With no hernia, the repair would be on the tunica vaginalis, located within the scrotum. We are confused and would like clarification that we did not get from the busy urologist. Dear Mike, What you have read about the two types of incisions is correct. In children, a hydrocele is often associated with a hernia. The presence of a hernia is not always obvious on physical examination, nor is it always easy to elucidate whether a hydrocele is communicating or not.
History is also important.
For instance, if a hydrocele changes in size at different times of the day, or if it always stays the same, would indicate the possibility of a communication in the former. I suspect your urologist is taking the inguinal approach to be sure that if a hernia is present, he would fix it. This would be the more definitive way to repair. I strongly recommend that you discuss this with your urologist before going ahead with the surgery. This information is provided for general medical educational purposes only.