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Could this be an occult hernia? How/where can I get an accurate diagnosis?
Hello! I experienced pelvic pain (among other things) before, during and after my menses last month (Sept 2018). Right away, I was sent for a transvaginal ultrasound, which proved inconclusive. My symptoms are:
- General overall weakness/can’t function
- Flatulence
- Groin lump/swelling (right side)
- Intermittent burning sensation on front of thigh, groin area, outer hip, back
- Pinching pains in pelvic area, groin area
- can’t sit upright for long periods without pain
- can’t drive without pain
- spend some days in bed, unable to function
My ObGyn wants to scan again in 6 weeks. I pushed the issue with my HMO and saw an internal medicine doctor, who says he suspects endometriosis because the birth control prescribed my the ObGyn has helped my symptoms. Can you really get endometriosis at age 49? The internal doctor also told me that he could rule out hernias entirely because I had no prominent bulge and asked me to be more patient with the diagnostic process. Truthfully, I have experienced debilitating pain when sitting for long periods of time or when driving since August 2015, when I ran a half-marathon (which I shared with my doctor) Initially, this issue manifested as back pain and I’ve been on muscle relaxants for that pain since March 2017. Who can I trust to rule out hernias? I am in the Portland, OR area.
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4 Replies
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Dr Martindale has not retired, I just had surgery with him in August and am seeing him again in November… but not sure if he is taking new patients? He has done 4 surgeries on me and is great! Unfortunately I am just swiss cheese it seems..
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Sounds like a hernia to me.
We have a lot written about “hidden hernias” or “occult hernias” on this site. Search them.
Dr. Martindale has retired. Seek consultation with Dr. Orenstein. He can help you in Oregon.
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I’m sorry you’re going through this.
Regarding an occult hernia: you might want to request a dynamic valsava ultrasound of the inguinal region where the location of pain is. It is essential that it is done with valsava (sometimes even while standing) so that adequate intra-abdominal pressure may reveal a hernia. You might even want to aim to schedule the ultrasound while you’re actively the most symptomatic, so if you know you’re most symptomatic during menses that could be the timeframe to schedule the ultrasound for. Just a thought.
Ultrasound of the inguinal region should be pretty effective at finding an ‘occult’ hernia, and they’re cheap enough that insurance usually doesn’t fight the imaging request.
Here are some potential resources for hernia surgeons on the west coast that may be a helpful starting point:
– Dr Sean Orenstein in Portland, OR
– Dr Robert Martindale in Portland, OR
– Dr Paul Dally in Vancouver, WA
– Dr Peter Billing in Seattle WA
– Dr Michael Mastrangelo in Bend, OR
– Dr William Brown in Fremont, CA
– Dr Shirin Towfigh in Los Angeles, CA
– Dr David Chen in Los Angeles, CA
– Dr Edward Phillips in Los Angeles, CA
– Dr Robert Burns in Newport Beach, CA
Good luck and keep us updated on your case and decision making.
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Lisa A, I thought I’d weigh in since I have had some similar experiences. Firstly, if your doctor said he can rule out hernias entirely because there is no visible bulge then you need to see another doctor! That statement is false. I have had several hernias with no bulge. Also, when my pain first started I was told that maybe I had endometriosis at the age of 47 and after having 4 kids. Ridiculous! Of course, I didn’t have endometriosis. A lot of the symptoms you describe are symptoms of a hernia. You need to see a hernia expert to help with diagnosis. I know Dr. Sean Orenstein is in Portland Oregon and his name has been mentioned on this forum before. He may even be a contributing surgeon. Dr. Robert Martindale has also been mentioned and is in Oregon. I would check with these doctors since your current doctor doesn’t seem to be a hernia expert. Best wishes in finding the proper diagnosis and treatment!
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