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  • Chronic pain that will not go away

    Posted by TJ on August 16, 2015 at 4:25 pm

    This is my first post and I’m sorry that it is a long read but I am out of options and really have no one else to ask. I had my first IH operation in 2008 and everything was going great until I decided to go back to the gym in 2010. I was in the middle of a workout when I felt the mesh tear open. I went back to the original surgeon and he did an MRI but said everything was fine. I went to get a second opinion and the surgeon said everything looked fine but something felt weird and decided to operate. Sure enough the mesh had separated but was still laying in place and that’s why it didn’t show up on the CT. He operated and everything was going great till I was working on my car one evening in 2012 and once again I felt the mesh tear but it was a different feeling than the previous time. I go back to see the surgeon and once again the MRI showed nothing. I go for a second opinion and that surgeon says everything looks and feels fine but I do have a IH on the opposite side. The day of the surgery I explained to him that I was very uncomfortable with him not at least going in and looking at the side I have been having problems with. After the surgery he said he fixed the new IH and when he looked at the side that I had been having problems with he discovered that the mesh was still attached as it should be but the mesh had split down the middle. I was in shock but he had pictures to prove it. So he plugged it and once again everything was going good. Then in late 2013-early 2014 I was again working on my car and felt the mesh on my left side rip open (the new side) and I go through the same MRI routine. They tell me everything is fine but at this point I do not trust the MRI machines because I’ve been down this road too many times. The surgeon tells me its just swollen seminal vesicles and I listen to him and go to a urologist. He treats my but my nausea (which I experience every time I rip open a patch) has not gone away and tells me that there is no way the swollen seminal vesicles could be causing that. This time I go to another surgeon and he tells me that my left side patch did indeed rip open. He told me that since I’ve had so many problems that he put a small patch over the incision then a larger patch over the smaller one on both sides. Well once again everything was going great till about 5 months later when I went to get into my truck. I set down and felt something pull and immediately after that everything started convulsing and I became very nauseated. After about 30 seconds the convulsing stopped and I managed to make it home but stayed on the couch for 4 days. Well the convulsing never happened after that night but I had issues with the nausea and it has been hard to stand for long durations. I also have had a lot of pain in my left testicle and have been having issues with my left leg going numb. I kept hoping that this will get better but a couple weeks later the pain started to increase and I noticed some bruising on the underside of my penis and a bruising line that runs down and divides my testicles. Well here it is in 2015 and I’m still having issues with pain in my testicles and left leg. I can’t even go to the gym to walk on a treadmill because long strides cause a good bit of discomfort. I’ve been telling myself that this is something that I’m just going to have to live with but I thought I would post this to see if there is any hope that one day I might have a normal life. I’m 33 and have given up on the gym, working on cars, and other typical guy stuff just so I can function at work. If I do anything to aggravate my current situation then I miss work due to the pain. Any help or words of wisdom will be greatly appreciated. I live in Texas if that helps. Sorry for the long post.

    drtowfigh replied 8 years, 5 months ago 2 Members · 3 Replies
  • 3 Replies
  • drtowfigh

    Moderator
    October 4, 2015 at 5:20 pm

    Chronic pain that will not go away

    Based on your description, you may have a genitofemoral and/or ilioinguinal nerve injury.

    Did you get local anesthetic injection by your pain doctor? This should help. It’s a bit difficult to do for that nerve in particular. If your pain doc can’t do it, seek one who can.

    You may also have an occult inguinal hernia. Dynamic ultrasound or MRI pelvis should help discuss this.

    I can help you if you wish to drive up a couple of hours. Dr Chen is also an excellent resource, also in Los Angeles.

    I don’t recommend re operation unless you have no long term improvement in your symptoms or if you have an inguinal hernia as the cause of your symptoms.

    Btw, did your original preoperatice pain ever get better?

  • TJ

    Member
    September 10, 2015 at 1:58 am

    Chronic pain that will not go away

    Thank you for taking the time to respond to me. In the past the mesh usually rips off, I can tell because I can feel the patch come loose. This may sound crazy but I can literally count the stitches as they pop off. I have also had one of my patches tear in half. So when they repaired the one on my left side they went in and plugged the one on the right that tore. I forget the exact name of the patch that was used but I am aware of the ones that were recalled and the ones that are installed now are not the ones on recall. The majority of my operations have been open but my last one was laparoscopic. As far as the size of the patch goes, I currently have a smaller patch over the direct point of the repair and then have a larger patch over that one on both sides. I went to see a nerve specialist last week and he injected me with a temporary nerve blocker in a couple areas to diagnose where my pain is coming from and he is fairly confident a surgery to clean up the scar tissue and nerves will releave my pain. I am going back to see him in a couple weeks to discuss the surgery and recovery process to see if I want to proceed. Other than a numb leg after the injections, it was the best I have felt in years so hopefully there is a light at the end of a tunnel, but unfortunately I’ve thought that after my previous surgeries. I really just want to get on with living my life. If this doesn’t work I will travel where ever I need to go in order to be able to finally live again.

  • drtowfigh

    Moderator
    September 6, 2015 at 10:59 pm

    Chronic pain that will not go away

    Dear TJ from Texas:

    Some thoughts comments and questions for follow up:

    – mesh can tear off its repair and it can also tear in half (though that is less common)

    – nausea can be a sign of hernia occurrence

    – it is certainly not expected that every single hernia repair you have be torn or tear off. We have to figure out why this happens so that it is not repeated with the next repair. So here are key questions to have answered prior to the next operation:
    1. We’re all of these open style repairs (ie, a scar in the groin)? If so, did anyone talk to you about performing your repair laparoscopically? That is usually the go-to technique when open has failed.
    2. What types of mesh were used and of what size? Do you know the surgical technique or the brand of the mesh used? These should either be noted in your operation report or elsewhere in your surgical chart. Lightweight mesh is more likely to fail than heavier weight mesh. Small size mesh is more likely to fail than larger size mesh (3×6 inches or larger).
    3. What risk factors do you have which make you prone to hernia recurrence? Any of the following: constipation, chronic cough or asthma or bronchitis, nicotine use of any form, overweight or obese, family history of hernias, immune suppression or healing problems such as with use of steroids, collagen disorders, diabetes, other medical problems such as cirrhosis?

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