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Surgeon diagnosed hernia, other doctor said no hernia
First doctor said I might have small hernia, referred me to surgeon. I went to second doctor, she said I didn’t have hernia, and ordered an ultrasound to check. tech said I didn’t have hernia.Doctor didn’t look at the ultra sound, just pointed to the paper that the tech wrote which said no deformities detected. Doctor referred me to ortho. Appt with surgeon today and she said I had small inguinal hernia on my right side wanted to schedule surgery for the hernia on the right side and said they place a plastic mesh. was confused because I figured there would be some type of test done MRI to verify that the hernia is actually there. but the surgeon didn’t order one, she said it was obviously there and felt it during the physical exam. Help
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12 Replies
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[USER=”2661″]mackerel[/USER] There are a lot of causes of groin pain. Hernia is a common one.
I am happy to see you in consultation. If too far for you to travel, I do offer online consultation to at least review your images and make sure they were correctly interpreted, and also to review your symptoms (I can’t examine you online, he he). That way, I can offer some direction for you and you can seek the specialty care you need closer to your home.
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If you’re in Los Angeles consider seeing Dr Shirin Towfigh for a consultation, she is adept at diagnosing hernias and very well regarded (and also runs these forums)
Elsewhere in California, a variety of other practitioners who have been recommended by various patients on these forums or elsewhere:
– Dr William Brown in Fremont, CA
– Dr Shirin Towfigh in Los Angeles, CA
– Dr David Chen in Los Angeles, CA
– Dr Edward Phillips in Los Angeles, CA
– Dr Robert Burns in Newport Beach, CA
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Got a second opinion and the new doctor said he wasn’t sure if I had one. Got an MRI and it didn’t show anything but he said it wouldn’t show a very small one. Not sure what to do next as I’m having the same symptoms
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First things first, you have to establish if you have a hernia or not. There are rare cases where diagnosis is not all that simple, but these cases are very rare by what I understand. It sound like this is such a case. Get a third or even fourth opinion if you have to and then make the call for surgery. If they just open you up to see if they can find and repair a hernia, then that’s explorative surgery and should be reserved for only urgent and very complicated surgeries.
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If you know people who do what you plan to do and they have had a good repair consider using their surgeon. It doesn’t seem to be mesh per se that is the problem. It’s how it is used, and/or the type of mesh. For whatever reason, perhaps protecting fellow surgeons or protecting device makers or protecting their own practices, nobody seems able to distinguish the good from the bad, or they do know and just aren’t telling anyone else. So the good gets tarnished by the bad. What the industry and the surgical profession need are a few people brave enough to speak out and be specific. Identify the bad devices, identify the improper usage.
The recent comment on Dr. Towfigh’s tweet about the Bard Perfix plug is a good example (Momof4 mentioned the tweet in another topic). But it’s only one and it’s not very specific. It’s by Dr. Yuri Novitsky, who seems to feel that mesh can work, but plugs are bad. We need more of this, much more, and much deeper. The professional societies should be promoting this type of sharing and discussion, and they should be modifying their guidelines to include these types of things. Without the professionals who know speaking up the chronic pain problem will just continue. As things stand today it seems like a big circle of “not my responsibility”, with the patients paying the price of this abdication.
https://twitter.com/Herniadoc/status/1021561699290116097
https://www.crbard.com/Davol/en-US/products/PerFix-Plug
https://www.columbiadoctors.org/yuri-w-novitsky-md#about-yuri-novitsky
Good luck mackerel.
What do you see?
This is a medium size Perfix #plug #mesh that has balled up, aka #meshoma . It was causing chronic groin & nerve #pain due to erosion into the spermatic cord, so I excised it. He is now #pain free!🙏🏻#meshcomplication #hernia #chronicpain #itsnotjustahernia pic.twitter.com/EgnLh0ULXR
— Dr. Shirin Towfigh (@Herniadoc) July 24, 2018
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I set up appt next week to get a second opinion. Thank you for the referral, I’ll have to check if my insurance covers her office. I’ve talked to several people who’ve had the surgery with plastic mesh and they don’t have any issues but the 15% chance of chronic pain is very concerning to me. Also don’t want to get cut up for no reason if I don’t have a hernia
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quote mackerel:Thanks for the responses. 34 year old male, athletic, like to run, hike , stay active. Burning sensation, when coughing , or doing ab work like leg lifts, crunches. Los Angeles area. Pain in is right side of groin near Pubic bone. Essentially right where you feel your pubic bone. Only feel pain when doing certain activities. Not when at rest Surgeon said it is small. She was young so but graduated sc Med school. Don’t know how much experience since she is surgeon for minor surgeries. Probably does a wide range of surgeries
If you’re in LA, you could always see Dr Shirin Towfigh, she’d almost certainly be able to tell you with certainty one way or another.
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Thanks for the responses. 34 year old male, athletic, like to run, hike , stay active. Burning sensation, when coughing , or doing ab work like leg lifts, crunches. Los Angeles area. Pain in is right side of groin near Pubic bone. Essentially right where you feel your pubic bone. Only feel pain when doing certain activities. Not when at rest Surgeon said it is small. She was young so but graduated sc Med school. Don’t know how much experience since she is surgeon for minor surgeries. Probably does a wide range of surgeries
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What is your symptom and/or complaint?
If you just have a hernia occasionally palpated on exam and it does not bother you in any way, ‘watchful waiting’ is very reasonable.
If you have no bulge, and there is no troubling symptom, again “watchful waiting” is very reasonable.
If you have pain as a complaint, it could be a hernia or other possibilities. What is the pain? Where is the pain? Are you athletic? Thin? Overweight? Male/Female? Age? When did the pain start? Was there an event like an injury or movement? How long have you been in pain? What makes the pain better or worse? Is the pain constant? Is it tearing, burning, tingling, throbbing?
An ultrasound with valsava is pretty effective at finding a hernia, the valsava is necessary to appreciate the hernia because it increases abdominal pressure to push anything through a hole, if a hole exists. MRI and CT can be effective too but are very dependent on who reads the images.
Chronic pain is the biggest risk with hernia surgery. It is your groin, it is highly innervated and the area is full of complex anatomy. Seek out a specialist if possible, with plenty of experience. Recurrence is a smaller and vague risk as well but that’s not nearly as life altering as chronic pain in the groin.
There are many possibilities, for both the causes of pain, as well as for diagnostics, surgeries, etc, perhaps share some more details about your case, and your general location.
Good luck and keep us updated.
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Are there any definitive tests that can be done so I can sure it’s a hernia and not like pubic osteitis or pubic fracture etc. she did mention the chance of chronic pain as a result of the surgery due to all the nerves and being sensitive area. Not something I want to risk
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I’m not even sure there is a hernia since there is no bulge. That’s what worries me the most. The surgeon did a physical exam and said there was one on the right side but it’s small. Didn’t specify direct or indirect just inguinal. Other doctor I had there wasn’t one and did an ultra sound so I’m confused I do t want to get cut open and have there not be a hernia. She didn’t discuss any other options just the plastic mesh surgery. Said it’s outpatient but recovery can be a few months
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It is still being taught that mesh itself can cause no harm. That’s why surgeons are so nonchalant about implanting it. The disconnect between what the few long-term studies have shown and what the prevailing thinking is astounding and disturbing.
Can you give more detail in the type of hernia, indirect or direct, and the reason that your first doctor diagnosed a hernia. Did you go to the first doctor for pain, or was it found during a general physical exam?
Not too long ago “watchful waiting” was the recommendation for small and/or asymptomatic hernias. It’s surprising that your latest surgeon went directly to recommending surgery using mesh. Did she discuss any other options? If not, she’s not even following general guidelines, as I understand them. I would be wary. Most surgeons do not tell you that they “want” to repair your hernia either. They discuss the possibilities and let you decide.
If it is small and not extremely painful or dangerous you should certainly take the time to learn about the options, and the long-term risks. The results of the operation with mesh are meant to be permanent, good or bad. There are very few “we’ll try again” options if there are problems.
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