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Hi Watchful, yes it is Dr. Echo. I have actually seen him twice and both times he said he would cut the genital nerve branch. So I presume he cuts it in most everyone if you say it is common practice in men and I’m female. I wasn’t really clear which method he would perform – perhaps a combination of the two? He did mention the first time studying under Dr. Muschaweck. I’m sure he is a very good surgeon, but he was also very quick in his delivery. I think had it not been for the fact that he cuts the nerve, I may have gone with him because of his background in plastic surgery. Your last comments are exactly why I have not had it done. However, it does continue to get larger and I fear that I may run into the situation where a pure tissue repair would not be feasible. When I had my first surgery done on my left side back in 1994 (this unrepaired hernia is on my right side), I saw several doctors and many of them were starting to use the mesh at that time. I went to an “old school” doctor that didn’t and am so happy that I did. Unfortunately, he’s long retired or passed on (he was older when he did my surgery). I appreciate this forum so much. It has educated me – but it has also frightened me. It’s not an easy decision and I find it so ironic that it is presented as an “easy” surgery by so many general surgeons. Are you in Houston, by chance or just familiar with Dr. Echo through this forum? You can PM me if you would like.