Differential Diagnosis for a Shrunken Right Testis After Inguinal Hernia Repair
- Single Most Likely Diagnosis
- Testicular artery ligation: This is a known complication of inguinal hernia repair where the testicular artery is inadvertently ligated during the procedure, leading to ischemia and subsequent atrophy of the testis. The timing of one month post-surgery fits with the potential for testicular atrophy to become noticeable after such an injury.
- Other Likely Diagnoses
- Tight external ring of the inguinal canal: If the external ring is too tight after hernia repair, it can cause compression of the spermatic cord, leading to impaired blood flow to the testis, which may result in testicular atrophy.
- Thrombosis of the pampiniform plexus: Although less common, thrombosis of the veins in the pampiniform plexus could lead to venous congestion and subsequent atrophy of the testis. This could potentially occur as a complication of the surgery.
- Do Not Miss Diagnoses
- Mesh prolapsed into the scrotum: While less likely, if mesh used in the hernia repair were to prolapse into the scrotum, it could potentially cause mechanical compression of the testis or spermatic cord, leading to atrophy. This is a serious complication that would need prompt attention.
- Rare Diagnoses
- Other rare causes could include direct trauma to the testis during the procedure, infection leading to orchitis and subsequent atrophy, or other vascular complications. However, these are less directly related to the common complications of hernia repair and would be considered only after more likely causes have been ruled out.