I am 25 years old,i had varicocelectomy 6 years ago (both sides),
after 7 days from operation i noticed that my left testicle is much more bigger that the other one,
the doctor told me that i developed hydrocele,so from that time untile now (after six years),it is
really bigger than that time(and it is communicating hydrocele).i have seen many doctors here and
most of them told me that i have to undergo the hydrocelectomy operation,but recently after color
doppler sonography i found that there is a little hernia in right side of my abdominal area and
varicocele in both sides of testis.
1.Since i have to undergo the hydrocelectomy surgery,Is it possible to Fix the Varicocele again?
and the little hernia beside that operation?
2.Is there a chance to get the hydrocele in right side after surgery?
3.Are these all curealbe after surgery?
I am really anxious and depressed,please tell me what to do.
Thank you very much in advance.
Here are my blood and sperm analyses:
The results reported by "Technicon RA 1000 " Autoanalyzer System
In my blood test i had 2 H noted:
FSB 102 H (70-100) mg/dl
U.A 9.0 H (3.0-7.0) mg/dl
Voulme:-------- 8.0 ml
Sperm count/ml- 20 mill/ml
%Prog Motility- 25 %
%Normal Morphlogy 18 %
Motile Sperm count/ml (MSC) 5.0 Million/ml
Functional Spermcount/ml(FSC) 1.9 Million/ml
Sperm Motility index(SMI) 62 Million/ml
All Sperm Count/vol----- 160
All Motile Sperm/vol---- 40
All functional Sperm/vol 15.20
"The ultimate goals of varicocele repair should include occlusion of the offending varicosity with high success, preservation of arterial flow to the testis, and the minimization of patient discomfort and morbidity. Viable options for repair include radiographic obliteration and surgical repair of various approaches. The efficacy of the myriad techniques is nearly equivalent. Therefore, special attention must be paid to the morbidity of the individual procedure and the expertise of the operating surgeon"
The correction of the hernia at the same time as a varicocelectomy can be decided upon on the basis of the type of hernia that is present.
Since your sperm count is borderline, it would be better to discuss alternatives to surgery for correction of the varicocele.
This includes radiographic embolization.
"A hydrocelectomy is typically performed on an outpatient basis with no special precautions required. The extent of the surgery depends on whether other problems are present. If the hydrocele is uncomplicated, the doctor makes an incision directly into the scrotum. After the canal between the abdominal cavity and the scrotum is repaired, the hydrocele sac is removed, fluid is removed from the scrotum, and the incision is closed with sutures. If there are complications, such as the presence of an inguinal hernia, an incision is made in the groin area. This approach allows the doctor to repair the hernia or other complicating factors at the same time as correcting the hydrocele. Some surgeons use a minimally invasive laparoscopic approach to repair a hydrocele. The operation is performed through a tiny incision using a lighted, camera-tipped, tube-like instrument (laparoscope) that allows the passage of instruments for the repair while displaying images of the procedure on a monitor in the operating room"
Do keep us posted on your doubts and progress.
Thank you so much for your complete answer.
Dear Dr Mathews, i just want to mention that the hydrocele is in my left side testicle but the Hernia is on the right side of my lower abdominal area,so it's not related to left testicle,is there a chance to get the hydrocele on right side(after the surgery) if they try to fix the hernia???
The hernia might have been operated on if it was on the same side as the hydrocele as the repair could have been carried out in the same approach, at the discretion of the operating surgeon.
A hydrocele would be a rare complication of a inguinal hernia repair. The commonest complications of the inguinal hernia repair include urinary retention, scrotal hematoma, ilioinguinal nerve damage, ischemic orchitis and recurrent hernia.
Additional complications may be associated with individual body conditions or comorbidities.
You will have to schedule corrective surgical treatment depending on whatever condition requires priority attention. This can be decided upon once you finish discussing your options with your surgeon.
Unfortunately there is no laparoscopic method used in this case in my country,
if i tell you that i have seen over 11 doctors you can not believe!!! all of them told me that we just can perform open surgery...no new technology here.i just feel sorry for myself and my country
The good news is that chances of recurrence of an inguinal hernia after open herniorrhaphy is 4% as compared to the recurrence rate of 10% in laparoscopic herniorrhaphy.
These results are based on a study conducted in the US and the duration of the study was 2 years.
Chances of recurrence are similar for the hydrocele correction by laparoscopy and open surgery.
Guess this would factor as the silver lining, right?
Ideally, plan your surgeries at least 6 months apart so that there would not be any significant disruption in your life, and the healing process will also be better.
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