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4 weeks post op inguinal hernia surgery
Hi to all,
I hit 4 weeks post op left inguinal open hernia surgery tomorrow. I would classify my first 2 weeks as probably a normal recovery. However as I entered my 3rd week I started to develop fairly severe pain in my scrotum, inner thigh areas, horizontally across my lower abdomen, a tender/painful area in the lower part of my incision, and some numbness in both legs. Pain intensifies when I sit, lying down gives me relief although not instantaneous. I still have pain when I stand but it is quite a lot less than when sitting – so pain runs like this on a scale of 1-10; lying down (i.e., after sleeping all night pain =0-1, standing 4-5, sitting 7-9. I returned to my surgeon this past week and he seemed surprised that I was having this pain and he wants me to take Gabapentin along with Celebrex. I am currently taking 800 MG Ibuprofen 2-3 times a day. So that’s where I am, some questions:1.) What is causing my pain and why would it start in week 3?
2.) In conducting some research my symptoms sound like possible Ilioinguinal nerve trauma or possible entrapment. How do I know whether this is trauma to my nerves that just needs time to heal versus entrapment or something that needs intervention?I will spare you the frustration and anger I am going through as I work through this debilitating situation.
Thanks for helping.
Brad -
10 Replies
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4 weeks post op inguinal hernia surgery
It’s difficult to say exactly what the problem is especially so early after the repair.
In general, needing to slouch back implies the mesh is not flat but I can’t judge that without examining you and reviewing imaging.
Let us know what add Belhansky has to offer.
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4 weeks post op inguinal hernia surgery
Hi Dr Towfigh,
I am 55 yrs old, 6’2″ and 185lbs. I work out regularly ( used to pre-op), running and lifting weights. I would consider myself to be in good shape. I think the problem I have with not being able to sit without considerable post op pain has now caused a back issue…possibly sciatica. Because of the pain I was sitting slouched (butt scooted out) and I now have bad back pain and numbness in my right lower leg/foot. On the post-op front, I made a little progress this past week with sitting with a little less groin/lower abdomen pain…scrotum pain still comes for periods of time. I am thinking I should take periods of rest (lie down) until my back gets better. Although I am still in post op pain I will view any progress as positive….still very frustrated with recovery, which has weighed heavily on me emotionally and is probably not helpful. Thanks for responding.Brad
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4 weeks post op inguinal hernia surgery
I agree with Drs Earle and Goldstein.
Sounds like you had an onlay mesh repair with Parietex self grip mesh.
Pain in legs/feet are not hernia-related. More likely a local problem (any swelling?) or a spine issue.
What is your body type? Thin, overweight, normal?
Stationary cycling is a good thing. Helps with the recovery.
Belyansky is an excellent choice. Please let us know what he thinks.
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4 weeks post op inguinal hernia surgery
Ah yes. The infamous autocorrect. Yes, intended to say “reoperating”. Agree that Belyansky is a good choice. Pain in your feet could be a spinal problem. Sciatica? Best of luck. DE
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4 weeks post op inguinal hernia surgery
I think Dr. Earle was sabatoged by spell check and meant “reoperating”. Dr. Belyansky is excellent and a great person to see.
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4 weeks post op inguinal hernia surgery
Thanks to both of you…it’s really great to get your advice. Some questions:
Dr Earle – What do you mean by this: ‘Reiterating at 3 weeks would be very difficult, and possibly dangerous”.
And to answer your questions:
1.) Do you know what type repair you had? I had an Open repair
2.) Mesh vs no mesh. Mesh was used
3.) What type of mesh? I was told a “synthetic, self adhering mesh”. Also note I received a CT scan 3 weeks post op after I started to complain about this pain – the surgeon wanted to see if the mesh had moved somehow. This came back negative (Mesh had not moved).Dr Goldstein – thanks, I will try the stationary bike first
For both of you – Again thank you for helping. To note, I continue to have numbness in my lower legs/feet and fairly severe pain when sitting…more pronounced when sitting erect vice slouched position (butt scooted out from seat). BTW – I had “NO” pain pre-op with the exception of some pain in my scrotum after I ran. But besides that, again I had NO pain in everyday activities. Very frustrating! I have been so frustrated that I have set up an appt with another doctor for a second opinion (Dr. Igor Belyansky, MD – Annapolis). Am I rushing into a second opinion too fast? I am just feeling like I need some answers….but maybe the answer is “time”?
Thanks
Brad -
Surgery VS Watchful Waiting
Dr. Earle is correct that this is not the usual post-op course after a routine hernia repair. Your symptoms, however, are difficult to correlate with unilateral surgery which is why I think that this may be some sort of generalized problem. Gabapentin is supposed to work by inhibiting nerve conduction at the level of the spine, but I doubt we really understand completely what it does. Side effects are mostly tiredness and resolve with time in most people. Light jogging is probably OK, but I would get on a bike first. It’s much lower impact. Time does, indeed, frequently fix these issues.
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4 weeks post op inguinal hernia surgery
Brad – While I agree with Dr. Goldstein’s points, something is definitely wrong here. You are not following the anticipated, or typical course after an inguinal hernia repair. Having said that, conservative, non-operative treatment is likely the most appropriate thing to do. Reiterating at 3 weeks would be very difficult, and possibly dangerous. Given all that, you are more likely than not to resolve your pain without further operation. May need to give it 6-12 weeks. Do you know what type repair you had? Open vs lap. Mesh vs no mesh. What type of mesh?
Hope this helps! -
4 weeks post op inguinal hernia surgery
Thanks for the reply Dr Goldstein. I struggle taking medication I don’t understand and gabapentin fits that bill but I can give it a shot. I am concerned about side effects and whether there are any long term implications with gabapentin.
Also, Interesting that you indicate activity as something that my body may respond better to but at this point I am only walking around, primarily at work. I am a jogger and miss it but I cant see myself running right now when walking still gives me some pain…should I try to jog?
Thanks
brad -
4 weeks post op inguinal hernia surgery
I am sorry that you are having problems. Understand that pain is a symptom and can have may causes and it is not always possible to determine exactly what is causing it. It is not unusual to have pain develop several weeks after surgery as you stop taking medications and begin to return to normal activities. It takes many months if not years for full healing. It sounds like some inflammatory process around the mesh, which again, is not unusual. The pain in your legs, especially on the side opposite from your surgery is very difficult to explain and may represent some other issue, which is why the gabapentin may help. Activity has been shown to be better than medication for chronic pain reduction, so I would recommend you move as much as you can, try the gabapentin, and give it some time.
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