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Dr. Andrew Rynne

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What should be done for recurrent inguinal hernia in critical stage?

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Dr. G.Srinivasan

Urologist

Practicing since :1991

Answered : 1414 Questions

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Posted on Mon, 17 Dec 2012 in Men's Health
Question: Hi....I'm looking into having an inguinal hernia (bi-lat) repaired. I'm 54 & would also like to have testicles removed as non-causal/preventive...same procedure? Is it possible to have scrotal sack reduced also? Mine has increased in size along with the stress of hernia protrusion for a few years now. None of it causes me any day to day discomfort...I am able to perform ant & all tasks anyone else half my age could, its just beginning to be difficult to "deal" with every day.....not to mention self-image complications. Thanks
doctor
Answered by Dr. G.Srinivasan 36 minutes later
Hi
Welcome to XXXXXXX and thanks for your query.

I understand your concern on recurrence of the hernia after the repair, though it takes many years.
It is WISE to preserve at least one testes to have the benefits of testosterone (the male hormone), which is quite useful in preserving the male skeletal framework and bone strength (there-by avoiding fractures after a trivial fall), libido and maintenance of hemoglobin to mention a few.
Though the scrotum has expanded, it has done so, to accommodate the hernia. It is a very expandable and elastic part of the body and normally shrinks after the procedure in about three months.
So it is not worthwhile to do the scrotoplasty at the time of hernia repair. The same may be done later, if the size does not get reduced after waiting for the time.
Hope this helps; kindly do not hesitate to write back for further doubts, if any.
Wishing you good health,

Regards
DR GS

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. G.Srinivasan 2 hours later
what if....I feel very strongly about doing away with both...I do not want the possibility of testicular cancer to even enter into the picture as I age......I could never go thru what it can possibly "bring to the table with it". What would the long term effects of it be?....what would be necessary to maintain a somewhat normal lifestyle? I must say, at the onset for your consideration in answering, I am pretty much sexually ambivalent (i think thats the word for none/zip/nada) so I pretty much "entertain myself" as necessary ( that may have been too much information, sorry, but true to the point of discussion). The loss of testosterone production would really be the least of my worries, as I'm not sure my libido even suggests an overabundance of it anyway. I've always been somewhat of a "softer male" if you will, it's been recognized and verbally pointed out to me alot. Thank you, in advance, for your thoughtful consideration of my situation.
doctor
Answered by Dr. G.Srinivasan 1 hour later
Hi,
Welcome back. Thanks for your understanding.

It is reasonable and valid to discuss on testicular cancer at this point. Having said that, testicular cancer is a disease of young adults, the peak age being between 20 to 30 years and you have already passed it. So the concern about it can be negated, even though rare cancers do happen in old age but the incidence is too low to be considered as a serious issue.

Testosterone is so important for bones, especially, in an advanced country like yours, where life expectancy is high. Muscle mass and bone health are extremely important as you age. Sexual health is an additional benefit!

So, I have tried my best to share my knowledge on retaining at least one testis.
It appears to me that you are convinced that scrotoplasty is not needed now.

Kindly discuss these issues with your surgeon to come to a point of decision.

Wishing you good health,
Regards
DR GS



Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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