 |
 | Home | Contact Us | FAQ | Search & Site Map | Link to Us |
 | Sign In | Join | Other 45 Sites in Network |
Medical Forum / General / General / November 2006Hydrocele Surgery Scheduled--Recent Experiences?
I have had an apparently idiopathic very large complex hydrocele for several years. Monitored closely by urologist who recommends the surgery and calls it "routine". I've had testicular ultrasounds and transillumination performed with the last ultrasound for the first time noting "debris" in the testicular fluid. My uro still recommends surgery but does not seem alarmed by the ultrasound findings. I'm hoping a few of you have had a similar situation--a large, but not painful though esthetically weird to look at (my GF would be the only other "spectator!!") hydrocele--and evaluated and/or went through alternative approaches from continuing to live with it through surgery (and of course all pre and post surgical feedback experiences you can provide). Thanks in advance because I'd like to be fully informed well berfore the January surgery (which can be cancelled!!). Spare no detail!!! >I have had an apparently idiopathic very large complex hydrocele for > several years. Monitored closely by urologist who recommends the [quoted text clipped - 14 lines] > Thanks in advance because I'd like to be fully informed well berfore > the January surgery (which can be cancelled!!). Spare no detail!!! You don' t mention your age, you don't say which testicle, you don't mention how the operation is going to be done - inguinal vs scrotal approach. HMc > . > > [quoted text clipped - 12 lines] > > HMc Mr. McCollister: Age 62, right testicle and I have no idea how surgery is to be done. As stated, not painful but very "inconvenient" and semi-grotesque to look at. Any chance of feedback in the alternative (for both inguinal and scrotal approaches?) My guess: scrotal. Thanks for your response, Michael > Age 62, right testicle and I have no idea how surgery is to be done. As > stated, not painful but very "inconvenient" and semi-grotesque to look > at. Just as another bit of information. I had a hydrocele from birth through about 13. Why 13? Well that was when the hydroceled testicle became infected and swelled up to (literally) the size of a red delicious apple (about the same color, too). Probably the most painful thing I have been through. Rare happenstance, I agree, but still something to at least consider. >> . >> > [quoted text clipped - 28 lines] > > Michael At age 62, it is less likely that this hydrocele is associated with a hernia, so the best approach would normally be through the scrotum, especially since the ultrasound gave no particular indication of testicular malignancy (pediatric hernias are almost always associated with a hernia and need to be addressed through a groin approach). A scrotal approach will be less painful and have a quicker recovery for you. You will have some scrotal swelling with it but if done correctly by your surgeon, your recovery should go fine. HMc > I have had an apparently idiopathic very large complex hydrocele for > several years. Monitored closely by urologist who recommends the [quoted text clipped - 14 lines] > Thanks in advance because I'd like to be fully informed well berfore > the January surgery (which can be cancelled!!). Spare no detail!!! I don't think my experience is particularly illustrative but you don't seem to be getting much experience response, so... My hydrocele wasn't terribly large, nor was it very often painful. I had the surgery in my mid-twenties (about 25 yrs ago) so this may be entirely dated. I'd had no ultrasound. transillumination?!? AFAIK my urologist did the cutting, but there was a crowd so maybe he just 'supervised'. I think my surgery was scrotal, although I remember the urologist hedging about added complexity/recovery if hernia was involved (or found?). I'd had it since childhood, at least. There was some thought that it might have been caused by an anti-miscarriage drug my mother had taken (DES -diethylstilbestrol ... "three times more likely to have genital structural abnormalities than men without such exposure"). The worst part was the low grade infection after the fact (there was almost no local discomfort). They gave me tetracycline to counter that. I washed those down with milk at each of my meals when the pills arrived until a pharmacist friend visited and pointed out that calcium reduces absorption (complexing?). I was an in-patient for a couple days, then back to work... nothing worth worrying about. Good luck, Ed > > I have had an apparently idiopathic very large complex hydrocele for > > several years. Monitored closely by urologist who recommends the [quoted text clipped - 42 lines] > > Good luck, Ed Howard, Ed, Kurt: Thanks to all for your feedback. Obviously I'd "prefer" Howard's scenario but I'm just trying to get informed before finalizing (January) surgery. Though I've had 2 prior Hernia repairs on the side of the Hydrocele (right side) neither the Ultrasound nor the urologist's hands-on exam seems to indicate hernia complexity to my situation. The uro keeps calling this "routine" but I REALLY think it depends on which side of the sharp objects aimed at whose testicles you are!!! Thanks to all (and future feedback too will be appreciated). > Thanks to all for your feedback. Obviously I'd "prefer" Howard's > scenario but I'm just trying to get informed before finalizing [quoted text clipped - 5 lines] > calling this "routine" but I REALLY think it depends on which side of > the sharp objects aimed at whose testicles you are!!! Ah...TWO previous hernia repairs on the same side as the hydrocele? That's crucial information that IIRC you forgot to mention, illustrating one good reason why medical advice via internet is a BAD idea. It's apparent that your original hernia surgeon, and possibly the second one, didn't remove the hernia sac when those hernias were repaired then re-repaired. Failure to remove an indirect hernia sac is by far the most likely reason for recurrence of a hernia. The remnant of that sac (processus vaginalis) is what is now forming your hydrocele, assuming there are no local factors such as trauma to the testicle, no testicular infection/inflammation, no testicular tumor. Now the question is whether or not you have a simple hydrocele from a distal sac remnant, or a hydrocele that has reformed as part of a recurrent indirect hernia because the hernia sac was never removed or divided. There is no good radiographic study that will reliably rule out a recurrent hernia, and in your case the decision to approach the hydrocelectomy via the scrotum means that you may still have a second recurrence of your hernia at some point in the future. One method of making that determination would be a laparoscopy to identify the internal ring of your inguinal canal from the peritoneal cavity and see if there is indeed a hernia present. Complicated situation. Good luck. HMc > > Thanks to all for your feedback. Obviously I'd "prefer" Howard's > > scenario but I'm just trying to get informed before finalizing [quoted text clipped - 31 lines] > > HMc Howard: FYI I raised the hydrocele question months ago in this (or another) Group and you were instrumental then also in assisting me. Just looking for updated info/experiences here. Although I left out the salient "prior hernias" info in this Thread, my suspicion too has always been the previous hernia surgeries might have led to the hydrocele, but my urologist refuted my theory (perhaps informed by my months ago inquiries and your feedback) and insisted mine "probably" was idiopathic Please give me a toodle credit only in the sense that I was/will use any feedback gleaned on the Internet as an additional, but far from the primary, source(s) of info I need to make my final decision Your information however I give great weight to and will use it as a basis for additional questions to ask my urologist in the weeks preceding surgery. Ongoing thanks and one final (I think) question: given the possibility of hernia recurrence or involvement, as long as I accept that--not sure I will--is there any other impediment to going ahead with the hydrocele surgery and telling the uro "do the hernia too if you find it" or is it even more complicated than that? I can live with a hernia if I must but the hydrocele is annoying and darn unsightly. I would of course like to avoid TWO separate procedures no matter how "routine" the urologist feels they each are (but my prior hernia repairs were done by a general surgeon--a lot of good that did me!!-- not a urologist). Thanks for everything and sorry I left the most probative information out..... > Ongoing thanks and one final (I think) question: given the possibility > of hernia recurrence or involvement, as long as I accept that--not sure [quoted text clipped - 12 lines] > Thanks for everything and sorry I left the most probative information > out..... In your case, I would give serious consideration to doing a diagnostic laparoscopy and looking at the internal ring for evidence that there is a retained indirect hernia sac, and if not, excising the hydrocele through the scrotum. Unfortunately, it's unlikely that laparoscopy will be in the skill set of your urologist. Playing the odds, the next best option IMHO is likely to be excising the hydrocele via the scrotum and dealing with a recurrent hernia if and when it shows up. I suspect that the odds are that it won't. I would like to think that your surgeon, at the second operation, simly amputated the hernia sac in the spermatic cord and left the scrotal portion with the idea that if a hydrocele showed up, it could be excised through the scrotum. ICBW HMc > > Ongoing thanks and one final (I think) question: given the possibility > > of hernia recurrence or involvement, as long as I accept that--not sure [quoted text clipped - 26 lines] > > HMc Howard: I feel more armed than most with fodder for a whole bunch of pre-surgery additional questions to my urologist. For this I thank you. A final FYI (also involving a fairly recent--1999-right side surgery) is I had an emergency appendectomy performed by the same general surgeon who may/may not have contributed to/enabled my right side hydrocele in the course of the two hernia repairs--separate from the appendectomy surgery. Throwing that in there just in case it has any relevance. And though Howard has set the bar immensely high, any other input/experiences/thoughts will be greatly appreciated. > I feel more armed than most with fodder for a whole bunch of > pre-surgery additional questions to my urologist. For this I thank you. [quoted text clipped - 5 lines] > appendectomy surgery. Throwing that in there just in case it has any > relevance. The appendectomy is unrelated to your hernia. |
Reply to this Message |
 Sign In
 Join
 My Latest Posts My Monitored Threads My Blog My Photo Gallery My Profile My Homepage Start New Thread Enable EMail Alerts Rate this Thread
|
©2008 Advenet LLC Privacy Policy - Terms of Use
This website includes both content owned or controlled by Advenet as well as content owned or controlled by third parties.