Another Visit to the Urologist

I visited Dr. Yang Han Zhong at Taichung Veterans General Hospital. I began by mentioning that it had been nearly a year since our last appointment and asked whether he still remembered my case or if I should provide a refresher. He responded that he remembered, so I proceeded to explain that I was still experiencing significant pain. The discomfort in the previously unaffected testicle had improved, though I noted the pain seemed temperature-related—worsening in warmer conditions when the testicle hangs lower in the scrotum. I told him the recent colder weather had made the pain more manageable, but I was concerned about the upcoming summer.

Dr. Yang Han Zhong then conducted a physical examination, during which I pointed out the specific areas of pain. I explained that the now significantly smaller testicle itself was mostly painless, and that the most intense discomfort was at the surgical site. During the exam, I also shared that I had previously agreed with the surgeon not to use a mesh repair, yet the surgeon proceeded with it anyway, which left me feeling misled and betrayed.

I further described how the nature of the pain at the surgical site had evolved over time. Initially, the area was numb. Four months post-surgery, it began to feel abrasive—like a scouring pad—then progressed to a burning sensation, and now it has become a sharp, stabbing pain along the groin’s edge, near where the leg meets the torso. I asked if this could be due to nerve regrowth, and whether that was a positive sign. Dr. Yang Han Zhong clarified that nerve regeneration isn’t always beneficial, as nerves can regrow erratically and sometimes cause additional pain.

Originally, I had intended to request a testosterone test and an ultrasound to measure the damaged testicle. However, Dr. Yang Han Zhong advised against it, explaining that the testicle had already atrophied and would continue to shrink—illustrating its likely final size using the tip of his little finger.

We then discussed the possibility of mesh removal surgery. Dr. Yang Han Zhong explained that such a procedure would also involve removing the testicle and the damaged spermatic cord. However, doing so would likely result in the recurrence of the original hernia and potentially even more pain.

I asked about his experience with testicular implants, and he confirmed that he had performed them before. I inquired whether the implant would behave like a natural testicle—moving in response to temperature—but he said it would remain fixed in place. I expressed concern that this would be uncomfortable for me. I explained that walking is already uncomfortable due to the excess skin left behind from the atrophied testicle, which no longer fills the scrotal sac. This causes the skin to ride up between my legs as I walk, requiring frequent adjustments.

We also reviewed my current medications. I brought my usual folder listing the medicines I’ve taken. I thanked him for recommending Tramadol during our last visit, which had been very helpful. He asked if other medications, including Harnalidge which is a prostate medication and another pain reliever Cataflam, had been effective. I told him they hadn’t helped much, though I took them as prescribed.

I asked whether there was any chance the damaged testicle might recover, but he confirmed it was already fully atrophied and non-functional. I mentioned that past doctors had advised me to try gently pulling on the testicle to reposition it, but Dr. Yang Han Zhong indicated that this was not a good idea and would not be beneficial.

I emphasized that if there were any tests, treatments, surgeries, or medications—regardless of cost—that could improve my situation, I was willing to pursue them. I expressed my belief that the original surgeon had likely used the least expensive mesh and materials covered by national health insurance, without offering me any options.

Dr. Yang Han Zhong remarked that during our previous meeting, I had appeared noticeably depressed, but that my mood seemed improved this time. I acknowledged this, explaining that I had since begun seeing a therapist to help me come to terms with my condition.

Finally, Dr. Yang Han Zhong recommended that I begin taking aspirin to improve blood flow and renewed my Tramadol prescription. He also scheduled an appointment for me the following day with a pain specialist, suggesting that an injection might help alleviate the pain.