From the Guidelines

Hydrocele is typically managed conservatively or surgically, depending on the size and symptoms.

For small, asymptomatic hydroceles, observation and monitoring for changes in size or symptoms is recommended.
For larger or symptomatic hydroceles, surgical repair, such as hydrocelectomy, is often necessary 1. In some cases, aspiration of the hydrocele may be performed, but this is usually not a definitive treatment as the fluid can accumulate again.

Sclerotherapy, using a sclerosing agent such as tetracycline or doxycycline, may also be considered for some patients.
Imaging studies, such as ultrasound, may be used to diagnose and monitor hydroceles, as well as to rule out other potential causes of scrotal pain or swelling 1.

Post-surgically, patients are usually advised to:

Wear scrotal support
Apply ice
Take pain medication such as acetaminophen 650-1000mg every 4-6 hours or ibuprofen 400-600mg every 6-8 hours for 2-3 days
Antibiotics such as cephalexin 250-500mg every 6 hours may be prescribed for 5-7 days to prevent infection 1. It is essential to consult a healthcare professional for proper evaluation and management of hydrocele, as individual treatment plans may vary depending on the patient's specific condition and medical history.

From the Research

The management of hydrocele can be divided into several approaches, including:

Conservative treatment: This approach is often used unless the hydrocele grows to a critical size that leads to discomfort or difficulty in walking 2.
Fluid aspiration: This method can be used to drain the hydrocele, but it may not be effective in all cases and may require repeated procedures 3, 4.
Hydrocelectomy: This is a surgical procedure that involves the removal of the hydrocele sac and is often considered the standard treatment for hydrocele 3, 4, 5.
Sclerotherapy: This involves the injection of a sclerosing agent, such as polidocanol, into the hydrocele sac to reduce the size of the hydrocele and prevent recurrence 6.
Minimally invasive treatment: This approach involves the use of a small incision to drain the hydrocele and remove part of the tunica vaginalis sac, and has been shown to be effective in reducing complications and recurrence rates 5.

The choice of treatment for hydrocele depends on several factors, including:

Studies have shown that:

Aspiration and sclerotherapy with polidocanol can be an effective treatment for hydrocele, with a low recurrence rate 6.
Hydrocelectomy can be an effective treatment for hydrocele, but it may be associated with complications such as hematoma, infection, and chronic pain 5.
Minimally invasive treatment can be an effective and safe alternative to traditional hydrocelectomy, with a low risk of complications and recurrence 5.