Hernia and Hydrocele

In normal testicular development, the testicle, in the last few months of pregnancy, descends and travels through the abdomen into the scrotum. Typically, the “tunnel” from the abdomen to the scrotum (the processus vaginalis) closes at birth or during the first year of life. However, it is not uncommon for the tunnel to remain open, allowing fluid or bowel to enter, which is called a hydrocele or hernia. Inguinal hernias occur in up to 4% of children and 30% of premature infants. Hernias are nine times more common in boys and are most commonly (60%) found on the right side.

When there is just fluid in the scrotum, it is called a hydrocele, and this should resolve within 1 year. If a hydrocele gets larger (instead of smaller), causes pain or discomfort, and persists beyond the first year of life, surgical intervention is necessary. If bowel gets down into the inguinal canal or scrotum, it is called a hernia . If this causes discomfort, becomes red and hard, or makes the child ill (vomiting, nausea, fevers), surgical intervention is necessary.

Surgical Repair

Parents naturally are concerned about surgery and have many questions. Parents should be reassured to know that a hernia/hydrocele repair is one of the most common procedures preformed. Children will not be allowed to eat or drink anything before surgery, because general anesthesia is used. The procedure is preformed as an outpatient procedure, which means that your child should be able to go home after surgery once he is stable. An exception to this may be the child who has other special medical needs requiring closer postoperative monitoring.

The surgery itself involves very small incisions in the inguinal canal and the scrotum. Sometimes it may be necessary to do this on both sides if there is a concern that an opening exists on the other side as well. Parents also should know that it is not uncommon for the surgeon to make a small incision in the umbilicus to use a scope (laparoscopy) to look at the hernia(s).

Postoperative Care and Follow-Up

Activity

Your child needs to be kept quiet and under supervision for 24 hours after surgery. Avoid straddle toys (tricycles, rocking horse, etc.) for 1 week after surgery .Your child may return to school/daycare in 2–3 days if adequate supervision is available. It is important to avoid any injuries to the area. When lifting your child, support his buttocks to prevent strain at the surgery site.

Surgical Site

There is no special care for the incision. Leave the surgical dressing or tape in place until it comes off by itself.

Bathing

It is okay to bathe your son the day after surgery. A warm bath without soap will help reduce swelling and discomfort. Change diapers frequently to keep the incision site clean.

Bruising/Swelling

You can expect bruising or swelling of the scrotum. This should resolve over the next few weeks.

Diet

Start with clear liquids. When clears are tolerated without vomiting, you may advance to regular foods.

Pain Relief

We recommend alternating Tylenol or Ibuprofen for the first few days after surgery. You may give it as directed on the bottle or package.