Successful Right Mini-Incision Hydrocelectomy for Giant Hydrocele in a 38 Y.O. Male

Chief Complaints

A 38-year-old male patient with a body mass index (BMI) of 21 presented to the Urology Department at PACE Hospitals, Hitech City, Hyderabad, with complaints of Right scrotal swelling and pain.

The patient had no significant past medical history and no known drug allergies. There were no chronic illnesses or previous surgeries reported, and overall health was good prior to admission.

On examination, the patient was conscious, coherent, and oriented. General appearance and nutrition were normal. Vital signs were stable. Local examination revealed right scrotal swelling consistent with hydrocele, while the rest of the systemic examination was normal.

Upon admission to PACE Hospitals, the patient was thoroughly evaluated by the Urology team, including a detailed review of his medical history and a comprehensive clinical examination. He presented with right scrotal swelling and pain, raising clinical suspicion of a hydrocele.

The patient underwent diagnostic investigations, including ultrasonography of the scrotum, which confirmed the presence of a right hydrocele with normal bilateral testes. Laboratory investigations, including complete blood picture, renal function tests, blood sugar, coagulation profile, serum electrolytes, and viral screening for HIV, Hepatitis B, and C, were all within normal limits. Cardiovascular, abdominal, and neurological examinations were normal, and the respiratory system examination was stable with no abnormalities.

Based on these confirmed findings, the patient was advised to undergo Right Hydrocele Treatment in Hyderabad, India, under the expert care of the Urology Department.

Following the decision, the patient was scheduled to undergo a Right hydrocelectomy Surgery in Hyderabad at PACE Hospitals, under the expert care of the urology department.

The procedure involved the following steps:

• Anesthesia and Preparation: The patient was placed under spinal anesthesia, and the scrotal area was cleaned and draped in a sterile manner to ensure a safe surgical field. Proper positioning allowed full access to the right scrotum.

• Incision and Exposure: A scrotal incision was made over the site of swelling to expose the hydrocele sac. The sac contained clear fluid, which was completely drained to allow a clear view of the sac and surrounding structures.

• Sac Excision: The redundant portion of the hydrocele sac was excised carefully, preserving the testicle, spermatic cord, and adjacent tissues. The sac was assessed to ensure no abnormal tissue remained.

• Sac Eversion (Jaboulay Procedure): The remaining sac was everted using the Jaboulay technique, folding it outward and securing it to prevent recurrence. Hemostasis was achieved to control any bleeding.

• Closure and Drain Placement: A corrugated rubber drain was placed to prevent fluid accumulation, and the scrotal skin was closed using absorbable sutures. The surgical site was dressed, and the patient was monitored for recovery from anesthesia.
  

After surgery, the patient was closely monitored and remained stable throughout the hospital stay. His intraoperative and postoperative course was uneventful, with no complications observed. He received medications as indicated for pain relief and to prevent infection. The surgical site and drain were carefully observed to ensure proper healing and fluid removal. The patient was discharged in stable condition.

Upon discharge, the patient was prescribed medications for pain management, prevention of stomach irritation, and to support tissue healing and recovery. Pain relief was advised as needed for discomfort or fever, and measures to promote optimal healing were included.

Upon discharge, the patient was advised to follow a normal diet and use tight scrotal support.

The patient was instructed to contact the emergency ward at PACE Hospitals in the event of an emergency or if symptoms such as fever, scrotal pain, or wound discharge.

The patient was advised to return for a follow-up visit with the Urologist in Hyderabad at PACE Hospitals after 3 days for dressing and drain removal.

This case highlights a right giant hydrocele successfully managed with a right hydrocelectomy under spinal anaesthesia. The procedure, including sac excision and eversion using the Jaboulay technique, was completed without complications. The patient’s postoperative course was stable, with pain and infection effectively controlled. He was discharged in stable condition with a normal diet and appropriate follow-up instructions.