Year 2019, Volume 5, Issue 1, Pages 209 - 212 2019-01-04

A rare complication after inguinal hernia repair: testicular torsion

Yusuf Önder Özsağır [1] , Görkem Akça [2] , Mustafa Ozan Horsanalı [3] , Hüseyin Eren [4] , Eyüp Dil [5]

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Testicular torsion is the most common urological emergency characterized by reduced blood flow of the testis, often due to spermatic cord torsion occurring in adolescence. A 68-year-old male patient admitted our hospital emergency service with the complaint of acute scrotal pain for a week. On history, he had undergone right inguinal hernia repair with synthetic mesh one week ago. Due to reduced blood flow of right testicular artery on colored doppler ultrasonography, emergent surgery was performed. On intraoperative examination, 360 degree torsion of spermatic cord from distal to the mesh, thrombosis of right testicular artery and necrosis of testicular tissue was observed. After detorsion of right testis, absence of blood supply to the right testis was observed. According to these findings, right inguinal orchiectomy was performed. It should be kept in mind that persistent pain may be a sign of testicular torsion which may develop early after inguinal hernia repair with synthetic polypropylene mesh. In suspicious of testicular torsion because of persistent scrotal pain after inguinal surgery, scrotal colored doppler ultrasonography must be performed immediately and consulted to the urologist. Succeed results may be provided by multidisciplinary approach and early treatment. 

Orchiectomy, testicular torsion, inguinal hernia repair, synthetic polypropylene mesh
  • [1] Huang WY, Chen YF, Chang HC, Yang TK, Hsieh JT, Huang KH. The incidence rate and characteristics in patients with testicular torsion: a nationwide, population-based study. Acta Paediatr 2013;102:e363-7.
  • [2] Kingsnorth A, LeBlanc K. Hernias: inguinal and incisional. Lancet 2003;362:1561-71.
  • [3] Pepe P, Aragona F. Testicular ischemia following mesh hernia repair and acute prostatitis. Indian J Urol 2007;23:323-5.
  • [4] Peiper C, Junge K, Klinge U, Strehlau E, Krones C, Ottinger A, et al. The influence of inguinal mesh repair on the spermatic cord: a pilot study in the rabbit. J Invest Surg 2005;18:273-8.
  • [5] Shin D, Lipshultz LI, Goldstein M, Barme GA, Fuchs EF, Nagler HM, et al. Herniorrhaphy with polypropylene mesh causing inguinal vasal obstruction: a preventable cause of obstructive azoospermia. Ann Surg 2005;241:553-8.
  • [6] Akin EA, Khati NJ, Hill MC. Ultrasound of the scrotum. Ultrasound Q 2004;20:181-200.
  • [7] Arena F, Nicotina P, Scalfari G, Visalli C, Arena S, Zuccarello B, et al. A case of bilateral prenatal testicular torsion: ultrasonographic features, histopathological findings and management. J Pediatr Urol 2005;1:369-72.
  • [8] Pepe P, Panella P, Pennisi M, Aragona F. Does color Doppler sonography improve the clinical assessment of patients with acute scrotum? Eur J Radiol 2006;60:120-4.
  • [9] Dellabianca C, Bonardi M, Alessi S. Testicular ischemia after inguinal hernia repair. J Ultrasound 2011;14:205-7.
  • [10] Fong Y, Wantz G. Prevention of ischemic orchitis during inguinal hernioplasty. Surg Gynecol Obstet 1992;174:399-402.
  • [11] Heifetz CJ. Resection of the spermatic cord in selected inguinal hernias: Twenty Years of Experience. Arch Surg 1971;102:36-9.
  • [12] Holloway BJ, Belcher HE, Letourneau JG, Kunberger LE. Scrotal sonography: a valuable tool in the evaluation of complications following inguinal hernia repair. J Clin Ultrasound 1998;26:341-4.
Primary Language en
Subjects Health Care Sciences and Services
Journal Section Case Reports
Authors

Orcid: 0000-0001-8313-1273
Author: Yusuf Önder Özsağır (Primary Author)
Institution: Department of Urology, Recep Tayyip Erdoğan University School of Medicine, Rize, Turkey
Country: Turkey


Orcid: 0000-0002-7019-4264
Author: Görkem Akça
Institution: Department of Urology, Recep Tayyip Erdoğan University School of Medicine, Rize, Turkey
Country: Turkey


Orcid: 0000-0002-3651-0948
Author: Mustafa Ozan Horsanalı
Institution: Department of Urology, , Recep Tayyip Erdoğan University Training and Research Hospital, Rize, Turkey
Country: Turkey


Orcid: 0000-0002-1406-8781
Author: Hüseyin Eren
Institution: Department of Urology, Recep Tayyip Erdoğan University School of Medicine, Rize, Turkey
Country: Turkey


Orcid: 0000-0001-7739-4253
Author: Eyüp Dil
Institution: Department of Urology, Recep Tayyip Erdoğan University School of Medicine, Rize, Turkey
Country: Turkey


Dates

Publication Date: January 4, 2019

EndNote %0 The European Research Journal A rare complication after inguinal hernia repair: testicular torsion %A Yusuf Önder Özsağır , Görkem Akça , Mustafa Ozan Horsanalı , Hüseyin Eren , Eyüp Dil %T A rare complication after inguinal hernia repair: testicular torsion %D 2019 %J The European Research Journal %P -2149-3189 %V 5 %N 1 %R doi: 10.18621/eurj.381909 %U 10.18621/eurj.381909