Q: I am impressed by the simple explanation given under Hydrocoele. But I have a few questions: 1) On which category of patients do you normally advice needle aspiration? When is hydrocoelectomy a must? My father (aged 85, non- diabetic and non-hypertensive) needs immediate relief for hydrocoele. Can you suggest the best institution for elderly care at Chennai. What are the normal surgical charges (for aspiration/surgery)?

A:Aspiration: very rarely, if ever. However aspiration may be an option if the diagnosis is in doubt. I may consider aspiration if the patient has a very large hydrocele and absolutely refuses surgery. Aspiration is not favoured because the hydrocele will refill, and can develop infection. In the past aspiration, with injection of a chemical, was popular. This treatment has poor results and has now been abandoned. Hydrocelectomy is a must if large, and troublesome. If the hydrocele is small, and does not interfere with routine activity or walking, if it is painless, it can be left alone. Chennai: I do not know. Cost: In Delhi, in a private hospital, varies according to hospital, but averages Rs. 5000/- inclusive of medicines.