KidsUrologyCare.com Dr. Parviz Hajiyev
Testicles and groin

Inguinal hernia and hydrocele surgery

Inguinal hernia and hydrocele surgery in children: open and laparoscopic methods, anesthesia, going home the same day and recovery.

Quick answers

Duration
20–45 minutes.
Going home
The same day (small babies born prematurely are monitored overnight).
Recurrence
About 1%.
Back to normal life
1–2 days.

Goal of the operation

In an inguinal hernia and a communicating hydrocele, the cause of the problem is the same: a canal that has stayed open between the abdomen and the groin and scrotum. The operation closes this canal.

Methods

Open method

A 1.5–2 cm incision in the groin crease. The open canal (hernia sac) next to the spermatic cord is found, the testicular blood vessels and the vas deferens are carefully separated, and the canal is closed at the top. In a hydrocele, the fluid is drained. The incision is closed under the skin with absorbable stitches.

Laparoscopic method

With a 3–5 mm camera placed through the belly button, the canal is found from inside the abdomen and closed from the inside. The other side is checked at the same time, and if there is an open canal, it is closed too. The incisions are very small.

Both methods are safe and have similar results.

Day of surgery

  • Fasting rules before anesthesia (anesthesia in children).
  • General anesthesia with local anesthesia.
  • The child goes home a few hours after waking up. Small babies born prematurely are monitored in the hospital overnight.

At home

  • Mild swelling at the incision and bruising of the scrotum are normal in the first days.
  • A short shower after 48 hours.
  • Simple pain relievers for 1–3 days.
  • The child returns to usual play in 1–2 days and avoids strenuous sports and straddle toys for 1–2 weeks.

Possible problems

Complications are rare: wound infection, recurrence of the hernia (about 1%) and, very rarely, the testicle moving up or getting smaller.

When to seek urgent care

If any of the following is present, do not wait for a routine appointment: call the doctor or go to the nearest emergency department.

  • Increasing swelling or bleeding at the wound
  • Fever, pus from the wound
  • Pauses in breathing in a small baby (after anesthesia)

Note for pediatricians and family doctors

In children, hernia treatment consists only of high ligation of the patent processus vaginalis (herniotomy); mesh is not used as it is in adults. The laparoscopic approach makes it possible to see a patent canal on the opposite side and close it in the same session. In babies born prematurely and younger than 60 weeks postconceptional age, overnight monitoring is recommended because of the risk of apnea after anesthesia.

What happens at the visit?

  1. The side and size of the hernia or hydrocele are assessed.
  2. Open and laparoscopic methods are discussed according to the child's age and condition.
  3. Anesthesia, fasting rules and home care are explained.
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Frequently asked questions

Is mesh used in children?

No. In children, the abdominal wall is not weak; the problem is a canal that has stayed open. Closing it is enough.

Related topics

Sources

  • EAU Guidelines on Paediatric Urology, 2025.
  • Dreuning K et al. Laparoscopic versus open pediatric inguinal hernia repair. Surg Endosc, 2019.

This page is for education. Decisions about your child’s treatment are made together with the doctor after an examination.

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