Testicular Surgery: Recovery, Size Changes, and Fertility Concerns

Q: Testicular Surgery: Recovery, Size Changes, and Fertility Concerns

Jia-Jia： Hello, I really admire you for performing so many surgeries in such a short time. <br>It truly takes courage. <br>Generally, my patients are rarely willing to undergo complete surgeries at once; they prefer to minimize the extent of the procedure whenever possible, but u

Left testicular fixation surgery combined with bilateral varicocelectomy?

Doctor, I would like to ask about my condition.
Two months ago, I underwent left testicular fixation surgery along with bilateral varicocele surgery, with incisions made near the scrotum.
A few days after the surgery, I developed left epididymitis.
Currently, my right testis measures 3 cm and my left testis measures 2.5 cm.
Do I still have the ability to produce sperm? At that time, the doctor mentioned that I received over 20 stitches for the left testicular fixation and varicocele surgery.
Is it possible that the left testis has shrunk due to an artery being cut during the surgery? Doctor, does this mean my surgery was a failure? I feel very upset about having one testis larger than the other.

Jia Jia, 20~29 year old female. Ask Date: 2005/11/05

Dr. Xu Weikai reply Urology

Jia-Jia: Hello, I really admire you for performing so many surgeries in such a short time.
It truly takes courage.
Generally, my patients are rarely willing to undergo complete surgeries at once; they prefer to minimize the extent of the procedure whenever possible, but ultimately, it is the patients who suffer the consequences.
I believe your approach is the appropriate choice.
When there is a medical issue, it must be corrected.
Getting back to the main point, I think your condition may be relatively serious.
It is possible that mild testicular atrophy has already occurred prior to the surgery.
However, the key focus post-surgery will be the extent of recovery.
Typically, it is recommended to check the semen quality three months after the surgery (some advocate for six months), to see if there are any abnormalities in the semen.
If necessary, hormone levels and other tests should also be included.
The likelihood of affecting the arteries during the surgery is actually quite low, and the arterial system of the testicles can be supplemented by the arterial system of the epididymis.
Unless both sets of arteries are simultaneously injured, the chance of atrophy is minimal.
This is a message from the Department of Urology, Taitung Hospital, Ministry of Health and Welfare, expressing our concern for you.
Director Xu Wei-Kai.

Reply Date: 2005/11/05

More Info

After undergoing left testicular fixation and bilateral varicocele surgery two months ago, it’s understandable to have concerns about recovery, size changes, and fertility. Let’s break down your questions and provide some clarity on these issues.

Firstly, it’s important to note that post-surgical complications, such as epididymitis (inflammation of the epididymis), can occur after testicular surgeries. This is not uncommon and can happen due to various reasons, including infection or irritation from the surgical procedure itself. The fact that you experienced this complication does not necessarily indicate a failure of the surgery, but it does require monitoring and possibly treatment to ensure it resolves properly.

Regarding the size of your testicles, it’s not unusual for there to be some asymmetry following surgery. The left testicle measuring 2.5 cm and the right one at 3 cm suggests a slight difference, which can be a result of the surgical intervention. Testicular size can be influenced by several factors, including blood flow, inflammation, and the surgical technique used. If the left testicle appears smaller, it could be due to temporary swelling or changes in blood supply post-surgery. In some cases, if the surgery inadvertently affected the blood supply to the testicle, it could lead to atrophy (shrinkage), but this is not always the case.

As for your fertility concerns, the ability to produce sperm is primarily determined by the health and functionality of the testicles. Even if there is a size difference, it does not automatically mean that sperm production has been compromised. The testicles can still function normally even if one is smaller than the other. It is advisable to have a semen analysis performed to assess sperm count, motility, and morphology, which will provide a clearer picture of your fertility status.

If you are worried that the surgery may have been unsuccessful, it’s crucial to follow up with your urologist. They can perform a physical examination and possibly imaging studies to evaluate the blood flow to the testicles and ensure that there are no complications affecting their function. Additionally, they can address any concerns you have about the surgical technique and whether any unintended damage occurred during the procedure.

In summary, while it’s natural to feel anxious about changes in testicular size and potential impacts on fertility after surgery, many factors can influence these outcomes. Monitoring your recovery, addressing any complications promptly, and consulting with your healthcare provider for a semen analysis will help you understand your fertility status better. Remember, open communication with your doctor is key to addressing your concerns and ensuring the best possible outcome for your health and fertility.

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