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3 week post-op left IH repair concerns
Hi everyone, I am a 45 year old male that had laproscopic mesh inguinal hernia repair on my left side on 7/9/18 about 3 weeks ago. My history: I noticed a quarter size lump protruding from my left groin area – no pain at that time. After a CT scan, I was diagnosed with a groin strain. Over the next 5 years the “lump became a little larger and gradually became more tender especially after strenuous activity. About 3 months ago, the pain started to bother me more – pulling, heaviness, burning at the bottom of the scrotum and along the penis shaft and tip. I assumed the “hernia” was pressing against some nerves causing the pain. Usually if I laid down, the pain would subside.
I made an appointment with a recommended surgeon who made the hernia diagnosis and scheduled the surgery for 7/9/18. Surgery seemed to go well – Doctor stated surgery was “straightforward with no complications. On the 7th day post op, I removed the pain pump containing local anesthetic they installed during surgery. On the 8th day post op, I started noticing the same type of pain I had before surgery(Burning, throbbing, at the base of scrotum and penis shaft and tip). I figured the local anesthetic was probably masking the pain. On the 17th day post op, I had my 2 week follow up with the surgeon. I described to him, that I still had the original pain( burning,stinging). He said that this was normal, especially since I had pain preop, that the nerves were probably still stretched inflamed and it would take awhile for them to “calm down”.
It is now a little over 3 weeks post op and the pain is about the same. If I walk, the area becomes inflamed again. Advil does little to help. The only thing that helps is lying down. While the pain is not horrendous, it definitely affects my daily routine and can’t concentrate on much else.
I know its still early, just hoping for some advice or ideas of what could be happening.
Also, surgeon stated he used Bard 3D mesh and two absorbable tacks to hold it down.
Thanks to everyone who made this forum possible! -
4 Replies
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Thank you guys for your advice and ideas. Just wanted to give an update on how things are going. Seems like the nerve pain is getting a little better not much though. After reading a lot of horror stories about mesh hernia complications, I began to worry and so I went to the ER last night. They performed a bunch of tests (many probably useless) including CT scans with contrast. They diagnosed a seroma. I can actually see the “puffiness” which seems to extend from where the hernia was down to the scrotum. When i press on the seroma – especially next to the scrotum it is pretty tender and sore. Also, when I walk I can feel some pressure and soreness from the seroma. Just wondering if this pressure is contributing to some of the nerve pain that I am having. After researching online, from what I gather, the pain could be coming from the pudendal nerves? The pain seems to be at the bottom of scrotum and penis shaft and tip – Could the seroma be inflaming some of these nerves or did the hernia repair not address this problem? I had similar symptoms before surgery. I am about 3 1/2 weeks post op. Thank you for any help and ideas, I really appreciate it
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quote Samson1nite:… On the 17th day post op, I had my 2 week follow up with the surgeon. I described to him, that I still had the original pain( burning,stinging). He said that this was normal, especially since I had pain preop, that the nerves were probably still stretched inflamed and it would take awhile for them to “calm down”.
It is now a little over 3 weeks post op and the pain is about the same. If I walk, the area becomes inflamed again. Advil does little to help. The only thing that helps is lying down. While the pain is not horrendous, it definitely affects my daily routine and can’t concentrate on much else. ….If you had pain in the region before the surgery, what your surgeon said could certainly have some validity. Constant pain sensitizes the region and works a pathway to/from one of the most highly innervated regions of the body (the groin) and the brain, and it can absolutely take a while for that to settle down. There’s also always the risk of chronic pain with hernia surgery in general. Regardless, you can help that nerve/pain calming process along by engaging in mentally challenging activities (learning a foreign language, puzzles, sudoku, math problems, learning programming, learning an instrument, producing art, etc), anything that causes neurogenesis in a positive way.
But remember, you’re only 3 weeks out from surgery, and surgery causes additional trauma, swelling, inflammation, scar tissue, and irritation to a very sensitive area and nerves, so all of that can certainly contribute to discomfort. Try not to be overly concerned, as there are also many studies that demonstrates pain diminishes slowly over time regardless. Eat healthy and continue to be as active as you can tolerate and within doctor recommendations.
You could always follow-up with the surgeon again, and discuss a few options like:
– Confirm there is no recurrence (unlikely but possible)
– Nerve block injections, would probably similar effect to the pain pump but many people report success with these especially if they’re generally effective. Often they have to be repeated several times.
– Strong prescription NSAID / anti-inflammatory daily for 30-60 days (assuming your general health is tolerant to NSAID)
– Targeted physical therapy can help people recover from surgery faster (you’ll notice all professional athletes have physical therapy and rehab after injuries and surgeries, for an obvious example), likely focused on the pelvis, lower abdominals, upper legs, etc
– Daily Vitamin C supplement, there is evidence this helps neuropathic pain diminish over time
– Daily alpha-lipoic acid, there is also evidence this helps neuropathic pain over time
There are certainly other options too, things to try or to investigate, but given you’re still fairly fresh out of surgery they’re probably not worth considering yet.
Anyway, best of luck and keep us updated on your progress.
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I agree with good intentions-routine hernia repairs do not get a pain pump afterwards at least here in the states (I doubt elsewhere). That to me is a little susipicius. Get a hold of your operative report and review it.
also I’m am not saying this has happened to you but it happened to me and a quite a few others who had the Bard 3D (for me and the others it was the 3D maxx) but it has a tendency to fold over on itself. The mesh is designed to be concave so it can “better fit “ the inguinal region which is 3 dimensional but due to this has a tendency to clan shell on itself.
on one hand you are still early in your recovery and time may heal and the pain will go away on the other hand you still need to be proactive and try and find out all you can about your surgery. -
Most hernia repair patients do not get a “pain pump”. So that is unusual. Since you were originally diagnosed with a groin strain, and the pain is associated with activity, it might be that the hernia was not the actual cause of the pain. I had a direct hernia that was only painful “after” strenuous activity but not during. And the pain resolved after a few days to a week. I only had it repaired so that I could, supposedly, get back to my high level of activity.
Consider the possibility that the pain is actually from something like a “sports hernia”. Athletic pubalgia. There is a “sticky” about it on the forum’s front page. Here is the link – https://www.herniatalk.com/6882-in-depth-sports-hernia-guide-infographic
There are doctors who specialize in the condition, like Dr. William Brown, Dr. Muschaweck, and Dr. William Meyers. Good luck.
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