Post-Splenectomy Health Issues: Seeking the Right Specialist for Your Symptoms

Splenectomy performed?

Dear Doctor...
I had my spleen removed 14 years ago, and I am now 34 years old.
I feel fatigued every day, and my lower back is sore and weak.
I've heard that without a spleen, my hematopoietic function may be impaired, which could lead to poor blood circulation and difficulty in eliminating old red blood cells.
Additionally, I have not been able to achieve spontaneous erections since I turned 30; if I stimulate myself manually, it only stays erect for about 4 seconds before becoming flaccid.
I have consulted with hematology and endocrinology specialists at other hospitals, but they said I was in the wrong department and were unsure which specialty I should see.
If I want to seek medical attention, which specialty should I consult? Please help me; I really don't know what to do.

Bai Ying, 30~39 year old female. Ask Date: 2015/12/06

Dr. Wu Jiyu reply Internal Medicine

After reviewing your question, I recommend seeking assistance from a urologist.
Thank you for your inquiry.
The Nephrology Department of Changhua Hospital cares about you.

Reply Date: 2015/12/06

More Info

After a splenectomy, patients can experience a variety of health issues due to the spleen's role in filtering blood and supporting the immune system. The spleen is crucial for the removal of old or damaged red blood cells and for producing certain types of white blood cells that help fight infection. Without it, individuals may face increased risks of infections, fatigue, and other hematological issues.

Given your symptoms of persistent fatigue, lower back pain, and erectile dysfunction, it’s essential to approach your health concerns holistically. Here are some potential areas to explore and specialists to consider:
1. Hematologist: Since you mentioned concerns about blood circulation and the removal of old red blood cells, a hematologist would be a good specialist to consult. They can evaluate your blood counts, assess for any signs of anemia, and determine if there are any underlying blood disorders that may be contributing to your symptoms.

2. Endocrinologist: You have already consulted with an endocrinologist regarding your metabolic health. If you have not yet had a thorough evaluation of your hormone levels, particularly testosterone, it would be wise to revisit this specialist. Low testosterone can lead to fatigue and erectile dysfunction, and an endocrinologist can help manage these hormonal issues.

3. Urologist: For your erectile dysfunction, a urologist is the appropriate specialist. They can conduct a thorough evaluation to determine the cause of your erectile issues, which could be related to hormonal imbalances, psychological factors, or vascular health.

4. Primary Care Physician (PCP): If you feel lost in navigating specialists, your primary care physician can be an excellent starting point. They can help coordinate your care, refer you to the appropriate specialists, and ensure that all aspects of your health are being considered.

5. Psychologist or Psychiatrist: Given the emotional toll that chronic health issues can take, it may also be beneficial to speak with a mental health professional. They can help address any anxiety or depression that may arise from your physical health challenges.

In terms of your concerns about blood circulation and the potential impact of not having a spleen, it’s important to note that while the spleen plays a role in blood health, other organs and systems also contribute to overall circulation and blood health. Regular check-ups and blood tests can help monitor your condition and ensure that any potential issues are addressed promptly.

Additionally, lifestyle modifications can also play a significant role in managing your symptoms. Regular exercise, a balanced diet rich in iron and vitamins, and adequate hydration can help improve your overall energy levels and well-being. It’s also crucial to manage stress, as it can exacerbate fatigue and other symptoms.

In summary, I recommend starting with a hematologist to address your blood health concerns, followed by consultations with an endocrinologist and urologist for your hormonal and erectile issues. A primary care physician can help guide you through this process. Remember, it’s essential to advocate for your health and seek the appropriate specialists to address your multifaceted concerns.

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