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What Causes Painful Inflammation In Scrotum After Surgery?
Question: In february of this year my right testicle was removed due to severe infection with very limited response by antibiotics. The testicle had been swollen, painful and infected twice in the past but responded well to antibiotics. Within a 6 weeks after surgery my scrotum became inflamed and painful. The surgeon said this was a normal response to the surgery and that icing it would reduce swelling and pain. I followed his advice however in the morning of the third day after icing it for two days the incision oozed some blood and liquid with no noticeable odor. I got immediate relief from pain and the swelling was gone. Over the next 5 months this recurred again. I told the doctor and he ordered a series of tests and a soft tissue MRI. His diagnosis was to remove a urethral stricture. Over the last 5 months the incision has continued to excrete what now smells and looks like urine, an amount that soils my underwear about the area of 3" x 3". This is obviously disturbing. What possible conditions may cause 1) the incision to not heal, and 2) urine to enter my scrotum? The urologist strongly suggests open urethral reconstruction. What is the long term prognosis for the patient with this surgery and what is the duration typically of recovery? Thank you.
Brief Answer:
Probably you have developed Urethro Cutaneous Fistula,
Detailed Answer:
Hello
Thanks for your query ,based on the facts that you have posted it appears that you have undergone surgery for removal of Rt infected testicle (Orchdectomy) six months back since then developing recurrent infection of would .
I shall be happy if you can post me few more details to help me in making comments on your problem.
1) Did you have any urinary symptoms especially obstructing voiding symptoms before yo had scrotal abscess?
2) Was culture of a pus or fluid from infected wound done to trace out nature of bacteria and sensitivity?
3) Was radiological test called Retrograde Cystourethrogram done to confirm the site and length of urethral stricture? if yes please upload report.
4) Is it possible for you to upload report of your MRI done recently?
5) Does the location of wound is over scrotum or perineal region?
6) Will you specify the site of stricture ,length of stricture and the nature of surgery that your Urologist is planning to do ?
At the outset our primary aim will be to trace out organisms causing infection and their sensitivity pattern so that infection has to be controlled completely before going for major surgery of urethral reconstruction.
Get culture and sensitivity test of a discharge from the wound and urine done and start taking antibiotics as per culture report.
Please do write in details about the information I have asked for .I shall be happy to make precise suggestions and comments on getting feedback from you.
Thanks and Regards.
Dr.Patil.
Probably you have developed Urethro Cutaneous Fistula,
Detailed Answer:
Hello
Thanks for your query ,based on the facts that you have posted it appears that you have undergone surgery for removal of Rt infected testicle (Orchdectomy) six months back since then developing recurrent infection of would .
I shall be happy if you can post me few more details to help me in making comments on your problem.
1) Did you have any urinary symptoms especially obstructing voiding symptoms before yo had scrotal abscess?
2) Was culture of a pus or fluid from infected wound done to trace out nature of bacteria and sensitivity?
3) Was radiological test called Retrograde Cystourethrogram done to confirm the site and length of urethral stricture? if yes please upload report.
4) Is it possible for you to upload report of your MRI done recently?
5) Does the location of wound is over scrotum or perineal region?
6) Will you specify the site of stricture ,length of stricture and the nature of surgery that your Urologist is planning to do ?
At the outset our primary aim will be to trace out organisms causing infection and their sensitivity pattern so that infection has to be controlled completely before going for major surgery of urethral reconstruction.
Get culture and sensitivity test of a discharge from the wound and urine done and start taking antibiotics as per culture report.
Please do write in details about the information I have asked for .I shall be happy to make precise suggestions and comments on getting feedback from you.
Thanks and Regards.
Dr.Patil.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Here are the answers based on the information provided by my doctor:
1) Did you have any urinary symptoms especially obstructing voiding symptoms before yo had scrotal abscess?
Ans: 30 years ago I had a stricture that was repaired surgically with urethral dilation.
2) Was culture of a pus or fluid from infected wound done to trace out nature of bacteria and sensitivity?
Ans: No.
3) Was radiological test called Retrograde Cystourethrogram done to confirm the site and length of urethral stricture? if yes please upload report.
Ans: The only test performed was soft tissue MRI.
4) Is it possible for you to upload report of your MRI done recently?
Ans: I'll request a copy of the MRI report.
5) Does the location of wound is over scrotum or perineal region?
Ans: The incision was made at the center of the scrotum horizontally when standing.
6) Will you specify the site of stricture ,length of stricture and the nature of surgery that your Urologist is planning to do ?
Ans: The doctor did not provide the site or length of the stricture. He said that the only long term solution is to perform urethral reconstruction.
My urine flow has improved since the testicle was removed and the scrotal leaking began. I do not have urgency, excessive, or pain in urination and was tested to confirm proper emptying of the bladder; that test was fine, almost 90% voiding. I cannot see the opening in the scrotum at the site of the leak. My inner thigh is very red; it looks like diaper rash. This is due to the leakage in the scrotum. I keep the area very clean using antiseptic soap. This is helping. It seems there is some urine when I ejaculate from sex based on the color and odor of the ejaculate. Hope this helps.
1) Did you have any urinary symptoms especially obstructing voiding symptoms before yo had scrotal abscess?
Ans: 30 years ago I had a stricture that was repaired surgically with urethral dilation.
2) Was culture of a pus or fluid from infected wound done to trace out nature of bacteria and sensitivity?
Ans: No.
3) Was radiological test called Retrograde Cystourethrogram done to confirm the site and length of urethral stricture? if yes please upload report.
Ans: The only test performed was soft tissue MRI.
4) Is it possible for you to upload report of your MRI done recently?
Ans: I'll request a copy of the MRI report.
5) Does the location of wound is over scrotum or perineal region?
Ans: The incision was made at the center of the scrotum horizontally when standing.
6) Will you specify the site of stricture ,length of stricture and the nature of surgery that your Urologist is planning to do ?
Ans: The doctor did not provide the site or length of the stricture. He said that the only long term solution is to perform urethral reconstruction.
My urine flow has improved since the testicle was removed and the scrotal leaking began. I do not have urgency, excessive, or pain in urination and was tested to confirm proper emptying of the bladder; that test was fine, almost 90% voiding. I cannot see the opening in the scrotum at the site of the leak. My inner thigh is very red; it looks like diaper rash. This is due to the leakage in the scrotum. I keep the area very clean using antiseptic soap. This is helping. It seems there is some urine when I ejaculate from sex based on the color and odor of the ejaculate. Hope this helps.
Brief Answer:
Get Retrograde CystoUrothrogram done to trace out leak from Urethra
Detailed Answer:
Hello
Thanks for follow up and feedback .
Please get following two basic tests done to establish diagnosis
1) Retrograde and Micturating Cysto Urothrogram .This will help to find out the site of leak and extent of fistulous tract.
2) Urine Culture and sensitivity .
Please upload a report of your MRI to make me understand the facts and to make precise comments and suggestion .
Thanks and Regards.
Dr.Patil.
Get Retrograde CystoUrothrogram done to trace out leak from Urethra
Detailed Answer:
Hello
Thanks for follow up and feedback .
Please get following two basic tests done to establish diagnosis
1) Retrograde and Micturating Cysto Urothrogram .This will help to find out the site of leak and extent of fistulous tract.
2) Urine Culture and sensitivity .
Please upload a report of your MRI to make me understand the facts and to make precise comments and suggestion .
Thanks and Regards.
Dr.Patil.
Note: For further follow up on related General & Family Physician Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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