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Scrotal Swelling after Radiation or Surgery

Scrotal Swelling after Radiation or Surgery

Question

Dear OncoLink "Ask The Experts,"

My husband underwent 40 treatments of IMRT ending in December for locally advanced prostate cancer. He also had a hernia repair done in February. Since last week he has had swelling of his right testicle and pain radiating to his suprapubic area. Today his hernia surgeon said the pain is the result of the radiation. Could you tell me what this could be?

Answer

Richard Whittington, MD, Associate Professor of Radiation Oncology at the University of Pennsylvania School of Medicine, responds:

Pain in the testicle radiating to the inguinal and suprapubic region is usually related to an epididymo-orchitis (inflammation of the tissues of the epididymis and testis) related to obstruction of the spermatic cord. This can occur after a hernia repair due to scarring in the inguinal canal and it can occur after radiation due to swelling of the prostate occluding the ejaculatory duct. It is more common when both procedures are performed. The inflammation may wax and wane. It may recur up to 2 years after radiation, and I do not know how long after a hernia repair. It is usually treated with anti-inflammatory drugs like Aspirin/Ibuprofen and resolves over a few days. There is not a good way to prevent it of which I am aware.