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Positive Cough impulse but negative ultrasound
Hey Paul, sorry you’re going through this and had the unnecessary surgery, that sounds really awful. I can relate to some of your other story however, with ambiguous ultrasound and cough impulse findings, groin pain, misdiagnosis, the works… so I can relay what I have learned.
– Hernias are routinely overlooked on imaging, particularly if they are small. You might want to have another radiologist or hernia expert look at the actual images, CT or MRI results, not just the paper report.
– Was your ultrasound done dynamic with valsava? Was it done standing up or laying down? Make sure you get one with valsava so that a valid picture can be seen when pressure is going on.
Another option would be to consider a surgical laparoscopic exploration, but that has it’s own risks as well as potential benefits if they find something. You’d want to talk to a surgeon about this and only do it if there was genuine suspicion that it was worth pursuing.
I am puzzled that you had a faint cough impulse though, and I wonder if that is suggestive of anything. Do you play soccer (football) or other sports? Are you physically active and fit physically? I ask because there are groin pulls, muscle tears, hip issues, and sports injuries that can mimic some hernia symptoms but without the typical workup.
If you’re in the UK, you could consider going to The Gilmore Groin & Hernia Clinic.
http://www.thegilmoregroinandherniaclinic.co.uk/
Also sometimes in London, Dr Muschaweck does surgery there, but she is primarily based out of Munich Germany.
http://www.leistenbruch.de/english/index.html
Both of these clinics should be able to workup a hernia, a tiny hernia, a groin muscle tear, groin nerve entrapment, or related conditions. Personally if I was in Europe and had an ambiguous groin case, I would see Dr Muschaweck for a workup and testing, she is extremely well regarded in athletic communities.
Best of luck to you, keep us updated on your progress, diagnosis, and plans.