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Inguinal vs. Scrotal approach

Posted: Sat Sep 22, 2012 5:40 am
by hoosierdad (imported)
Does anyone have any input as to healing time for an Orchie using an Inguinal vs. Scrotal approach? Just wondering if one heals faster than the other. I have had 2 Inguinal hernia repairs and know that it takes about 3-4 days to get back on one's feet after that surgery and wondered if a scrotal approach would be have a quicker recover time. Any input would be appreciated.

Thanks, Hoosierdad.

Re: Inguinal vs. Scrotal approach

Posted: Sat Sep 22, 2012 8:25 am
by smoothie36 (imported)
Scrotal castration is just a small incision through the scrotum, either one in the middle or one on each side. The testicles are brought out there, tied and cut off. I was walking and traveling the next day. But, took it easy for a couple of weeks. I later had the scrotum removed. Inguinal, to my knowledge involves cutting muscle tissue, it will take longer to heal, and you will always have and see that scar. I did not seriously consider anything but scrotal. Others can probably provide better information on the inquinal approach.

Re: Inguinal vs. Scrotal approach

Posted: Sun Sep 23, 2012 11:32 am
by unencumbered (imported)
smoothie36 (imported) wrote: Sat Sep 22, 2012 8:25 am Inguinal, to my knowledge involves cutting muscle tissue, it will take longer to heal, and you will always have and see that scar. I did not seriously consider anything but scrotal. Others can probably provide better information on the inquinal approach.

Mine was done inguinally for fear that cancer might be present. It took me three days to get off paikillers and not struggling to get up. After the postop tests came back clean the physician told me that had she known she would have went the scrotal way. But the advantage of the inguinal method is that she was able to remove all of the cord so I now have absolutely no long term post castration pain. I don't notice the scar. If I had to do it again it would be inguinally if I had the choice.

Re: Inguinal vs. Scrotal approach

Posted: Sun Sep 23, 2012 1:47 pm
by raymar2020 (imported)
I was castrated using a scrotal approach, The urologist pulled the cords as tight as possible then clamped them for suture and cut. The result was that the cords retracted well into the inguinal canals ,and I had no scarring. The sctroal scars disappeared into the folds , and when the scrotum was later removed those scars were removed as well.

For someone who has had hernia surgery already, I would say that scrotal is the recommended method since the inguinal canals have already been breeched, and repaired.

Raymar

Re: Inguinal vs. Scrotal approach

Posted: Sun Sep 23, 2012 3:02 pm
by janekane (imported)
In the medical literature I read before my trans-scrotal orchiectomy in 1986, the scrotal route was consistently reported as having notably faster healing time and typically fewer complications.

As I have previously indicated, I pursued doctors in vasectomy clinics in northern Illinois, northern Indiana, and southeastern Wisconsin until I found a doctor who was willing to listen to my concerns. My orchiectomy was done in the manner of a vasectomy, so I was left with two typical vasectomy scars. When the prostheses, which were put in after the orchiectomy to avoid "freaking out" men in swimming pool showers, got involved in a foreign body reaction in the late spring of 2011, the university urologists who snatched out the prostheses decided to use the vasectomy scars as the routes for removing the prostheses. The prostheses were installed via the inguinal canals.

In addition to what I read in the medical literature, my personal experience was that the scrotal route heals considerably faster.

Re: Inguinal vs. Scrotal approach

Posted: Sun Sep 23, 2012 4:24 pm
by gandalf (imported)
I cannot say anything about the scrotal method since my Dr. used the inguinal method. The procedure(s) were done as two operations and the inguinal canal was used both times. This allowed the Dr. to remove a great deal of the "tubing". I had very little pain. The Dr. each time wrote me a prescription for pain med. Each time I only used one (1) of them. Then because there was not severity to my pain, I used ibuprophen when needed usually two 200 mg pills. I used ice the first day and part of the second day. After that I went my way doing whatever I wanted as long as it did not involve any heavy lifting. Maybe I have a high pain threshold and that is why I didn't need the heavy pain meds. Plus, they tend to make me constipated.

Re: Inguinal vs. Scrotal approach

Posted: Mon Sep 24, 2012 5:00 am
by unencumbered (imported)
gandalf (imported) wrote: Sun Sep 23, 2012 4:24 pm Maybe I have a high pain threshold and that is why I didn't need the heavy pain meds. Plus, they tend to make me constipated.
The constipation three days later was the most painful part of the surgery for me, caused by the pain killers.

Re: Inguinal vs. Scrotal approach

Posted: Tue Sep 25, 2012 5:29 am
by hoosierdad (imported)
Thanks for the input. I am still trying to get my local Doc to do the surgery but so far all he wants to do is take the one testicle he is sure has damage out through an inguinal approach. I am still trying to convince him they both need to go. If he sticks to his guns I will follow through with Dr. Arnkoff at the end of next month.

Thanks again, Hoosierdad.

Re: Inguinal vs. Scrotal approach

Posted: Tue Sep 25, 2012 8:52 am
by unencumbered (imported)
hoosierdad (imported) wrote: Tue Sep 25, 2012 5:29 am I am still trying to get my local Doc to do the surgery but so far all he wants to do is take the one testicle he is sure has damage out through an inguinal approach. If he sticks to his guns I will follow through with Dr. Arnkoff at the end of next month.

Thanks again, Hoosierdad.

If you have one testicle removed and the remaining one is under-functioning and doesn't fully take over for the missing one, you may be able to reduce your natural libido to an acceptable low level with only one testicle, perhaps without having to take HRT to supplement it. Just a thought.

Re: Inguinal vs. Scrotal approach

Posted: Tue Sep 25, 2012 12:23 pm
by Wellesley (imported)
Take them one at a time, hrt is a pain to balance.

Inguinally is good I think. Having had one done each way. For pain issues iguinally is best.

I was fine 2 days after the one done inguinally. The scrotal method was several days. I think there is more swelling etc that way. Also the scrotum never really stops moving.