Conservative treatment of testicular ischemia after right inguinal hernia repair: A case report

Abstract

Introduction: Generalized testicular ischemia is defined as the occlusion of venous return capable of generating edema and vascular rupture, preventing oxygenation and nutrition of tissues and germ cells such as Leydig cells. The risk factors for testicular ischemia are previous trauma, physical exertion, cold weather and especially abnormality in the bell clapper, which allows the movement of the testicle inside the tunic, increasing the risk of torsion of the spermatic cord. The diagnosis is made through clinical examination and ultrasound or ultrasound of the scrotum with doppler. Surgical methods vary depending on the observation of the testicles during surgery and the duration of ischemia. Objective: To demonstrate the importance of a good diagnosis of testicular ischemia and its complications, to improve treatment success. Methods: From a medical case that occurred at the Santa Casa da Misericórdia de Presidente Prudente, and its medical records, information was collected to carry out this report. Results: The fundamental importance of rigorous postoperative follow-up and readiness for rapid interventions in the face of crises, such as testicular ischemia, is highlighted. This manifests the need for constant and careful surveillance soon after surgical procedures of inguinal hernia repair. Conclusion: The relevance of early diagnosis and the use of technologies such as Doppler ultrasonography to monitor testicular vascularization is emphasized. Conservative management, including analgesics, anti-inflammatories, and continuous monitoring, can prevent more invasive interventions such as orchiectomy, preserving testicular function and avoiding further complications.