Reply To: Had my surgery done finally – Shouldice
Like I mentioned, I would think about it in two steps. The first is getting an accurate diagnosis, and the second is potential surgery. If you’re pretty sure it’s a hernia, I think it’s reasonable to go to Dr. Kang to be diagnosed and possibly treated. You have to decide based on what’s actually going on in there, and you don’t really know yet. Maybe you can have it looked at in the US first (Dr. Krpata, Dr. Towfigh) before going all the way to Korea. If nothing else, it will give you another opinion about what you have and how to treat it.
What does Dr. B. think? How bad is your pain, and when does it happen?
After extensive digging on the Internet and asking a bunch of people, I also found a surprising number of reports of short term as well as chronic pain after Shouldice Hospital repairs. The thing is that you can also find such reports after Lichtenstein as well as TEP. The conventional wisdom is that TEP is the least problematic in this regard.
Who knows what the real numbers are, though. Shouldice sometimes claims 1%, sometimes 2%, and there was even a mention of 5% on that interview with Dr. Towfigh. It’s definitely an issue. They are doing a multi-year study on that, but I don’t know how many patients bother with it because the questionnaires are lengthy and time consuming to fill out. German surgeons sometimes say 0% chronic pain with Shouldice, and sometimes they say 1%-3%. Basically, who the heck knows, but the numbers I’ve seen for mesh are worse. I really don’t think there are reliable numbers for any of these.
There’s also the question of how to treat chronic pain. There are some methods to treat it on mesh repairs (including removal). Not sure about Shouldice.
I know what you’re saying regarding the success of the local general surgeons. I observed the same thing. I have a couple in my area who have many stellar reviews. I actually consulted with one of them. He told me that he always cuts the ilioinguinal nerve, and that pretty much turned me off. However, he has many great reviews. He suffered from chronic pain himself after a Lichtenstein procedure, and required a nurectomy.
Honestly, much of it is luck. You need to pick the best surgeon you can, but it’s still a Russian roulette. Different people react differently to the same exact things, there are anatomical variations (such as with nerve locations), surgeons can be tired and pressed for time, etc.
I think you just got unlucky, and you shouldn’t be hard on yourself. You actually made the rational choice. I’m the one who went out on a limb more by going to Shouldice, and we’ll see how that turns out in the long run, but so far it has not been so good as I mentioned above.