Scar Tissue and Adhesions After Testicular Injury

It seems that the scar on the testicle is adhered to the inner side of the scrotum?

Hello Doctor: I had asked a question here around May or June of last year.
At that time, my issue was that my left testicle was punctured by a needle, causing a rupture of internal blood vessels and resulting in a hematoma the size of an egg.
After my consultation, the attending physician said that there was no rupture of the testicle, so conservative treatment and observation were sufficient.
Later, I also inquired whether surgery was necessary, and you advised that surgery was only needed if there was persistent bleeding or a rupture.
Around September or October of last year, during a follow-up visit, an ultrasound indicated that everything was stable and there were no issues.
However, my left testicle still feels slightly larger than before the injury and is no longer smooth and oval-shaped.
Instead, there is a hard band-like tissue in the middle part of the testicle.
When I asked the attending physician, he said that the band-like hard mass is scar tissue, which may resolve or remain permanently depending on individual physiology.

After returning home, I also noticed that there seems to be a tissue connecting the inner side of the left scrotum and the testicle.
When I pull on the left scrotum, the testicle does not move freely like the right one; instead, it feels restricted by this tissue.
Additionally, moving the left testicle gives a sensation of pulling or tugging on the inner side of the left scrotum.
This tissue seems to easily bruise or cause mild pain in the left scrotum with minimal external force (like gentle squeezing or pulling).

Could this be a complication from the healing process of the initial injury to the left testicle, resulting in adhesions in the inner scrotum? If so, is it necessary to perform surgery to remove the adhesions? If surgery is not necessary, can I still request the removal of the adhesions due to my discomfort? Thank you in advance for taking the time to respond.

RML, 20~29 year old female. Ask Date: 2020/01/13

Dr. Du Mingyi reply Urology

If adhesions are present during the physical examination in the outpatient clinic, surgical treatment may be considered.

Reply Date: 2020/01/13

More Info

Understanding scar tissue and adhesions after a testicular injury is crucial for managing symptoms and determining the need for further intervention. Based on your description, it appears that you have developed scar tissue and possibly adhesions following your testicular injury, which can lead to discomfort and restricted movement of the affected testicle.

When a testicle sustains trauma, such as the needle injury you described, the body initiates a healing process that involves inflammation and the formation of scar tissue. This scar tissue is a natural part of the healing process, but it can sometimes lead to complications such as adhesions. Adhesions are bands of scar tissue that can form between internal organs and tissues, causing them to stick together. In your case, it seems that the scar tissue has created a connection between your left testicle and the inner side of the scrotum, which is likely contributing to the sensations of pulling and discomfort you are experiencing.

The fact that your left testicle feels larger and has a hardened band of tissue is consistent with the formation of scar tissue. While some individuals may experience a reduction in scar tissue over time, others may find that it remains or even becomes more pronounced. The variability in healing is influenced by factors such as individual healing responses, the extent of the initial injury, and the presence of any complications during the healing process.

Regarding your concerns about the need for surgery, it is essential to consult with a urologist who specializes in testicular injuries and related complications. If the adhesions are causing significant discomfort or functional impairment, surgical intervention may be warranted. However, surgery is typically considered only when the symptoms are severe or if there is a risk of further complications. In many cases, if the adhesions are not causing severe pain or functional limitations, conservative management may be recommended.

If you feel that the discomfort is affecting your quality of life, you can certainly discuss the option of surgical intervention with your healthcare provider. They can evaluate the severity of your symptoms, the extent of the adhesions, and whether surgery would be beneficial in your specific case. It is important to have an open and honest conversation with your doctor about your symptoms, concerns, and the potential risks and benefits of any surgical procedure.

In summary, the symptoms you are experiencing are likely related to scar tissue and adhesions resulting from your testicular injury. While surgery may not be immediately necessary, it is essential to monitor your symptoms and consult with a specialist to determine the best course of action. If the discomfort persists or worsens, discussing the possibility of surgical intervention to remove the adhesions may be appropriate. Always prioritize your health and well-being by seeking professional medical advice tailored to your specific situation.

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