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2-week post-op pain while sleeping on back
Hi all. 54 year old male – active, fit, healthy weight. I am 2-weeks post-op from an open right inguinal hernia mesh repair. Nothing remarkable from the surgery and it seems to be recovering as expected up to this point.
However, I am waking up in the middle of the night (2am, 3am or so) with deep, aching pain all over my lower abdomen, and the only thing that resolves it is taking 400mg ibuprofen. I was wondering if it could be a bladder issue, but I have a urologist treating me for bladder pain and I’m seeing no change.
Who else has dealt with recurring pain/ache around the lower abdomen 2-weeks post-op during sleeping (on your back)? If so, how did you overcome it? Could it just be residual inflammation from the right inguinal canal that spreads around the abdomen through the night, or is this more likely a different issue?
Appreciate any similar experiences others can share –
Dan
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10 Replies
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How’s it going Dan?
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Thank you Watchful and Good Intentions for your insight and advice. Very helpful and much appreciated! 🙂
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Watchful was probably referring to the words below. The notes imply that it was problematic/unexpected, and had occurred recently, but “nonetheless” they got things done.
“bulky intact transversalis muscle that had just separated from the inguinal ligament. Nonetheless, we were able to get good reapproximation of the floor and reinforcement with mesh.”
It looks like you had a normal Lichtenstein repair. You can find quite a bit about it on the internet, and Youtube.
On the pain at night, of course, there are normal bodily functions that happen at night for men. It might be related to that. You say that you have to take ibuprofen but I wonder what would happen if you just walked around for a bit. It seems odd that a pain would appear for no reason and remain.
Anyway,as Watchful said, it’s early. Tissues got stretched out of shape when you had the hernia and then got stretched back to where they were supposed to be when you had the repair. You might try adding some things to your walking routine. Weights or stretching. See what happens. Good luck.
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Some of the open mesh repairs extend all the way down to the pubic bone. That could cause pain/sensations much lower than the external incision point. There is a variety of methods and materials described as “open mesh”. That’s why I asked for details. Good luck.
One example –
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Does it resolve if you sleep on your side and, if so, on either side or only one…or do you just always sleep on your back?
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What type of activities have you been doing during the day? I have found that sometimes more activity is better than less for pain after surgery. It’s counterintuitive.
Can you share the details of the repair method? Lichtenstein, plug and patch, PHS? And the type of hernia that was repaired.
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Hi Watchful – I appreciate you sharing! Very experienced surgeon, highly recommended referral as well, and I was completely confident in his approach when it was explained to me.
I’m curious – what are you seeing in the highlights that makes this case non-routine? Thank you for your thoughts!
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Looks like it wasn’t quite a routine case. How experienced was your surgeon? When it turns out not to be a “textbook” case, the experience, talent, and abilities of the surgeon make a big difference. Such surgeries also tend to take longer to get right, so you need a surgeon who doesn’t load themselves up with too many surgeries per day, and such surgeons are very rare in this high-volume hernia field.
I hope it’s just a temporary issue, and it resolves for you with time. You’re still very early at two weeks after surgery.
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Hi Good Intentions – Thank you for helping me better understand all of this! In terms of exercise, I’m now walking 2x/day at 2+ miles with some slow climbing and it feels good during the day. I’m hoping to get back into road cycling, but that hasn’t felt so good due to the location of the incision in the groin.
Just found the highlights of the operative report:
* Open repair of initial reducible direct right inguinal hernia with mesh
* The bulk with the hernia was evident as a direct space hernia.
* Approx. 3-cm defect; direct preperitoneal tissue likely including portion of the bladder were reduced into the preperitoneal space.
* Used a keyhole piece of polypropylene mesh, which was circumferentially secured to the floor of the inguinal canal using interrupted 0 Vicryl.
* Internal ring was made to fingertip tightness with the legs of the keyhole mesh.
* (This is interesting. Not sure what this means?) There was bulky intact transversalis muscle that had just separated from the inguinal ligament. Nonetheless, we were able to get good reapproximation of the floor and reinforcement with mesh.
* There was good reapproximation of our external ring, although the fascia was significantly attenuated in this location. Nonetheless, we completed this closure and then closed the Scarpa fascia … etc. -
Hi MarkT – thank you for chiming in! Although I haven’t tried to sleep extensively on my side, I noticed last night that I wasn’t getting any quick relief by trying to sleep on my left side. For now, I’m avoiding trying to sleep on my right side, since that’s where the repair is.
For the most part, I sleep on my back; and even if I fall asleep on my side, my unconscious self will shift to my back while I’m asleep.
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