Bilateral Shouldice with Dr. Conze

[Oceanic]

Had this done 10 days ago with the enigmatic Dr. Conze, still in a fair bit of discomfort although there seems to be small improvements every few days which is encouraging. I was completely wiped out the first 3 days and could barely walk.
Will give regular updates to this thread over the coming weeks, months etc as to how I progress.

[Watchful]

That’s a bit alarming and unexpected… I hope you recover completely soon. What did Dr. Conze say?

[Good intentions]

Good luck Oceanic. Could you describe the experience in broader terms? Where you stayed, the facilities, languages spoken, type of anesthetic used, any notes from the operation?

Also, when you say you could barely walk, what type of pain were you experiencing? Not much is known about Dr. Conze’s work, on the forum.

[William Bryant]

Thanks for the update Oceanic, much appreciated as there isn’t much discussion or feedback re Dr Conze or many of the other Germans on the forum as Good Intentions says.

I hope things improve for you. Maybe the fact both sides were repaired is why there is more pain. It can be a long healing process after such surgery so every reason tomhope it gets better and better. Please if you can keep us updated. Many thanks.

[Oceanic]

In hindsight I wish I’d had one side done and waited 6 weeks then gone back for the other side, double shouldice is a lot trauma. I only knew about the right side hernia although was getting testicle pain on the left but with no lump, Dr.Conze found a small direct hernia on the left side with the Ultrasound and by sticking his finger up my inguinal canal.

My right side feels great and is healing nicely but the left side is causing a lot of tension and discomfort, I can only walk short distances before needing to sit down. I can extend my range a little each day though, I’m hoping it just may be a long road of my tissues stretching and remodeling to accomodate the new tension, the key is movement so I’m doing gentle stretching and as much walking as possible, I managed 10,000 steps yesterday over the whole day broken up into segments.

The Clinic in Munich is very nice, the operating theatre is on the same floor and they kept me in over night for observation, I stayed in a Hotel virtually next door for 3 more nights before flying home with the help of some strong painkillers.

Everyone including Dr.Conze speaks excellent English, he gets a lot of international visitors I think. I had local anesthetic and sedation, didn’t know a thing about it, just woke up in the recovery room and it was all done. Anaesthetist and Nursing care was all top notch. Time from first contact to surgery was about a month, I travelled out in a reasonable anmount of discomfort so it was a bit of a mental challenge, the pain I have now is worse than the hernias but I still have a better sense of well being as my body now feels like it doesnt have bits protruding out of it that should be on the inside.

I’ll try and post weekly updates, I learnt a lot from this forums so it’s the least I can do if my ramblings help someone else here.

Lastly in case this helps anyone I’m taking BPC-157 and TB-500 peptides which are known to drastically increase/improve healing, be aware of options like this as when you’re older you don’t heal like you do when you were in your teens, these peptides will make your recovery much faster and more complete. This isn’t medical advice, do you’re own research and decide for yourself. Some specialist Doctors in the US can be found that prescribe peptides like these.

[pinto]

You’ve gotten over the worst of it and seem to be making good progress though incremental. I hope the discomfort is becoming manageable. I salute you for taking the challenge and once you’re able to leave all this behind, you gonna feel fantastic. Focus on that forward. BTW, you referred to your surgeon as enigmatic. He’s not very forthcoming about your condition or the surgery? Or is that his reputed disposition? Good luck with everything. I hope you’re pain free soon.

[Oceanic]

Dr. Conze did personally drop some stronger pain killers to me in the hotel a few days after surgery to help get me home, his diagnosis was swelling and pressure in the inguinal canal stretching the genitofemoral nerve and it would resolve in a few days, it hasn’t and the pain is coming from a bit higher up I think but I’m no expert. He did message me again last Thursday to see how I was getting on and I did message him back saying still having problems do you know why and not heard back from him and it’s been 3 working days now so make of that what you will, he is busy I’m sure but I did just spend north of 11k Euros with him so hoped for a bit more of a timely response.

• This reply was modified 3 months, 2 weeks ago by Oceanic.

[pinto]

I feel relief hearing your doc has been on top of it. Has it really been three working days since? It was Thursday last contact then hit against the weekend. I know you probably feel isolated and maybe a little scared but this weekend thing is so common even if big bucks are paid. His “few days” probably has a looser meaning and he might wait to see if his diagnosis was on target. That seems reasonable. Call his office if not already and at least talk with his secretary and press them it’s gone past the “few days” and you need/deserve some assistance. If no go, then I would ask for another surgeon in the same Dept./hospital for assistance. You’ve waited a reasonable time already and deserve attention.

[William Bryant]

I think Pintos advice is very good and reasonable. I’d give Dr Conze until tomorrow afternoon and then ring again. Sometimes messages don’t get passed on to the person they heed to be. It could be that.

Good to hear one side at least is how you’d hoped/expected.

Thank you for reports and feedback now and I’m the future.

I’m sure I read about a Desarda patient who had pain for about a month and then it resolved. Hopefully the same or quicker may be true of Shouldice in this case.

[Oceanic]

I communicate with Dr. Conze via Whatsapp so it’s fairly direct, he’s very open about all his patients having his mobile number which is refreshing.

[Watchful]

As long as you keep improving, it should turn out ok with some more time.

Does the pain and discomfort completely go away when you sit down or lie down?

If you lift your testicle/scrotum with your hand while walking or standing, does it get better? At the Shouldice Hospital, some surgeons give their patients a truss to lift the area during recovery.

[ajm222]

Double Shouldice hernia repair – no wonder you’re in a lot of discomfort. There are folks sometimes on these sites that seem to think people should be 90% recovered in like 7 days, which is absurd. These surgeries – and any surgery – take a long time to heal. Sometimes months or even years for certain things to fully resolve. In my experience there are usually big jumps in improvement after about 2 or 3 weeks and then again more in a couple of months. Wishing you the best. Be patient and don’t fret too much. It’s still very early. But also be persistent in getting in touch with your surgeon if you have questions and need their reassurance. The healing process has many stages. The initial trauma can take weeks to subside before the body even starts the primary healing stage. Then you’ve got weeks or months of scar tissue formation and then remodeling and nerves being restored and the mind body connection ‘forgetting’ the pain and discomfort. Plus, everyone heals differently, even with all things otherwise being equal.

• This reply was modified 3 months, 2 weeks ago by ajm222.

[William Bryant]

I fully agree with ajm, as I have posted before on another thread I had non hernia related and far less complicated surgery years ago. I had pain for sometime after. My mum had keyhole for another non hernia and was in pain at times ages after. Both cases resolved with time.

More recently I’ve had a flesh wound. It occured January still not healed and still sore 4 months later. It has improved during that time.

[William Bryant]

If Dr Conze wants patients to have his mobile, hopefully he will answer your concerns and address the issues soon.

[Oceanic]

Thanks for the encouragement Guys, I know it’s early days, I think the left side repair just may be a lot tighter than the right side for reasons I don’t understand.

@ Watchful, I feel completely fine laying down, sitting is ok (ish) but you still put tension on your groin doing this but I’m back at work today and have been sat in a chair all day and its only mildly uncomfortable, standing or walking causes the most discomfort. They were both direct hernias which I’ve read are more painful after a tissue repair. Not tried lifting my testicles (I will thanks) but the discomfort is mainly from under the incision site towards my thigh and down the inguinal ligament I think.

I’m taking collagen supplements, eating plenty of protein and pushing myself a little each day to let my body know what it needs to do, time will tell. As you all rightly say I think this is a jourmey of weeks to 6 months to a year full recovery.

I had a tendon graft in my arm done a few years ago and that was still improving nearly 2 years on, its a slow gradual process but I’d rather have the pain of surgery recovery than the pain of a hernia.

• This reply was modified 3 months, 2 weeks ago by Oceanic.

[Chuck]

Oceanic—thanks sooooooo much for your post. Its hard to get first hand reports on Conze. And your post just reiterates how difficult it is to get a decent painfree tissue repair. Shouldice is such an invasive repair I hear many reports of issues with it. Some reporting 3 year healing times. You seem like a smart guy who did a lot of research —any reason you chose Conze over Kang? To be fair one of our friends reported being badly gutted by a a double inguinal kang repair….hoping he is on the mend now. But this is why i selected lap mesh surgery…which turned out to be a disaster too. The state of hernia repair is a real mess.

[Oceanic]

Chuck- It was this forum that guided me to Dr. Conze, I’m in the UK so Germany was a 1.5 hour flight away, I exchanged a few emails with Stephen, Dr. Kangs assistant but the journey put me off and the fact he does 9/10 procedures a day

I just figured Dr. Conze was enough of a specialist that I was in with a fighting chance of not getting maimed by him.

I’ve read numerous accounts of Shouldice procedure patients feeling completely normal and like they hadn’t even had surgery within 3-6 months so it’s impossible to generalise, don’t discard Shouldice from your options would be my advice for what it’s worth, my right side is exactly as I could have hoped for and feels superb, I could easily do a 10 mile walk on that and there is zero pain apart from nerves tingling as they heal from being moved about.

• This reply was modified 3 months, 2 weeks ago by Oceanic.

[Oceanic]

Incisions at day 5 just before I had the dressings changed again

• This reply was modified 3 months, 2 weeks ago by Oceanic.

[Chuck]

Thanks Oceanic…will pray for your speedy recovery. I did not have the luck you did in finding pain free shouldice patients…althought i was mostly looking on Facebook forums and folks with problems tend to post. What really discouraged me from shouldice were the happy patients who said they were glad they got shouldice…but could still feel it when their dog pulled hard…or they lifted their grandkidss etc. I suppose a pain free experience is unavoidable…thanks for your supplement recommendations…you might add Wobenzyme N to your list–please continue to keep us posted

[Oceanic]

All the happy Shouldice procedure patients tend to just resume their lives and don’t feel the need to frequent forums discussing it, why would You?

Don’t let doom and gloom echo chambers put you off

Give it a few more months and I’l lift something heavy and tell you how I feel, I think a lot of the people who moan aren’t prepated to put the rehab in needed to make a full recovery and think sitting on the sofa doing nothing is all they need to do.

• This reply was modified 3 months, 2 weeks ago by Oceanic.

[MarkT]

Someone else understands! I have been saying this for a while.

I think a number of people here have skewed perceptions of risk/complication prevalence because they spend so much time reading about problem cases online which represent a significant minority of cases, especially from high-volume hernia specialists.

[Watchful]

The thing is that it’s not just anecdotes. The chronic pain results you see in studies aren’t good (ballpark of 15%). Also, see the numbers just posted by Dr. Kang who is about as focused and high volume as it gets. It’s certainly a minority who get bad results, but a minority that’s too large for comfort.

[MarkT]

I didn’t say chronic pain was anecdotal…I said people have skewed perceptions of reality, largely as a result of spending too much time on forums, FB groups, etc. with non-representative samples of problem cases.

A 15% complication rate is indeed too high for comfort…but that is not what patients of most high-volume specialists realize, it almost surely is lower for ‘normal’ cases (smaller hernias, no comborbities, etc.), and it still invalidates some of the ridiculous statements around here of ‘so much chronic pain with Shouldice’, that ‘almost everyone who gets a tissue repair has problems’, that there are ‘no good options out there’, that all mesh should be ‘banned’, etc.

There are people coming to this forum for legit information, not hysteria and lies.

What has Dr. Kang recently posted, btw? I have not seen it.

[MarkT]

Oh, just read Dr. Kang’s post…

It’s nice that a rather small % have problematic pain, but that more than 16% have ‘pain that not possible to ignore’ is indeed concerning and not all that different from what other studies are finding.

It will be interesting to see longer term data since his timeframes are inherently short.

In his potential defence, more nuanced data could be extremely helpful. He really should break that down by patient/hernia characteristics since he doesn’t turn anyone away. Maybe a certain subgroup of patients have disproportionately high pain rates that are dragging down his overall stats and misrepresenting what the average patient can expect…?

[Oceanic]

Chuck I’ll take short term pain for long term gain over doing nothing and suffering for years, sure it’s a gamble we all know that but that’s life, everything is.

I can completely understand why you’re cautious though after reading of your lap experience. I’ve read your numerous posts agonising over this and I really feel for you, but just go for it and chances are it will be ok and you can start a new chapter of your life pain free and put this all behind you in a few months.

• This reply was modified 3 months, 2 weeks ago by Oceanic.

[Watchful]

Wow – your incisions are completely different than mine even though we both had a Shouldice procedure. Yours are horizontal, and mine is vertical.

[Oceanic]

Watchful my friend I owe you a beer, I just tried your tip of hoisting my testicles up and I really mean I had to yank them higher than they’ve ever been but 90% of the pain vanished immediately and I had pretty much free range of motion of my legs again.

Thank you so much, I have no idea why this works but it really does, this makes me much more hopeful for a full recovery.

Now I just need to find an undersized jock strap and I’ll be walking pain free.

[ajm222]

you have remarkably little swelling. i had a large lump for quite a while. externally at least it appears good.

[Oceanic]

I think that picture may be deceptive the area above my canals and the area in between is very puffy and full of fluid.

I’ve been doing regular red light therapy too which from past experience hugely helps with wound and internal healing.

• This reply was modified 3 months, 2 weeks ago by Oceanic.

[Watchful]

Glad this worked for you, Oceanic. If jockey underwear doesn’t hold it high enough, you may want to look for some kind of truss.

If I were you, I would share this with Dr. Conze, and see if he has seen this before, or if this makes the potential cause clearer to him.

I hope this problem subsides soon as you heal. Please keep us posted.

• This reply was modified 3 months, 2 weeks ago by Watchful.

[Oceanic]

Dr. Conze kindly got back to Me this morning by email and as expcted he has just been busy at a Hernia conference, he still thinks the problem is swelling fluid around the inguinal canal putting a stretch on the genitofemoral nerve when I stand up. He’s confident when the swelling subsides things will resolve and I tend to agree after the testicle lifting revelation that gives near complete relief. I’m now walking comfortably with a pair of socks wedged under my balls in some supportive underwear.

Who would have thought the answer to my salvation was a pair of socks!

[William Bryant]

Ah yes fluid. Could be that. I had fluid and swelling near the bin hernia flesh wound. Have heard fluid build up is common post hernia repairs.

Brings a new meaning to The sock down the pants trick. (Not that I’m sure rock stars really did that).

[Jack2021]

Thanks for your posts Oceanic and for sharing your experience so openly, I really appreciate it.

I’m also UK based and posted about Dr Conze and the other surgeons in Germany, along with the very limited surgeon options in the UK early on in my research, probably a couple of years ago now. From speaking with them all apart from Dr Wiese, Dr Conze was my preferred option.

I’ve been watchful waiting since, so it’s great to hear about a first hand experience with Dr Conze. I just wish that he wasn’t more than double the price of the other German surgeons, but having worked with Dr Muschaweck in the past, they seem to share a similar price structure.

While it’s important to interrogate the data, there seems to be a lot of unnecessary arguing and overly critical hair-splitting pickiness on the Hernia Talk website these days, which I think will be putting people off from using/posting on the site, which is a shame, as it’s such a fantastic resource. I signposted someone to HT in the hope that they’d post about their tissue repair experience, but they said all the arguing put them off and declined to, so I’m glad you’ve posted your experience and look forward to further updates.

Wishing you a speedy recovery,

Jack

[Oceanic]

Thanks Jack, there are some understandably very traumatised people on here who skew the reality of getting this surgery, if you find a good hernia specialist the odds of getting an excellent happy result are hugely in your favour.

[pinto]

Oceanic, impressive. Not only were both direct but you flew home in just a few days. Great achievement. Was the second one found just before surgery or during?

[Watchful]

Oceanic,

It’s a reasonable explanation. Did he say if he had encountered cases with the same post-surgery symptom before?

In the original Shouldice procedure this nerve is resected along with the cremaster. That would prevent this problem, although that’s not the main reason for this resection.

If this doesn’t improve or go away, I can give you some further information (beyond the lifting trick that I suggested) based on my personal experience, but hopefully it will just go away.

[Oceanic]

@ Pinto, the left side Hernia I didn’t know about but suspected due to testicle pain on that side, it was found at the consultation the day before the surgery, both with Ultrasound and a physical examination, there was no lump though

@ Watchful, Yes the Dr said he has seen this before. He thinks as soon as the swelling goes down it will resolve, he said 1-4 weeks post surgery should do it, I’m not even at 2 weeks yet. What are your tips if it doesn’t go away? PM me if you like but it may help others who read this thread in years to come if they have the same situation.

• This reply was modified 3 months, 2 weeks ago by Oceanic.

[pinto]

Oceanic, btw, I forgot to say thanks for the imaging pic above. It’s helpful for many of us I’m sure. It made me think how placement of incisions are made. Yours seems much higher than mine or maybe you’re a hairy devil. 🙂 If you don’t mind could you tell us about your doc being “enigmatic”?

[Oceanic]

Charismatic would probably have been a better adjective to use

I’m fairly hairy to be fair, the incisions are 6cm above the base of my Penis if that helps you comprare the location to yours.

• This reply was modified 3 months, 2 weeks ago by Oceanic.

[Oceanic]

[Oceanic]

Incisions at 3 weeks post surgery, already significantly better

[pinto]

That’s great news Oceanic and handsome scaring. You take care fella.

[Oceanic]

1 Month Update

Well a bit more time & healing has yielded great results, I can now stand and walk for as long as I like. There is some residual tightness on the left side but to be expected from a double Shouldice procedure, but I’m confident it will loosen as the tissues remodel over the coming months, it may also be from the hardness/inflexibilty of the scars too which I know will also soften with some more time.

I have no pain now so can report this looks like it has been a success hopefully.

I’ll update again in another month.

[William Bryant]

Brilliant Oceanic. I was only thinking last night hope we hear from you so thanks for taking the time.

Glad it’s calmed down. It does take time.

[Oceanic]

2 Month Update

I’m a few days past the 2 month point now and the improvements still continue, the tightness from the stretching and stitching of muscle is getting noticebaly less. I can barely feel the right side and there’s still a bit of tightness on the left but defintely less than a month ago..

Again it’s not pain just a sensation I can feel, it doesn’t bother me. Even the slight electrical shock feelings from the nerves healing has completely stopped now.

The only slight discomfort is from the actual incisions themsleves as the scars are now fairly hard and will be for quite a few months before the skins softens again. I’ve had surgery before so this is no surprise and to be expected.

Overall I’m very happy with the result as the pain I was in before the surgery was quite unpleasant.

Life is slowly getting back to normal. I picked up a 30kg bag the other day and there was no pain or wierd sensation.

I’ll post again at the 3 month point.

[William Bryant]

Thanks Oceanics. All sounding good

[spinotza]

Congratulations on making so much progress after such a difficult surgery.
It was very useful for me to read your journe beause I am day 1 after my own bilateral hernia surgery, this time with mesh. It’s crazy how difficult it is to walk right now even though i feel no pain lying down but so the early days are.

[Oceanic]

Hi Spinotza I’m glad my thread has helped you, if you are comfortbale laying down that is a good sign according to my surgeon, I was in a lot of discomfort walking any distance and even standing for prolonged periods but it sorted itself out, the first week was the worst and then slowly I could walk further each day and the discomfort diminshed, its still vey early days for you so don’t despair, just give it some time, you will be in a lot better place in a week, then 2 weeks more improvements then a month even more, and the healing will still continue for a year or more, its a marathon not a race recovering form major surgery like this. Stay positive. I’m at about 2.5 months post surgery and still feeling changes happening.

[Watchful]

Dr. Conze is wise. The attitude of my surgeon regarding pain after surgery was the opposite. He told me that it was rare to have significant pain after hernia surgery, and having this indicated an increased likelihood of getting chronic pain. Fortunately, I did improve eventually, but it took 8 months to go from what I considered an unacceptable level of symptoms to acceptable.

[Oceanic]

3 Month Update

I’m pleased to report things have continued in a positive direction, the scars and healing ridge are ever so slightly softer and more comfortable now. I still have no pain whatsoever and when I stretch there is barely any tightness felt.

I sometimes forget I’ve had surgery and think about it less and less but still get the occasional twinge and sensation which is be be expected, tissue is still remodeling but it’s in no way painful. Will update again at the 6 month point unless anything changes significantly.

I have No regrets on getting the surgery and although it was a tough first few weeks the experience and skill of Dr. Conze has proved itself with how I feel now and the likely end result.

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