the Risks of Combined Hernia and Varicocele Surgery

Could you please tell me if there are any complications associated with a surgeon performing hernia surgery while simultaneously performing varicocele ligation?

I called the surgical clinic today to inquire about my planned surgery in May, and they informed me that both procedures could be done together (which is good since it can address two potential sources of pain at once).
My question is, will performing a varicocele surgery at the same time significantly extend the duration of the surgery? (Both procedures are on the left side.) Last time, with local anesthesia and sedation, the surgery took 15 minutes, and I was still awake.
I'm concerned that a longer surgery might be too taxing...

For the surgeon, is this type of surgery considered straightforward? I have some psychological doubts about whether I should have a urologist perform it, but after this second hernia repair, I wouldn't dare undergo another surgery unless absolutely necessary...
Will the additional ligation of blood vessels increase pain compared to a simple hernia repair? Since there will be ligatures on the blood vessels, will I still be able to feel the knots as they heal? (That's a bit scary :o) Currently, I experience pain while walking due to increased abdominal pressure; is this related to the severity of my condition? Is it okay to wait until May for the surgery? If I experience an incarcerated hernia, will the pain be very noticeable? (I'm extremely worried about not realizing it until it becomes necrotic and requires removal, only to collapse at the last moment ==) (I can't see any external signs.) I don't understand why news cases of hernias often show a bulge the size of a ping pong ball, while my appearance seems normal.
orzz I hope the doctor can help clarify my doubts.
Thank you.

Da Kai, 10~19 year old female. Ask Date: 2015/03/05

Dr. Ke Fangxu reply Surgery

1.
There should not be significant differences in time and pain perception.

2.
The palpable cord is due to the hernia surgery and is not related to the varicocele surgery.

3.
Walking generally should not be affected; if there is no vigorous exercise during this period, it should be fine.

4.
Incarcerated hernias can be very painful, and the hernia sac cannot be reduced.
If left untreated for a long time, there is a risk of bowel necrosis, but it is unlikely to lead to bowel necrosis without notice.

Reply Date: 2015/03/05

More Info

When considering the simultaneous surgery for both a hernia and a varicocele, there are several factors to take into account regarding the risks, benefits, and overall surgical experience.
First, it is important to understand what each condition entails. A hernia occurs when an organ or tissue protrudes through a weak spot in the abdominal muscles, often leading to discomfort or pain, especially during activities that increase abdominal pressure, such as lifting or straining. A varicocele, on the other hand, is an enlargement of the veins within the scrotum, which can cause pain, swelling, and potentially affect fertility.

Combining these surgeries can indeed be beneficial, as it allows for addressing two potential sources of discomfort in one surgical session, thereby minimizing recovery time and the need for multiple anesthetic exposures. However, there are considerations regarding the duration of the surgery. Typically, performing both procedures may extend the overall surgical time compared to performing just one. The surgeon will need to assess the complexity of each case, but generally, both surgeries are considered relatively straightforward for experienced surgeons.
Regarding anesthesia, if you previously had a local anesthetic with sedation for your hernia repair, it is likely that a similar approach will be taken for the combined procedure. However, the longer duration of the surgery may require adjustments in the anesthesia plan. It is crucial to communicate your concerns about the length of the procedure and your comfort level with the anesthetic to your surgical team.

As for the concern about increased pain due to additional ligation of blood vessels during varicocele surgery, it is possible to experience some additional discomfort postoperatively. However, most patients report that the pain is manageable and resolves with time. The surgeon will take care to minimize trauma to surrounding tissues, which can help reduce postoperative pain.

You also mentioned anxiety about the possibility of developing an incarcerated hernia, which can be a serious condition. Symptoms of an incarcerated hernia include sudden pain, swelling, and the inability to push the hernia back in. If you experience these symptoms, it is essential to seek immediate medical attention. The absence of visible swelling does not rule out the presence of a hernia, as some hernias can be "occult" and not easily seen.

In terms of timing for your surgery, if your symptoms are manageable and you are not experiencing severe pain or complications, it may be reasonable to wait until May for your procedure. However, if your pain worsens or if you notice any changes in your condition, it would be wise to consult your healthcare provider sooner.

In conclusion, while combining hernia and varicocele surgeries can be advantageous, it is essential to discuss all your concerns with your surgeon. They can provide personalized advice based on your specific medical history and the details of your conditions. Open communication will help ensure that you feel comfortable and informed about your surgical options and what to expect during the recovery process.

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