
Hello. Greetings From XXXXXXX XXXXXXX I Am 78 Years Of

Greetings from XXXXXXX XXXXXXX
I am 78 years of age, 175 cms tall, and weigh 83kgs.
I have Type 2 diabetes and elevated triglyceride levels which are under control with mediation. I have regular medical checkup with qualified doctors. I am a vegetarian and am a teetotaler. I lead a healthy and active life with regular walking and free hand excercises in a moderate way.
IN 2011, while in XXXXXXX with my son, I by chance noticed the enlarged scrotal sac and went for a check. I was informed that it was a hernia case (left inguinalsac) and was advised corrective operation. I underwent hernia operation in XXXXXXX at XXXXXXX hospital and the operation was performed by a renowned XXXXXXX awardee doctor and his able assistance. The operation was successful.
Operation findings: Bilateral inguinal hernia
Right Side: indirect inguinal sac+ cord lipoma
Left side: Indirect inguinal sac
Bilateral Prolene 15x13cm mesh placed
Fixed with tacks.
I have noticed that although 8 years have gone by, my left sac continues to be large. I am very worried. I do not have any pain or discomfort right from the day of the operation. After the operation,I was informed that the sac will come back to normal size within 6 months. But even after all these years, it remains big, What could be the reason. What treatment I should take to bring it back to normal size.
Thank you in advance for your time and advice.
Regards
Seshadri.

Greetings from XXXXXXX XXXXXXX
I am 78 years of age, 175 cms tall, and weigh 83kgs.
I have Type 2 diabetes and elevated triglyceride levels which are under control with mediation. I have regular medical checkup with qualified doctors. I am a vegetarian and am a teetotaler. I lead a healthy and active life with regular walking and free hand excercises in a moderate way.
IN 2011, while in XXXXXXX with my son, I by chance noticed the enlarged scrotal sac and went for a check. I was informed that it was a hernia case (left inguinalsac) and was advised corrective operation. I underwent hernia operation in XXXXXXX at XXXXXXX hospital and the operation was performed by a renowned XXXXXXX awardee doctor and his able assistance. The operation was successful.
Operation findings: Bilateral inguinal hernia
Right Side: indirect inguinal sac+ cord lipoma
Left side: Indirect inguinal sac
Bilateral Prolene 15x13cm mesh placed
Fixed with tacks.
I have noticed that although 8 years have gone by, my left sac continues to be large. I am very worried. I do not have any pain or discomfort right from the day of the operation. After the operation,I was informed that the sac will come back to normal size within 6 months. But even after all these years, it remains big, What could be the reason. What treatment I should take to bring it back to normal size.
Thank you in advance for your time and advice.
Regards
Seshadri.
Please give additional information
Detailed Answer:
Hi.
Thanks for your query.
Noted the history and understood the concerns.
Please give additional information for me to assist you better:
Was the sac of left scrotal area present even after surgery?
Or increase in size to remain stable over these years?
I hope the size of the sac remains same throughout.
Any Ultrasonography or consultation with any Surgeon?
Awaiting for your feedback.
With Regards.
Dr T Chandrakant.

Please give additional information
Detailed Answer:
Hi.
Thanks for your query.
Noted the history and understood the concerns.
Please give additional information for me to assist you better:
Was the sac of left scrotal area present even after surgery?
Or increase in size to remain stable over these years?
I hope the size of the sac remains same throughout.
Any Ultrasonography or consultation with any Surgeon?
Awaiting for your feedback.
With Regards.
Dr T Chandrakant.


Thanks you for your response. I am furnishing the additional information as noted below.
Q. Was the sac of left scrotal area present even after surgery?
A:Yes. After 6/8 months (after the surgery) I emailed the doctor about my condition and informed him about the sac. I was informed that it would gradually shrink . But that does not seem to have happened.. It remainslarger than normal.
Q: Or increase in size to remain stable over these years?
A:I think more or less. Sometimes it appears a little hard and shrunk and some times it appears loose and big.
Q: I hope the size of the sac remains same throughout.
A:More or less. It has remained big. But varies through out the day like it was in my normal younger days.
Q: Any Ultrasonography or consultation with any Surgeon?
A: No. I have’t had any consultation with any surgeon nor had any Ultrasonography done till now regarding this matter. Because I did’t feel any pain or faced any problem I kept quiet.
Regards
Seshadri

Thanks you for your response. I am furnishing the additional information as noted below.
Q. Was the sac of left scrotal area present even after surgery?
A:Yes. After 6/8 months (after the surgery) I emailed the doctor about my condition and informed him about the sac. I was informed that it would gradually shrink . But that does not seem to have happened.. It remainslarger than normal.
Q: Or increase in size to remain stable over these years?
A:I think more or less. Sometimes it appears a little hard and shrunk and some times it appears loose and big.
Q: I hope the size of the sac remains same throughout.
A:More or less. It has remained big. But varies through out the day like it was in my normal younger days.
Q: Any Ultrasonography or consultation with any Surgeon?
A: No. I have’t had any consultation with any surgeon nor had any Ultrasonography done till now regarding this matter. Because I did’t feel any pain or faced any problem I kept quiet.
Regards
Seshadri
As discussed in details below.
Detailed Answer:
Thanks for your feedback.
The possibilities I can think are as follows:
The sac of hernia if very long is left in the scrotal area as it is to avoid too much dissection and by virtue of its openness the fluid is not collected. But if at all the opening gets closed it can appear as a hydrocele - as a swelling.
Recurrence of hernia: but in this case it will show varied sizes at different times , say like reduced in the morning before getting up from bed and increasing in size on moving around.
Hydrocele as primary swelling:
All this can be easily diagnosed by the following ways:
Clinical examination by a General Surgeon: If one can go above swelling and feel it to be a separate one not extending to groin and above this may probably be hydrocele or encysted sac as explained above.
Hernia is diagnosed by it nature to increase on coughing/straining and reduction (reducibility)
Can further be confirmed by Ultrasonography.
Once diagnosed then this can be treated as per the cause found.
I hope this answers your query and helps in decision making.
With Regards.
Dr T Chandrakant.
General Surgeon.

As discussed in details below.
Detailed Answer:
Thanks for your feedback.
The possibilities I can think are as follows:
The sac of hernia if very long is left in the scrotal area as it is to avoid too much dissection and by virtue of its openness the fluid is not collected. But if at all the opening gets closed it can appear as a hydrocele - as a swelling.
Recurrence of hernia: but in this case it will show varied sizes at different times , say like reduced in the morning before getting up from bed and increasing in size on moving around.
Hydrocele as primary swelling:
All this can be easily diagnosed by the following ways:
Clinical examination by a General Surgeon: If one can go above swelling and feel it to be a separate one not extending to groin and above this may probably be hydrocele or encysted sac as explained above.
Hernia is diagnosed by it nature to increase on coughing/straining and reduction (reducibility)
Can further be confirmed by Ultrasonography.
Once diagnosed then this can be treated as per the cause found.
I hope this answers your query and helps in decision making.
With Regards.
Dr T Chandrakant.
General Surgeon.


Thanks very much for your prompt response.
Do you think this might be a case of recurrence of hernia?
Is it possible that the mesh has given away and tacks broken? If so , is this a serious problem involving a repeat operation?
Is the so called hydrocele or encysted sac is a common occurrence among patients undergone such operations? What kind of treatment this may require?
I am a bit confused. Sorry for asking.
regards
Seshadri

Thanks very much for your prompt response.
Do you think this might be a case of recurrence of hernia?
Is it possible that the mesh has given away and tacks broken? If so , is this a serious problem involving a repeat operation?
Is the so called hydrocele or encysted sac is a common occurrence among patients undergone such operations? What kind of treatment this may require?
I am a bit confused. Sorry for asking.
regards
Seshadri
As detailed below.
Detailed Answer:
Thanks for your appreciation.
My most probable diagnosis is the hydrocele like cyst as explained above.
Recurrence of hernia still has the classical presentation: watch for if the sac increases on coughing or straining and is fully reducible on pressure. If these two things are not present then this may not be recurrence.
So let us get the exact diagnosis by getting examination by a General Surgeon and Ultrasonography.
Please get these done and give me the feedback so that further discussion will be directive.
With Regards.
Dr T Chandrakant.

As detailed below.
Detailed Answer:
Thanks for your appreciation.
My most probable diagnosis is the hydrocele like cyst as explained above.
Recurrence of hernia still has the classical presentation: watch for if the sac increases on coughing or straining and is fully reducible on pressure. If these two things are not present then this may not be recurrence.
So let us get the exact diagnosis by getting examination by a General Surgeon and Ultrasonography.
Please get these done and give me the feedback so that further discussion will be directive.
With Regards.
Dr T Chandrakant.


The tests were conducted as desired by the doctor and I am attaching the same for his review and advice.

The tests were conducted as desired by the doctor and I am attaching the same for his review and advice.
Surgeon's opinion please.
Detailed Answer:
Thanks for the feedback and report.
Report say: Fat containing content around left testes. Extends up to inguinal canal. No collection - to rule out inguinal hernia.
(Such reports only assist an actual clinical examination)
What is the opinion of the Surgeon who advised the Ultrasonography?
Has any Surgeon examined, so that we can know for sure whether this is left out hernial sac or recurrence as only an actual examination tell about hte diagnosis.
With regards.
Dr T Chandrakant.
General Surgeon.

Surgeon's opinion please.
Detailed Answer:
Thanks for the feedback and report.
Report say: Fat containing content around left testes. Extends up to inguinal canal. No collection - to rule out inguinal hernia.
(Such reports only assist an actual clinical examination)
What is the opinion of the Surgeon who advised the Ultrasonography?
Has any Surgeon examined, so that we can know for sure whether this is left out hernial sac or recurrence as only an actual examination tell about hte diagnosis.
With regards.
Dr T Chandrakant.
General Surgeon.

Answered by

Get personalised answers from verified doctor in minutes across 80+ specialties
