Hydrocele
In a hydrocele, fluid collects around the testicle. This causes a usually painless swelling that may grow over time and become bothersome when walking, sitting, exercising or in everyday life.
Before any treatment, I examine the finding and usually perform an ultrasound. This rules out other causes of a swelling.
A small hydrocele that causes no symptoms does not necessarily need surgery. If it grows, causes discomfort or significantly affects the patient, the fluid collection can be removed surgically.
Simplified illustration of the position at the testicle.
- Hydrocele: fluid around the testicle
- Spermatocele: cyst on the epididymis
- Varicocele: enlarged veins of the spermatic cord
Spermatocele
A spermatocele is a fluid-filled cyst on the epididymis. It is benign and usually painless and is often noticed by chance as a small swelling above the testicle. As with a hydrocele, an ultrasound clarifies the finding. Surgery may be considered if the spermatocele grows or causes symptoms.
Varicocele
A varicocele is a varicose-like enlargement of the veins along the spermatic cord, usually on the left side. It can cause a feeling of heaviness or a dragging sensation in the scrotum, especially after standing for a long time or physical exertion. Often it causes no symptoms and is only noticed during an examination or when investigating difficulties conceiving.
Diagnosis includes an examination while standing and a Doppler ultrasound. Not every varicocele needs treatment. If it causes symptoms or the findings are abnormal, surgery may be advisable – whether and which procedure is suitable, I discuss with you after the examination.
Phimosis and circumcision
In phimosis, the foreskin cannot be pulled back over the glans, or only with difficulty. This can lead to pain, recurrent inflammation, skin changes or problems passing urine.
Depending on the findings, non-surgical treatment or complete or partial surgical removal of the foreskin (circumcision) may be considered. I also perform other minor procedures on the external genitalia.
Urethral stricture
In a urethral stricture, the urethra is narrowed by scar tissue. Possible symptoms include a weak or split urine stream, prolonged urination, residual urine and recurrent infections.
Diagnosis may require a urine flow measurement, measurement of residual urine, cystoscopy and further examinations of the urethra.
The right treatment depends on the position, length and cause of the narrowing, and on any previous treatment.
When should you see a urologist?
- a painful or growing swelling of the scrotum
- a tight foreskin or repeated inflammation
- a recurring urethral stricture