Q: I am 33 years old male. I had undescended left testicle at birth. This later on led to an inguinal hernia, which was operated three years back. Since then, though my hernia is cured, I have been having excruciating pain in the stitch area and also in my left testicle. The left testicle has reduced in size, and feels numb most of the time. A small lump is also felt at one end of the testicle. Kindly advise on fertility and how to reduce pain, as my surgeon has given up, and other consultants say that maybe, the nerves were not joined right.

A:Inguinal hernia and undescended testis usually go together. Your inguinal pain could indeed be neuralgic, a result of scar entrapment of the nerves, an uncommon complication of any open surgery. Undescended testis till as late age as yours at surgery may get very small and atrophied. Infertility is a problem if both the testis were undescended during childhood. A simple semen examination will answer the question regarding infertility. You may consult a neurology Clinic or a Pain clinic where the investigations would prove that pain indeed is neuralgic. Options for neuralgic pain at present are: trial with antineuralgic medications, testing with infiltration of local anaesthetic agents, and permanent treatment with alcohol injection if previous measures were working. Sometimes neurolysis with open surgery may have to be attempted in refractory cases.