Ischaemic orchitis

The patient had been referred to a general surgeon by his GP because of a bulky recurrent left inguinal hernia.

The surgeon advised a further open mesh repair. After discussion, the patient signed the consent form at the clinic, but no comment was made on the form of specific risks or complications, nor was the patient given written information about the procedure.

The procedure was uneventful, but two weeks later the patient attended his local hospital complaining of a swollen left testicle. The surgeon there diagnosed orchitis, prescribed antibiotics and reassured him. However, five weeks later the patient attended complaining of left testicular pain.

The hernia repair was intact and at review again two weeks later the pain was settling, and it was felt that no further intervention was required.

A year later an ultrasound of the patient’s scrotum showed a normal right testicle but a small left testicle.
The claimant alleged he had suffered ischaemic orchitis as a result of the hernia repair, resulting in testicular atrophy.

The operative procedure was not criticised. However, the claimant alleged that if he had been warned of the risk of ischaemic orchitis he would have sought a second opinion and would not have had surgery on the day that he did.

Although the surgeon, in accordance with his usual practice, would have warned the patient of the risk of testicular ischaemia, there was no documentation of this discussion in the medical records or on the consent form.

The expert instructed by the MDU advised that ischaemic orchitis is a well-recognised complication of surgery for recurrent inguinal hernia, but the failure to complete the consent form was a breach of duty of care. In the light of this, and following discussion with the surgeon, the claim was settled for £15,000.

This page was correct at publication on 29/11/2012. Any guidance is intended as general guidance for members only. If you are a member and need specific advice relating to your own circumstances, please contact one of our advisers.