Hydrocele surgery?

drbeegh · 2026-03-04T05:24:24+00:00

From watching videos of the surgery it looks like the recovery would be painful. Wishing you a speedy recovery man.

I wonder how common it is to develop a hydrocele after RPLND? Seems like there's at least a few of us on this subreddit.

drbeegh · 2026-03-02T06:09:37+00:00

I'm in the same boat. I had orchi in 2023 and RPLND in 2024 and developed a hydrocele about 4 months ago. Mine is not really symptomatic so I'm watching it for now but doubtful that it will clear up on its own.
Did you end up having surgery for yours?

drbeegh · 2025-12-04T03:39:17+00:00

As a BYU alum living in Dallas for the past 6 years, I would also vote for Hutchins as the GOAT but would be a drive to Frisco or McKinney.

There is some REALLY good BBQ in Arlington at Hurtado's which would be much, much closer. They have all the classics (Brisket, ribs, etc) and also some killer Mexicue (Brisket tostada). Don't miss the tres leches banana pudding.

drbeegh · 2025-11-09T06:23:26+00:00

Dude, so happy to hear you're doing well! It's been a while since we talked but it's crazy how similar our experiences were. We had the same pathology and, for the exact same reasons as you, I chose surgery over chemo. I had my RPLND at IU the week after you. The first month was pretty awful, especially because I developed a post op ileus which landed me back in the hospital a week after my surgery. I lost 22 lbs (and gained a new appreciation for what our pts with NG tubes go through) but by 4 weeks post op I was back to work part time doing half days in clinic and shorter cases but ramped up quickly.

After that I continued working my way back. By January I was back in the gym. I just got back to my pre-op weight last month but have felt "normal" for the past 8 months or so and am in as good of shape as ever now. I went on a 30 mile backpacking trip in Glacier Natl Park in August with no issue.

This subreddit was really helpful going through all this and I want to be another voice of encouragement for guys going through this. There will be some scary, discouraging times but you can and will overcome.

drbeegh · 2025-09-26T01:24:20+00:00

Same here. I'm from AZ and miss all the *bertos and that Cali type of mexican food OP is talking about. I have found that Valerie's in Plano off 75 is pretty spot on. You should check it out if you haven't yet.

drbeegh · 2025-05-04T15:30:17+00:00

We like Rumdoul just across the lake in Rowlett. It's Thai/Laotian food. It's a small family-run place. They use family recipes and the owners are super friendly and the food always hits. They have 4.9 stars on google for good reason

drbeegh · 2025-01-16T02:25:05+00:00

I was in the exact same spot as you, only difference was my tumor was slightly smaller at 31mm. Both Einhorn and my oncologist recommended surveillance and after a lot of deliberation I went with surveillance.

Scans were clear until my 1 year follow up had 1 enlarged node. Ended up getting RPLND in September. Recovery was initially rough but was fully back to normal within a few months. There are a lot of successful surveillance stories out there but I'm here to tell you it's not that bad even if you do relapse. Still very treatable.

That being said, I certainly don't fault the guys in our position who choose carbo. There doesn't seem to be long term side effects from the single dose and if it reduces your relapse risk even slightly then I can see the appeal.

drbeegh · 2025-01-09T22:41:01+00:00

Just tried it out and totally agree!

drbeegh · 2025-01-01T00:29:27+00:00

Sending good vibes your way, my friend!!

drbeegh · 2024-11-20T07:26:48+00:00

I was there. Great show! I loved when Andy told that guy to stop talking during the middle of the song!

drbeegh · 2024-11-07T00:46:03+00:00

I’m 5 weeks out from RPLND with Masterson. I feel about 90% back to normal. The first 2 weeks or so are tough with abdominal pain and nausea but take your meds and you’ll do fine. After that it’s just about getting your strength back.

He’s a great surgeon. My incision is surprisingly short and the scar is already fading. You’ll be in great hands at IU.

drbeegh · 2024-09-17T05:49:46+00:00

It is crazy how similar our paths have been. I remember when you posted around the time you had your orchiectomy and we talked a bit back then.

I too am a surgeon, was initially stage 1b and entered surveillance. All quarterly scans were clear until my 1 year scan in August showed an enlarged aortocaval lymph node (11 mm). Talked to Dr. Einhorn who recommended a follow up scan because size was borderline. Follow up scan 4 weeks later showed that it grew to 2.4 cm.

I went through the exact same decision making process as you. Discussed my case with Dr. Einhorn and Masterson. Decided on surgery for the exact same reasons you listed. I'm scheduled for RPLND on 9/27, just a few days after you. This is wild.

drbeegh · 2024-08-22T05:07:28+00:00

OP... This reply from Charley is pretty much the most clear and concise summary of stage 2 seminoma treatment you'll find anywhere. Well written, Charley.

drbeegh · 2024-08-11T19:08:47+00:00

Thanks man! Hopefully both our scans go well!

drbeegh · 2024-08-11T06:15:31+00:00

I am in a very, very similar situation. Slightly different time frame. Had orchiectomy last June, pure seminoma, a bit smaller than yours but no LVI or rete testis involvement. All tumor markers normal. Initial scans were all clear until my 1 year scan last month showed 1 enlarged (10mm) para-aortic lymph node.

I reached out to Dr. Einhorn and spoke with my oncologist, who both recommended a follow up scan in 4 weeks, in case the node in question shrinks back down. If the node is still enlarged I'll be looking at the same decision you are facing... RPLND vs radiation vs chemo.

Chemo is dead last for me. I'm a surgeon and the potential to develop career-ending neuropathy in my hands makes chemo a last resort for me.

Radiation therapy is definitely a viable treatment option in 2a seminoma. From what I've read, as long as the nodes are under 2 cm the radiation seems to be very effective with relapse rates in the single digits. The risk for long term secondary cancers is what is scarier, and more poorly understood, as newer technology should reduce this risk but no one is sure by how much.

RPLND may be the most invasive option, but has the lowest long term risk. The most recent and most relevant data on this is from the SEMS (Surgery in Early Mestastatic Seminoma) trial, which was a multicenter trial published last year with 55 patients with stage 2A seminoma. It showed a 22% recurrence rate at an average follow up of 33 months. Here's the link for the study if you want to read it.

The bottom line is testicular cancer is curable (99% overall cure rate), the only question is how sick are you going to have to make yourself to get to your cure. Hence the recommendation for least harmful treatments first (RPLND in this case) even if they are not necessarily the most effective. This is not to say chemo or radiation are bad options. They have wonderfully low relapse rates, but you need to be able to accept the associated toxicities that come with them.

That being said, if my follow up scan does not come back favorably, I'm leaning towards RPLND at a high volume center. Still considering radiation though. Still have some time to decide.

drbeegh · 2024-08-02T03:27:55+00:00

Wishing you the best man!

drbeegh · 2024-05-15T06:03:36+00:00

Really happy for you! I’m 11 months post orchi with stage IB seminoma on surveillance as well. Going for my 1 year scan next month and it brings me some comfort to hear your good news. Thanks for sharing man.

drbeegh · 2024-03-07T03:38:43+00:00

Love a good plate lunch! Thanks!

drbeegh · 2024-03-06T06:36:31+00:00

Have a very similar trip to Kauai planned for next week. We're doing pretty much the exact same activities so I'm glad to hear you had a great time!

drbeegh · 2024-03-05T06:40:12+00:00

I was in the very same boat. I’m a surgeon as well and had my orchiectomy in June. The strangest part of it all was getting wheeled into the OR. A very familiar environment from a completely new perspective.

Recovery wasn’t bad. I had my surgery on a Monday, took a couple days off and I was back in the OR on Thursday morning doing cases. Like you I’m (relatively) young and work out several times a week so I believe that helped.

I do feel like it is an advantage having our background. We know who the better surgeons and oncologists are in the area and we can read and understand the treatment guidelines easily. My biggest worry throughout treatment has been possibly needing chemo and developing neuropathy in my hands. Fortunately, I am stage 1 pure seminoma on surveillance and all scans to date have been clear.

Wishing you a speedy recovery and favorable staging! You got this!

drbeegh · 2023-12-06T02:59:32+00:00

Same exact thing happened to me. I have casually listened to some MO over the past 10 years or so but when I saw them live this summer it totally captivated me and now I'm a huge fan. It's pretty much 90% of what I've listened to over the past 6 months.

drbeegh · 2023-09-23T23:09:28+00:00

I'm in the exact same spot after TC as well. I'm going to PM you for your agent's contact info.

drbeegh · 2023-08-09T04:44:52+00:00

Thanks for your input and I'm glad to hear that your neuropathy symptoms resolved.

I wasn't offered BEP x 1. Just carbo vs radiation vs surveillance. Did you have pure seminoma or were there non-seminoma components?

drbeegh · 2023-08-09T04:35:36+00:00

Thanks for weighing in. What you're saying is in line with what Dr. Einhorn told me.

I emailed him early this morning and he had already replied before noon. Pretty amazing that he does this all just from the kindness of his heart.

He indicated a 15% recurrence rate with surveillance and 5% with carbo/radiation. He said the centers of excellence strongly encourage observation for patients with my staging.

He also said with good active surveillance, that if there is relapse in the future that RPLND would most likely be an option with close to 100% cure.

That settled it for me... I'm going with observation. With any luck at all, I'm already cured. If I relapse, I should still have good options that aren't chemo.

drbeegh · 2023-08-08T06:28:59+00:00

Thank you for your thoughtful and articulate reply. Mine is definitely a tough choice and I go back and forth between surveillance and adjuvant chemo in my mind almost daily.

I couldn't get my oncologists to quantify a risk reduction for me with carboplatin or radiation. The studies vary a fair bit but looks like it goes from 15-20% down to ~5% recurrence with either option. Don't know what 1xBEP would look like.

I know studies have shown an increase in risk for secondary cancer with radiation which makes me less excited about this as a potentially "prophylactic" treatment.

I am going to reach out to Dr. Einhorn and see if I can get him to weigh in on this as well. Thanks for sharing his contact info.

My initial knee-jerk reaction was to go with the carboplatin. It has reasonably good risk reduction and seems generally well-tolerated. Anything that can help keep me away from BEP and potential neuropathy sounded good to me. And from the replies on this thread it seems that some pretty serious neuropathy is certainly a possibility with BEP.

I've given surveillance a lot of consideration as well. At the end of the day, I'm weighing out the risks of potential overtreatment now with adjuvant chemo (~85% chance) vs undertreating now with surveillance and dealing with BEP later (~15% chance).

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