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Ask Dr.S.A.Alam Your Own Question
Dr.S.A.Alam, Doctor
Category: Health
Satisfied Customers: 4373
Experience:  MBBS/FCPS(Internal medicine/cardiology) MRCP(R) U.K
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In 2006 my husband had a right inguinal hernia operation, on

Resolved Question:

In 2006 my husband had a right inguinal hernia operation, on a day surgery basis, using keyhole surgery.

He was offered an operation opportunity a few days before Christmas, which he accepted. However, when he arrived, the surgeon that was scheduled to do the op was not the surgeon that his GP had originally referred him to. This one appeared to be competent when he asked whether my husband would accept his substitution, the latter accepted and the op went ahead.

Unfortunately, sometime after he returned home, either the following day or the day after, internal bleeding started - resulting in his penis and scrotum going jet black, and later, after the bleeding stopped, resulted in a haematoma which filled the r/hand segment of the scrotum including the r/h testicle, which subsequently ceased to function.

The hospital A&E Dept, which still existed then, said that there were no surgeons available over the Christmas break to correct any surgical deficiencies, and no other intervention or medication was considered suitable.

Changes in blood circulation adjacent to the haematoma area, and [presumably] changes to testosterone levels as a result of the loss of function of one testicle, have resulted in a substantial loss of erectile performance since the operation and subsequent bleeding, although there has been some recovery since the immediate post operative period. However, sustained erections without prescription medication, particularly at bed-time, are essentially non-existent.

My husband is currently 59 years old. Do you think that it is worth pursuing this matter any further? Is there any surgical or other procedure that could improve his erectile performance?? Is it safe to leave the condition as is, given the age he has reached?
Submitted: 6 years ago.
Category: Health
Expert:  Dr.S.A.Alam replied 6 years ago.

Thank you for your question,

As his problem is more due to decrease in the testosterone levels so it will be a suitable option to give him medicine like Sildenafil (Viagra)
Tadalafil (Cialis).

Plus he has shown good results with this medicine so it is a suitable option for him.

Here you should be careful that this medicine is contraindicated in people with heart disease.

other options like penis pumps, penis injections are more invasive and painful so they should be reserved for people who do not respond to oral medicine.

I hope this answers your question.
Customer: replied 6 years ago.
I don't feel that my last sentence has been answered. Is the condition that he has been left with, liable to carry any other risks e.g. testicular cancer.

If so, what should he do to protect himself against this?
Expert:  Dr.S.A.Alam replied 6 years ago.

Thank you for your input,

yes testicular trauma and resulting damage to the testis are the risk factors for testicular

cancer, to keep an eye on this he needs to learn to check/examine his testis on regular

basis to see for any enlargement or cysts. ultrasound of the testis on annual basis is

another option he can avail to keep an eye on any possible growth in the testis.

I hope this answers your question.
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