Post-Surgery Scrotal Edema and Related Complications

Scrotal edema occurred after varicocele surgery?

In high school, I underwent surgery for a right-sided hernia and bilateral varicocele surgery (the varicocele was discovered during an ultrasound examination).
During a follow-up appointment a year later, the ultrasound indicated that there was hydrocele (is this a mistake, or can there really be fluid in the testicle?).
If the condition worsens, I was advised to return.
After a few years, I felt that the left testicle was hanging lower and was larger than the right one.
I had previously visited a small clinic, and the doctor said that it was the epididymis and other structures, and that the testicle itself was not particularly enlarged.
Until last summer, due to work conditions, I was in wet clothes all day, which led to a fungal infection of the scrotum.
After applying medication, I still experienced itching, and at night, I would unconsciously scratch.
One time, I scratched hard enough to wake up in pain, reaching the back of the oval-shaped testicle (which should be the epididymis, right?).
After that, the scrotum gradually enlarged day by day, appearing translucent under light.
In the morning, there were no issues, but by the afternoon, the swelling became very noticeable, and sometimes it would even hurt, along with discomfort in the left abdomen.

1.
Is this a worsening of the original condition? Is it scrotal edema? Or is it something worse?
2.
If surgery is needed, will the previous varicocele surgery make the current surgery more difficult? (Do I have to return to the original hospital for the surgery? The hospital is in another county.)
3.
How many days will I need to be hospitalized for the surgery? Will I need to have fluid drained with a needle beforehand? Thank you.

Xiao Wang, 30~39 year old female. Ask Date: 2015/11/05

Dr. Fu Shizhang reply Urology

1.
Based on the described symptoms, it is likely to be a hydrocele, but a definitive diagnosis still requires a visit to the outpatient clinic.

2.
If it is a hydrocele, the surgery is generally not considered difficult and is less affected by previous surgeries; however, if it is another condition, it may be influenced by prior surgical history.

3.
In the case of a hydrocele, the typical hospital stay is three days; aspiration can also be performed, but the recurrence rate is higher.
For other conditions, the length of hospitalization will depend on the specific disease.

Reply Date: 2015/11/05

More Info

Understanding post-surgery scrotal edema and related complications can be quite complex, especially after undergoing surgeries such as hernia repair and varicocele ligation. Let's break down your concerns and provide clarity on the issues you're facing.

1. Scrotal Edema and Hydrocele: It sounds like you have been diagnosed with a hydrocele, which is a collection of fluid around the testicle. This condition can occur after surgeries, particularly those involving the groin or scrotal area. The fluid accumulation can lead to swelling in the scrotum, which may explain why your left testicle appears larger and hangs lower than the right. It's important to note that while hydroceles are generally benign, they can sometimes indicate underlying issues, especially if associated with pain or discomfort. Given your history of surgery and the subsequent symptoms, it would be prudent to have a thorough evaluation by a urologist to rule out any complications.

2. Infection and Symptoms: The fungal infection you mentioned could exacerbate the swelling and discomfort in the scrotal area. It’s not uncommon for infections to cause inflammation, leading to increased swelling. The itching and discomfort you experienced could be a result of the infection, and if you were scratching the area, it could lead to further irritation or even secondary infections. The fact that you are experiencing pain and discomfort in the left lower abdomen could also be related to the scrotal issues or could indicate another underlying condition that needs to be evaluated.

3. Surgical Considerations: Regarding the surgical options, if a hydrocele or another condition is confirmed, surgery may be necessary to correct it. The previous surgeries you had (hernia repair and varicocele ligation) could complicate future surgeries, but they do not necessarily preclude you from having additional procedures. The complexity of the surgery will depend on the specific findings during evaluation. It is not mandatory to return to the original hospital for surgery; however, it is advisable to choose a facility that has experience with these types of surgeries.

4. Hospital Stay and Procedure: The length of hospital stay for hydrocele surgery can vary, but typically, it is an outpatient procedure, meaning you may go home the same day. In some cases, if there are complications or if the surgery is more extensive, a short hospital stay may be required. The decision to aspirate (drain) the fluid with a needle versus proceeding directly to surgery will depend on the size of the hydrocele, your symptoms, and the urologist's assessment. Aspiration can provide temporary relief, but it may not be a permanent solution, as hydroceles can recur.

In summary, your symptoms warrant a comprehensive evaluation by a urologist who can assess the current state of your scrotal health, determine whether surgery is necessary, and discuss the risks and benefits associated with any potential procedures. It’s essential to address these issues promptly to avoid further complications and to ensure your overall health and well-being.

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