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Generally, surgical repair of a hydrocele will eliminate the hydrocele and prevent recurrence.In adults, surgery is used to remove large or painful hydroceles.

As the hydrocele fills with fluid and grows, the scrotum itself gets larger.

It typically occurs on one side only; only 7–10% occur on both sides of the scrotum.

Inflammation is not usually present, although if the hydrocele occurs in conjunction with epididymitis (inflammation of the epididymis), the testes may be inflamed and painful.

To remove it, the surgeon cuts through the skin and tissue layers (B), then drains the hydrocele with a tube (C).

The hydrocele is opened completely (D), and skin and tissue layers are stitched (E).

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