Please Help: Chronic Issue

[cherokee4558]

I had a hydrocele removed in February of 2010 on my right testicle. The hydrocele was very large. Before I had it surgically removed, the urologist drained it (11 ounces came out of it). The hydrocele reformed less than a week after the drainage so the urologist determined that a surgical removal of the hydrocele was necessary. I had an operation to remove the hydrocele and it went well with no complications.

As a result of the Hydrocele Removal operation, a speramotcele (epidydimitis) formed on top of the same testicle about 2 months after the surgery. It was a cyst on top of one of the testicular tubes, It was benign, and I sought out multiple opinions on the spermatocele that formed from the surgery. All 3 urologists I saw told me that I had to wait at least a year or so to get a surgery on the spermatocele (due to potential damage to the area with scar tissue forming). I ended up waiting a few years, until it became so large that it was a nuisance. It wasn't painful, but just annoying, and I didn't feel any sexual pleasure from my right testicle, I couldn't sleep in certain positions, so I decided to seek out a procedure of some type.

I got several opinions on the spermatocele. 1 nurse told me to just live with it and deal with it, and 2 urologists that I saw said that it warranted an operation due to the size of it (being larger than the actual testicle). They said they typically don't advise for spermatocelectomys because of potential damage to the sperm ducts, but that the size of it and problems it presented were enough to get it taken care of. They couldn't drain it because it was a solid mass/cyst. They clearly articulated the potential risks, and that it likely wouldn't be a chronic issue after removal so I decided that it was worth getting it removed.

I had a spermatocelectomy performed on May 2nd 2013 (Today is September 11th 2013) so it was over 4 months ago. The procedure went well according to the urologist that performed the operation, and my follow up appointment with him went well. The right testicular area did not heal nearly as quickly as the outlined timeframe indicated. He said it should be fully healed within 2-3 weeks, it took about 2 months for the skin/wound to seal up. He said that it was good and that there were "no restrictions" after 6 weeks. There certainly were, and have been restrictions however.....

As a result of the spermatocelectomy, the testicle itself is healthy, and the area itself is smaller than it was prior to the surgery, which I suppose are positive things...... However a bunch of fluid has accumulated around the right testicle. The region is very sensitive, not necessarily painful, but I can't walk comfortably or engage in sexual activity without the use of a scrotal support. I had an ultrasound and a CT scan performed on the region about a month ago (beginning of August 2013). Both revealed that the fluid wasn't puss, and it was hard to tell if another spermatocele had formed (which I was told was highly unlikely after the spermatocele removal: about a 10% chance). It was then drained because of the fluid accumulation (they didn't get as much fluid from the drainage as they expected) and analyzed the fluid they did get, and it's what's referred to as "Simple Fluid". I'm currently on a regimen of antibiotics (ciprofloxacin 500mg 2x a day) and anti-inflammatories (Naproxen 500mb 2x a day). The fluid they analyzed had a little bacteria in it, but they couldn't tell if it was topical bacteria (from the skin) or from the fluid within the testicle itself.

I've been on the above oral medical regimen for 4 weeks, and the doctor said it hasn't really gotten any better. I'm supposed to stay on it for 6 weeks in total, then they are going to do another ultrasound on the region to see what to do....

I have 3 follow up appointments, one with the urologist that performed the surgery, my old urologist, and a new urologist (3 in total)  for the week of the 23rd-27th.

I was wondering if there are any herbal remedies, homeopathic, or "do it yourself" techniques that might help me. I've been considering getting a lymphatic drainage supplement to get the fluid out, or possibly sleeping at a very steep angle. I've just been icing the region on and off for 30 minutes at a time, about 5 times a day.

Please let me know if there are any suggestions on this matter. They would be much appreciated!

[cherokee4558]

Thank you, i've recieved 2 out of 5 opinions on the matter now locally, and it looks like another hydrocele has formed. It appears as if the hydrocele in 2010 wasn't completely removed, and after my spermatocelectomy, the hydrocele re manifested. It appears as if i'll need  another surger. I'm getting 3 more opinions on it, and will likely get the hydrocele removed at Johns Hopkins, as this must be the final surgery in the area. I can't risk having 4 procedures in the same area, so this will likely be my 3rd and final one. I'm going to take time off work and fully devote my time to make sure after my hydrocele surgery that it's properly taken care of and heals completely. I thank you for your response, and have realized that there is no solution other than another procedure unfortunately. I will post again and let you know how the final procedure goes, hopefully within the next month or so.

Is it safe to have a hydrocele removed after a spermatocelectomy only 4 months after the spermatoceletomy????

The 2 doctors i've seen have said it should be fine, i was wondering what your opinion on the matter might be, or if you can have one at all without diagnosing the area physically. Thanks and have a good day.

[Bhupinder Kaur, MD]

Hello,
Unfortunately there is no ayurvedic measure or any do it yourself measure which will help in draining the fluid. It has to be done surgically and you need to get a repeat ultrasound done after the course of antibiotics to check whether the fluid has dried up or the inflammation has subsided.

It is very difficult to precisely confirm a diagnosis without examination and investigations and the answer is based on the medical information provided. For exact diagnosis, you are requested to consult your doctor. I sincerely hope that helps. Take care and please do keep me posted on how you are doing.