 hours post-op on my right side hydrocele, I’ll comment below on decision making I made, preparation, and recovery as I use a lot of “lessons learned” from the first, to not repeat on the second round.

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Number 1, at the time of my first left side hydrocele diagnosis & treatment, it was already known I had slight hydrocele on the right.  The idea of doing both, when I had zero idea about hydrocele coming into the first was simply unimaginable.  In hindsight, having both operated on at the same time would have been wise... maybe.

Number 2, armed with experience & family/friends I could now talk to about this, once the right side started growing - a “wait & let’s see how big it gets” option was not an option at all.  I was out of country living when I first started taking notice, upon returning to the US I went to the same Urologist who performed the 1st surgery and started preparing to have surgery.  2 months later (other life was happening) I had surgery without aspiration & the hydrocele was about the size of a large egg... 1/3 that of my left size at its surgery date.

Number 3... arm youself with a 6-pack of at least 1-size too small “sports briefs”... i.e., whity tighty with legs.  Most likely your surgeon will fit you with a stripped down jock strap, we can just call a “nut hammock”.  Keep it on, but once you wake up from surgery, the first piece of clothing you should put on is 2 pairs of your undersized sports briefs, and hiking them up a bit from the legs, not the waistband.  You want your nuts up high, not hanging low —> if they are not “swinging”, you are less likely to hit your testicles and this is where the drop you to the ground pain comes from - not the incision in your scrotum or that “stretched waterballoon” later being peeling off the testicle & stitched up top.  The latter 2 pains are managable with regular doses of medium painkillers (Ibuprofin or Motrin).  A slight tap to your testicle - that pain is not manageable, even with heavy (and unnecessary) opiodes.  Even “careful” walking with your boys swinging low... it’s only a matter of when you’re dropped to the ground in pain.  Trust me... first round, I was walking like Mogli in the Jungebook keeping nothign but air between my jewels & my legs, and wouldn’t you know it the left would haul off and smack the right.  Comfortably secure them to your pelvis, don’t let them move around - life is good. smile

Number 4 & 5 - get yourself a p**s bottle or 2.  Use it.  I have a super small bladder, but every trip to the bathroom is unnecessary steps and potential for upsetting healing process, as well as dropping you to the ground (see #3).  I’ve taken no more than 200 steps today, but I have urinated at least 20 times (if not more).  New knowledge gained today - peeing in the bottle via the healthy side leg hole of your sports briefs takes a lot less movement, aim & potential you hit your sensitive testicle than digging through the barn door and aiming at the toilet.  Today, I’ve had only 1 accidental “hit” to my sensitive jewel, and it was only when I accidentally closed my legs together too close.  2 years ago, in the first day I had to have hit it 20 times if not more.  I do stand to urinate, but I have not been taking unnessary steps, and I’ve not aggregrevated the injury site any more than the surgery has done itself.

I’ll add more tomorrow, especially on the post-op swelling.  But I think I much better along after 1 day (than I was 1 week out 2 years ago), largely bc of what I am doing this time around vs last time.

 

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All Swelling (& Post-Op Growth) is Not Created Equal… nor is how the body deals with it over time.

There are 3 types, each different in duration & reduction in size.

#1 - Scar tissue formation… in essence, that is what a hydrocelectomy is doing, turning the membrane surround the teste, which normally lubricates it & provides some cushioning, into a scar tissue “packet” attached atop the teste.  The doctor is folding-up the “latex” of the water balloon and stitching it to where it normally is attached to the teste.  It turns into scar tissue.  The longer one waits for surgery, the larger this “packet” will be.

The horror story @Patsfan7 & others have unfortunately experienced, seems to be much more excessive scar tissue formed than was expected & desired.  Scar tissue is a reality with any surgery, the body repairs soft connective tissues with collagen. 

Wherever, the surgeon physically separates the membrane from its connections to the membrane, scar tissue will form - a bit like if you’ve ever lost your fingernail.

#2 - Inflammation & Interstitial Fluid… this is largely a fluid that supports & provides the pathway for the body’s “little repairmen” outside the blood vessels.  It will take up as much space as is available, although it really doesn’t need that much to get the job done.  Icing can reduce extra, but those doubled up 1-size too small sports briefs are going to be your best friends here.  Once the “little repairmen” are done working, the IF is reabsorbed into your system and swelling goes away pretty rapidly.

#3 - Blood Clots & Blood Masses… here is what we are trying to avoid.  This is the “cement” of the “little repairmen”.  Every time you upset, hit or otherwise disturb your jewels & the “little repairmen”, you are most likely tearing off some scab formation, leading to more bleeding… and all this starts forming a mass.  The body normally dissolves blood clots, scabs, etc., once the repairs are done… but it is slow going - especially the larger it gets.  Scabs are fibrous, hardened glue (not unlike gum in your hair)… and they are hard.

Icing doesn’t speed the process, only time through the body’s normal rate of dissolving the scab/mass, and bringing your back to the “new normal” size (teste + scar tissue + stitched membrane “packet”).

My first surgery & post-op recovery, I stupidly & actively allowed this mass to grow - about the size of an extra large egg.  Your surgeon isn’t going to do anything about it, so doing whatever you can to prevent it (like I outlined above & am doing now), the quicker the recovery.

I joked last night to my grandparents that if I allowed this “hardened blood mass” to form again, I was going to hop on my motorcycle that vibrates a lot, and treat myself to some “ultrasound” to try to break it up.  Unlike a kidney stone & high frequency ultrasound used to break them apart, I’m pretty certain this would have no effect on this unwanted formation.

Oh, ps… there is also a drain tube your surgeon installed.  Keep this secure, as there is much more inside than outside.  Let it jostle around, you’ll know it when you’re once again dropped to your knees as it hits your teste.  Also, you’ve just added more bleeding & broken loose scab to add to that mass. 0.0