News Feed Discussions Did I get Botched? Inguinal Hernia Repair Complications

  • Did I get Botched? Inguinal Hernia Repair Complications

    Posted by Luke7 on October 22, 2019 at 11:17 pm

    Hi,

    I am not sure what to do so I thought it would be helpful to get some outside perspective. I’m a 37-year-old Male with no previous medical issues and was in great shape. I’m an Electrician by trade.

    A year ago, I went to the doctor because my right testicle was beginning to swell a little and I had mild pain in the lower abdominal. I was given an ultrasound and they said I had a small right Inguinal hernia, right hydrocele in my right testicle and a small hydrocele in my left testicle. About a week later while at work I noticed my testicle swell up much more and my right pelvic area had become super painful.

    I saw a general surgeon who initially prescribed anti-inflammatories. After a couple weeks of them not working he recommended open hernia repair with mesh.

    During surgery the surgeon found that I did NOT have a hernia but rather the “Inguinal floor was weak” so he decided to install the mesh anyway as a preventative measure to reinforce the inguinal floor in order to avoid a potential hernia in the future. He also found a cord lipoma and excised it off my spermadic cord.

    I waited a month and went back to have a Urologist perform a Bi-Lateral Hydrocelectomy.

    I healed up and went back to work.

    It’s never felt quite right but I figured there would be some residual pain so that is life..

    Almost exactly a year later, while at work I noticed my right testicle swelling back up and soreness where the mesh had been installed. I had 2 ultrasounds done over the course of a month and the results are that I have a “new” right inguinal hernia adjacent to the mesh that was installed, and I also have epididymitis. Every doctor says the epididymitis (infection causing the epididymis to swell) is not related but both symptoms occurred at the exact same time.

    I couldn’t get into see a surgeon right away, so I went to the ER because the swelling and pain had become almost unbearable one day. They gave me a ton of antibiotics and some pain relief.

    I was prescribed at least 5 different antibiotics over the course of 2 months and nothing has stopped the inflammation in my testicle. Which leads me to believe that it is not an infection but rather a symptom or side effect of this new hernia or the existing mesh.

    I finally saw a surgeon that was not willing to accept that these two could be related and ordered an MRI. Now, the results from the MRI actually show that I DON’T have a new hernia… Now I’m totally confused.

    I have been dealing with this for almost two months now, out of work, in pain that is consistent with an inguinal hernia. My pelvic is sore to touch and I get shooting pains all the time. My right testicle is tender, and the inflammation of my epididymis does fluctuate but is constant. It feels like my right testicle is being squeezed most of the time. Not so much in the morning but especially when walking around or on my feet all day.

    Now that I know that I don’t in fact have another hernia and that really, I never had one in the first place why am I dealing with this?? I feel like there is a complication with the mesh that was installed and it’s causing inflammation and continuous pain. What’s extremely frustrating is that all this could have been avoided if the doctor had not installed mesh where there was no actual hernia. The more I research the more options I find including non-mesh hernia repair. If this is an option for actual hernias, why would they install mesh where there wasn’t even a hernia? I would like to just remove the mesh but at this point I think that might create a hernia… I don’t know, I’m lost at this point.

    I met with a Hernia Specialist recently and she referred me to a pain clinic and if they can’t help then she said surgery might be an option. If I just got get a nerve block or some other temporary remedy, won’t this pain just return at some point down the road making surgery inevitable?

    I’m really trying not to write a book here and just keep it concise. Based on what I’ve written so far, does it sound like I got botched or is this just a typical complication? All of this just really doesn’t seem right to me…

    Thank you for any help or advice in advance,

    L

    Good intentions replied 5 years, 1 month ago 4 Members · 7 Replies
  • 7 Replies
  • Good intentions

    Member
    October 27, 2019 at 9:53 pm

    [USER=”3038″]dixonv66@email.com[/USER]

    Can you get the actual details of your surgery, including the type of mesh used? There are many different types, even for open surgery. The Prolene Hernia System (PHS), “plug and patch” (with a variety of mesh designs within that category), Onstep, flat Lichtenstein-type mesh placement, etc. Plus the different knit patterns and material type (polpropylene, polyester, PVDF, etc.) on top of the forms. It’s chaos.

    It sounds like you had a preventative triple neurectomy, which is a way for the surgeon to feel like they are removing the pain transport method, but ignoring the potential for neuromas caused by the cutting. Most surgeons, Dr. Towfigh included, say that preventative neurectomies are not the “standard of care” for hernia repair. But it sounds like you got a maverick surgeon.

    You should get your records and consult with a mesh removal surgeon. Not that they will remove the mesh but they will be more open-minded to the cause of your pain. Your original surgeon has a vested interest in avoiding a mesh-related problem, or even a surgery-related problem. The current meme for hernia repair is that only poorly skilled surgeons will have patients with problems. It’s a meme that keeps surgeons quiet and afraid to acknowledge problems.

    Good luck.

  • dixonv66@email.com

    Member
    October 27, 2019 at 8:24 pm

    i had inguinal open surgery with mesh in january 2019. the chronic pain i have is far worse than before surgery. i have dull constant lumpy pain that feels like a lump is dropping into my upper inner thigh from my groin. i also have sharp shooting pains in the groin that feel like something inside is ripping. i also have a hard time sitting up straight and the pain that makes it hard to sit up because the pain radiates from my groin to my lower back. i have been working construction that requires lifting 80 to 180lb objects. i have lost dozens of days of work due to pain. i called my surgeon and spoke to his head nurse and expressed concerns of a failed surgery and she tried to ensure me that it was not possible for the surgery to have failed. she said no matter how much weight i was lifting that it would be impossible for the mesh or surgery to have failed. she also told me that there are three nerves that are cut in an inguinal surgery and it will just take time for them to heal. i dont know what to do at this point because the pain is chronic and debilitating at times. the pain and discomfort is 100 percent of the time. does any of the pain i describe sound familiar to anyone?

  • DrBrown

    Member
    October 24, 2019 at 8:24 pm

    [USER=”3030″]Luke7[/USER]
    Dear Luke.
    Most likely the mesh is wrapped too tight around the spermatic cord, or the cord has become scarred to the mesh.
    A Spermatic cord block may provide some relief.
    Sometimes injecting the mesh with steroids will provide relief.
    But there is a high chance that you will want the mesh removed.
    Regards.
    Bill Brown MD

  • Luke7

    Member
    October 23, 2019 at 3:45 am

    Also, this is something I can’t seem to get a answer on. Is it a possibility that whatever complication that is happening with the mesh is causing epididymitis? Or could it be a result of my previous surgery somehow? All doc’s so far that I’ve talked to say these two things can’t be related as epididymitis is typically a sign of infection from an STD.. I was tested for everything and I’m negative of any. Also, I was fed different antibiotics for over a month and inflammation still remains.
    These issues are literally inches apart, noticed them both at the same exact time and it’s uncanny that the last time I went through this I had a hydrocele on the same the same right testicle, only now its epididymitis. It seems pretty clear to me that the pain in my groin is the cause of inflammation. Any thoughts on this?

    Thanks again,

    Luke

  • Luke7

    Member
    October 23, 2019 at 3:14 am

    [USER=”2029″]Good intentions[/USER] thank you so much for your response.

    I was working at the same level but I think I did exert myself before the re-occurrence. When at work, I lift heavy supplies on a daily basis so it’s hard to avoid it.

    In the post op report it states that the surgeon chose to “buttress it in a Lichtenstein manner using a light weight wide weave polypropylene mesh”. It doesn’t tell me the brand, though.

    My new Surgeon has 19 years experience and she focuses almost solely on Hernia repair at UW Medicine. Her name is Dr. Nicole White. When I met with her I was really impressed with her professionalism and she did give me confidence that I am good hands. She really took the time to listen.

    I can understand the protocol thing you mentioned. It would make sense to exhaust all options before going back in to an area that was just operated on.
    My biggest concern is that the solution to my problem will be to do just that and remove or replace the mesh which will most likely lead to more potential complications and nerve pain. Also, that the pain management approach will just drag out the inevitable of having another surgery.. I’d really rather not just put a band aid on it, so to speak, but rather get to the root of the problem so I can hopefully just heal up permanently.

    I also feel like the first surgeon maybe should of held off on implanting the mesh when he realized that I didn’t actually have a hernia. In your experience is this typical? If I were aware of this discovery at the time, I would have opted out of installing the mesh in the first place.. It’s very frustrating not knowing whether that was normal protocol or if he used bad judgement and this could of all been avoided..

    Anyway, thanks again for taking the time, if you have any more advice on how I should proceed, it is really appreciated.

    Luke

  • Good intentions

    Member
    October 23, 2019 at 1:01 am

    [USER=”3030″]Luke7[/USER] [USER=”2580″]DrBrown[/USER]

  • Good intentions

    Member
    October 23, 2019 at 1:00 am
    quote Luke7:

    It’s never felt quite right but I figured there would be some residual pain so that is life..

    Almost exactly a year later, while at work I noticed my right testicle swelling back up and soreness where the mesh had been installed.

    I finally saw a surgeon that was not willing to accept that these two could be related and ordered an MRI. Now, the results from the MRI actually show that I DON’T have a new hernia… Now I’m totally confused.

    I have been dealing with this for almost two months now, out of work, in pain that is consistent with an inguinal hernia. My pelvic is sore to touch and I get shooting pains all the time. My right testicle is tender, and the inflammation of my epididymis does fluctuate but is constant.

    I feel like there is a complication with the mesh that was installed and it’s causing inflammation and continuous pain. What’s extremely frustrating is that all this could have been avoided if the doctor had not installed mesh where there was no actual hernia.

    I met with a Hernia Specialist recently and she referred me to a pain clinic and if they can’t help then she said surgery might be an option

    I’m really trying not to write a book here and just keep it concise. Based on what I’ve written so far, does it sound like I got botched or is this just a typical complication? All of this just really doesn’t seem right to me…

    Thank you for any help or advice in advance,

    Were you working/functioning at the same level when the pain reappeared or did you exert yourself before it happened.? Mesh has been known to tear free and cause new pain. Do you know what type of mesh was used for the repair? There are many different types and sizes and some have more complications than others. It;s important to now exactly what the first guy used, how much, and his method of implantation, if you can. The records should be available.

    Hernia repair is now a business, not so much a passion for healing. Your first surgeon was sold a type of mesh by a device maker’s rep and trained in how to use it and told that it is harmless. He didn’t know. Your second surgeon is following what seems to be the new “thing”, sending people off to pain management to try to save the mash before recommending mesh removal. You’re in the mesh repair “system” protocol now. This new protocol could actually have long-term value if the results are collected and shared. Certain types of mesh probably have common problems.

    Is your second surgeon an actual hernia repair expert or does she just work at a hernia repair center? Make sure that you find a surgeon with years of experience and an objective view about what your problem is. There are many surgeons today who made it through medical school and residency and learned the minimum necessary to get the mesh in, but might not really be well-versed in all of the potential problems it causes.

    Good luck. Keep searching for the right doctor. There aren’t very many.

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