left Hernia, pain in left testicle

[Hawk336]

Dear Doctor:

I'm a 28 year old male. I was operated on for an inguinal hernia repair, left side, in 1994. Shortly after my surgery, I developed an infection in the wound. There was a big pimple like thing that had to be cut with a scissor and then pus had to be squeezed out of the wound.

Over the years my complains didn't go away. In year 2004 another surgeon determined that I had to go in for a second round surgery in the same spot. This time around a mesh was inserted.

After so many years, the following are my complains:

1. From time to time, I still feel pain in my left side. It is more discomforting than anything else. At times, it seems like there is a pattern to it such as days I stand for long durations; have high levels of stress; eat way too much etc. Other days, it seems like there's no pattern to the pain at all. Sometimes weeks go by and there is no sign of anything.

2. It seems that there is a strange link between my left testicle with the area, and around the area, of my hernia repair incision. This link starts from the back side of my testicle. From the research I've done, it seems that the Vas deferens or spermatic cord (or some other nerves) have a discomforting link with the area around the hernia repair wound. This is discomforting. It is intensified sometimes during ejaculation and this has become more prominent over the years, relative to the earlier post surgery years. Sometimes, when I wear loose clothing and sit myself down on a chair, the left testicle comes in contact with the seating surface first and the uncomfortable sensation/link is felt. Other days, like today, when I've had to sit in class for over 6 hours, I feel it bugging me more than usual. There is pain.

As for the Hernia pains, a local Urologist and my GP have both tested for a bulge with the cough method and they don't feel any abnormalities. Not sure what to do about the testicle. Don't want to get cut open again. Scared.

[Stephen Liroff, MD]

Discomfort at the site of hernia surgery can go on for years and, as you describe, be intermittent and without a pattern. Sometimes just the change in the weather can bring with it some discomfort. The nerves to your testicle passes through the area of the hernia repair and can be involved in the scarring that follows this surgery. I cannot explain the increasing discomfort that you have been experiencing with ejaculation, however. You might try getting the area of the repair injected with a long acting local anesthetic (Marcaine, 0.25-0.50 %) to see if this provides any relief. Also, a course (few weeks) of an anti-inflammatory drug such as ibuprofen or one of the other anti-inflammatory medications (naproxen, clinoril, to name a few).may help. Tight underwear, if you are not already wearing them, would also be worth a try.
Exploratory surgery is usually NOT the way to go.
Good luck!
S.A.Liroff, M.D.