Chronic Testicular Ischemia in long standing inguino-scrotal hernia in elderly

An 84-year-old white man with a history of ischemic cardiomyopathy, acute myocardial infarction, stent placement, and a pacemaker due to atrial fibrillation under dual antiplatelet therapy was the patient. The patient has a past surgical history of right-side inguinal mesh repair. He arrived at the outpatient surgery clinic and complained since 2016 of a left inguinal hernia. On physical examination, a complete left inguinoscrotal hernia was found. The left testicle felt with diminished consistency and tenderness was present. Given these findings, a testicular Doppler ultrasound was performed with the results of chronic testicular ischemia with almost no Doppler signal.