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Hydrocele
Hydrocele
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Scrotal swelling from a hydrocele rarely needs surgery in our hands. We treat most hydroceles in-office with drainage and sclerotherapy — no incision, no general anesthesia, no hospital.
A swollen scrotum doesn't have to mean surgery
A hydrocele is a buildup of fluid around the testicle that causes painless (sometimes uncomfortable) scrotal swelling. The traditional fix is hydrocelectomy — open surgery in a hospital or surgery center. At New York Urology, most hydroceles are handled a different way: in-office, without surgery.
How we treat it — drainage + sclerotherapy
The procedure
We use aspiration and sclerotherapy: the fluid is drained with a fine needle, then a sclerosing agent is injected so the space seals and doesn't simply refill. It's done in the office, typically with local anesthesia, and you walk out the same day — no incision, no general anesthesia, no hospital stay.
Why patients choose it
Aspiration and sclerotherapy is a recognized, minimally invasive first-line option that avoids the cost, downtime, and complications of open surgery. It's an especially good fit for men who want to steer clear of the operating room or aren't ideal surgical candidates. We'll talk through expectations honestly — including that a sclerotherapy approach can occasionally need to be repeated — so you can choose with clear information.
Why it matters
Diagnosed and treated in one place — without the hospital
Because we have a combined urology and interventional radiology team in-office, we can image you the day you arrive, reach a diagnosis, and treat many conditions right here — no separate hospital visit, no operating-room scheduling. See how our in-office model works.
When to see us
If you've noticed scrotal swelling or been told you have a hydrocele and want to avoid surgery, we can usually confirm it with an in-office ultrasound the same visit and lay out your options. Call (212) 991-9991 or book a consultation.
Common questions
Can a hydrocele be treated without surgery?
Yes. Many hydroceles can be treated in-office with aspiration and sclerotherapy — the fluid is drained and a sclerosing agent is injected so the space seals rather than refilling. It avoids the incision, general anesthesia, and hospital stay of open hydrocelectomy.
What is sclerotherapy for a hydrocele?
After the fluid is drained with a fine needle, a sclerosing solution is injected into the space so its lining seals and stops re-accumulating fluid. It's a recognized, minimally invasive alternative to surgery, done in the office under local anesthesia.
Is it done in the office or the hospital?
In the office. We perform hydrocele drainage and sclerotherapy in our office, typically under local anesthesia, and you go home the same day — no hospital admission.
Does it always work the first time?
Most simple hydroceles respond well, but sclerotherapy can occasionally need to be repeated, and not every case is a candidate. We'll evaluate yours with ultrasound and give you an honest read on what to expect before proceeding.
How soon can you tell me what's going on?
Usually the same visit. We can perform an in-office ultrasound when you arrive to confirm a hydrocele (and rule out other causes of scrotal swelling), then discuss treatment that day.
UNDERSTAND YOUR CARE
Explain the swelling before deciding to treat it
A hydrocele is fluid around the testicle. The important first step is confirming what is causing the swelling and whether the testicle and surrounding structures can be adequately assessed.
A swollen scrotum has more than one possible cause
A gradual fluid collection can feel heavy or uncomfortable, but a lump, hernia, infection or other condition can produce swelling too. History and examination guide the assessment. Ultrasound may be useful when the diagnosis is uncertain or the testicle cannot be examined clearly.
Tell the clinician whether swelling began suddenly, changes with activity or position, follows an injury or operation, or comes with pain, fever or urinary symptoms. A new swelling should not be diagnosed by appearance alone. The question is both what the fluid represents and whether another finding needs attention.
The decision depends on burden and the supported diagnosis
A confirmed hydrocele that is not causing significant problems may be observed in selected circumstances. Treatment becomes a discussion when size, discomfort, daily activity or another concern makes intervention worthwhile. Ask about the available approach, anesthesia, recovery, swelling, recurrence and complications.
Pain does not always arise from the fluid itself. If pain is the main concern, ask whether the examination and imaging support the hydrocele as its source. An operation that reduces the fluid cannot guarantee relief of pain from a different mechanism. Agree on the functional goal, the review plan and which changes should prompt earlier assessment. Understanding the diagnosis before treatment helps avoid equating every scan finding with an automatic need for surgery.
Questions to bring to your visit
- Is the swelling definitely a hydrocele, and has the testicle been assessed?
- Can it be observed, or is treatment likely to improve my symptoms?
- What are the recovery, recurrence and persistent-pain considerations?
When to seek care: Sudden severe pain, rapid swelling, fever or major injury needs urgent assessment. Do not assume that an acute painful scrotum is simply a known hydrocele.
Explanation adapted from A Urology Consult in a Book by David Shusterman, MD, chapter 16, “Testicular And Scrotal Pain.” Original illustration reproduced from the book. EAU: urological health guidance.
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