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Dr. Kang,
im curious if you have done any research or are aware of research regarding hernia formation as a process. I read an interesting article where it is suggested that the actual hernia one see as a bulge is actually the final stage of a three step process. And ongoing this interesting for me Bc I never had the classic bulge and the hernias never showed up on MRI or cat scan or during physical examination. But I felt internal heaviness and pressure in the groin. It went undiagnosed for 13 months until I went to a surgeon to rule out a sports hernia and he said I did have a hernia when he did the physical examination. I should not he did the classical examination the finger in the scrotum and cough test but he also did something other before Him hadn’t and that was with me lying down he put his finger at different spots in the surface of the groin and asked me to cough. Anyways when he operated he found a direc and a indirect hernia. Before him at different intervals I had the MRI, the Cst scan and another surgeon spread out months apart all said or showed no hernia-when I actually had two!!!
Anyways the article suggested that the hernia formation is a three stage process and people could feel pain along any three of the stages: weakness in the muscle, fat being hammered into a wedge and then finally entering the inguinal canal. It says this can explain why people may present with groin pain but show no bulge, no confirmation on physical examination and does not show up on scans Bc it has not gone into the canal-which most radiologists are looking for.
just curious as to your thoughts. Thanks