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Urology (Expert Forum)
SEVERE swelling on scrotum after varicocelectomy. Normal? Help!
Answered by
Kevin Pho, MD - Internal Medicine
Kevin Pho, MD
Boston - MA
Questions in the Urology forum are answered by Dr. Stephen Liroff, affiliated with the Henry Ford Hospital. Topics covered include benign prostate disease, penis curvature, cystisis, kidney stones, pediatric urology, prostate, sexual dysfunction, urinary tract infections (UTI), and urological cancers.
SEVERE swelling on scrotum after varicocelectomy. Normal? Help!
by Jon in Mass, Apr 18, 2003 12:00AM
I had a varicocelectomy 8 days ago, after a failed attempt back in January. I was told that my case was very severe as the veins dropping into my scrotum were enormous, and would cause severe enlargement of my scrotum.
The first attempt did not work; there was almost an immediate recurrence. This time around, the Dr needed to be more "aggressive". From what I am told, the testicle was pushed up to where the incision was and the veins were removed, and then the testicle was returned to the scrotum. The same incision as last time was used.
The swelling and pain last time around was very mild. This time, the swelling is near shocking, and still is as of writing this. The scrotum is absolutely enormous, and the shaft of my penis is also very swollen. It seemed to get worse yesterday (after 7 days). It is very uncomfortable and heavy, and also very hard, the skin on the scrotum is stretched across tightly because it is so enlarged inside. It has crossed over t othe right side and is covering my right testicle. I called my Doctor and he said not to worry, but he isalways very quick with me and doesn’t explain anything. I am concerned that after 8 days there is no obvious progress? Is this normal? How long will it take to see a reduction in the swelling? Can I walk around or should I be bed ridden? Lastly, I am scared to have a bowel movement because I am concerned the pushing will cause more harm to what the surgery did. Is this ok?
The first attempt did not work; there was almost an immediate recurrence. This time around, the Dr needed to be more "aggressive". From what I am told, the testicle was pushed up to where the incision was and the veins were removed, and then the testicle was returned to the scrotum. The same incision as last time was used.
The swelling and pain last time around was very mild. This time, the swelling is near shocking, and still is as of writing this. The scrotum is absolutely enormous, and the shaft of my penis is also very swollen. It seemed to get worse yesterday (after 7 days). It is very uncomfortable and heavy, and also very hard, the skin on the scrotum is stretched across tightly because it is so enlarged inside. It has crossed over t othe right side and is covering my right testicle. I called my Doctor and he said not to worry, but he isalways very quick with me and doesn’t explain anything. I am concerned that after 8 days there is no obvious progress? Is this normal? How long will it take to see a reduction in the swelling? Can I walk around or should I be bed ridden? Lastly, I am scared to have a bowel movement because I am concerned the pushing will cause more harm to what the surgery did. Is this ok?
Doctor's Answer
by Kevin Pho, MD, Apr 19, 2003 12:00AM
, Apr 19, 2003 12:00AM
Hello - thanks for asking your question.
The most common complications from varicocelectomy are hydrocele, varicocele recurrence, and testicular artery injury. The rate of each of these complications depends on what technique the surgeon used in the procedure.
The incidence of hydrocele is 2-5% and the overall recurrence rate for varicoceles has been reported as high as 10%.
From your description, it sounds like you are developing a hydrocele. In adults, hydrocele is managed by draining the fluid under local anaesthetic using a syringe (tapping). This gives an instant cure, but is usually temporary as the fluid re-fills again. For this reason a sclerosing agent is sometimes introduced following the tapping procedure, which causes the hydrocele to stick to itself and prevents re-filling. Alternatively, the hydrocele can be removed surgically with a small operation.
You may want to discuss these options with your urologist.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Thanks,
Kevin, M.D.
The most common complications from varicocelectomy are hydrocele, varicocele recurrence, and testicular artery injury. The rate of each of these complications depends on what technique the surgeon used in the procedure.
The incidence of hydrocele is 2-5% and the overall recurrence rate for varicoceles has been reported as high as 10%.
From your description, it sounds like you are developing a hydrocele. In adults, hydrocele is managed by draining the fluid under local anaesthetic using a syringe (tapping). This gives an instant cure, but is usually temporary as the fluid re-fills again. For this reason a sclerosing agent is sometimes introduced following the tapping procedure, which causes the hydrocele to stick to itself and prevents re-filling. Alternatively, the hydrocele can be removed surgically with a small operation.
You may want to discuss these options with your urologist.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Thanks,
Kevin, M.D.
