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Dr. Y.
Dr. Y., Urologist
Category: Urology
Satisfied Customers: 20141
Experience:  I am fellowship trained specializing in general urology and reconstructive urology.
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How familiar are you with hydrocele surgery and

Customer Question

Hi, how familiar are you with hydrocele surgery and complications?
Submitted: 1 year ago.
Category: Urology
Customer: replied 1 year ago.
Posted by JustAnswer at customer's request) Hello. I would like to request the following Expert Service(s) from you: Live Phone Call. Let me know if you need more information, or send me the service offer(s) so we can proceed.
Expert:  Dr. Y. replied 1 year ago.

I am very familiar with this surgery and the complications. How can I help?

Customer: replied 1 year ago.
hi - Sorry for the delay. I hope you can provide some insight.Over a year ago, I went in for surgery to repair a right inguinal hernia. Previous to this, I had had no surgeries, no urological issues, and I am in better than average health, 5'10, 150lbs, 50 years old (at the time). I had had a vasectomy a year or more before.Immediately after the hernia surgery, I developed a hydroelectric on the right side of my scrotum. From what I could gather (unfortunately, I've found that my urologist seems to take offense at communicating specifics) it was in the process vaginalis related membrane. I went in for a seemingly routine procedure, where he said he drained the hydrocele, then folded the membranes back around (behind?) the testicle and sewed them in place (or something like that).Recovery seemed normal, except that very quickly the swelling increased, appeared to be fluid filled rather than tissue swelling, and then did not go down. Also, it seemed to be adhering to the inside of the skin of the scrotum, not allowing for the normal mobility of the scrotum skin over that area. The doctor refused to entertain the idea that it was not typical of recovery, but it became very obvious that there was a new hydrocele, significantly larger than the original one. Finally, after several months, the doctor acknowledged that there was a new hydrocele, and concluded that it was communicating from the abdominal cavity. Note for later: while the sutures took a long time to heal fully - basically continuing to ooze puss in various small eruptions along the scar until a long thread under the skin was essentially erupted out, after which the small randomly opening and closing pus eruptions went away virtually immediately, the external appearance and characteristics of the scrotum were smooth and normal (Notwithstanding having another hydrocele present).The urologist then arranged to do a second hydrocelectomy, but with the surgeon who performed the hernia operation present, to deal with what he thought was the translation issue.Immediately after that surgery, I noticed that on the right side of the front of my scrotum, to the right of the incision, from just below the penis, the tissue was lumpy and pinched, creating a protruding fold, about 1/2 x 2 inches long, hanging vertically below the penis. Also, just to the outside of that were 2 areas where it literally appeared that a point of the skin had been pulled sharply down into the scrotum, by about 1/4 inch, and stitched to something inside, creating a relatively deep "fold" around a single point - though there was no external suture visible. The urologist also had put a drain in, and it exited the scrotum further to the right from the previous items. I can send a photo, if needed.The doctors found no translation from the abdominal cavity, and the hernia surgeon felt that everything there was in order (though I had been experiencing some discomfort there, and seeming hardness in the spermatic cord, since the surgery.) I asked the urologist about the lumpiness, and, with irritation, he said that there was lots of tissue that he had to bunched up in that area to keep the hydrocele from coming back - which seems odd to me - and that's all he would tell me. I later learned from the other surgeon, who was much more communicative, that the new hydrocele was in one of the membranes that was integral to the testicle itself, vs, one which surrounded it as the process vaginalis did. (I understand that, but does that make sense?)There was relatively little swelling and drainage, and again, after the internal sutures (a thread about 4 inches long) - finally, weeks later - erupted from the closed but repeatedly-erupting-with-pus scar (is that normal?!) the wound seemed to heal fine.It has been several months since then, and the deep pockets in the scrotum I described earlier are not evident, but there is now a large fold that starts partially up the base of the shaft of the penis, and extends about 3 inches down until it fades into the normal shape of the scrotum. The skin that makes up that fold is thicker and more lumpy than the skin on the other side of the scrotum, and though totally healed on the outside, is still somewhat tender inside when pressed (there is no tenderness on the other side with the same pressure). The entire area of the fold continually has a feeling of being tender or irritated, and parts of the testicle and cord remain more tender than normal.I would like your opinion on what is going on. Is the above normal? Should there have been a bunch of tissue “wadded” up against the top of the scrotum below the penis, actually up the shaft somewhat, creating the now existing large fold and thickened, lumpy skin of the scrotum? If so, why was that not done on the first procedure? Given the tissues involved, it seems like it might have made more sense then, than on the second one. Should it still be tender anywhere?To be continued:
Customer: replied 1 year ago.
continued:Please note, the urologist proceeded to become very difficult in the follow-ups. He became very irritated, evasive on any aspect, and responds to questions with only very non-specific and sometimes contradictory answers. I only know what I do from the hernia surgeon who was mainly just observing for the first part of the operation. I’ve never had to fire a doc before, but he’s fired. :-/I hope that makes sense. Thanks for your help.