Did I injure/damage my repairs?

Hernia Discussion Forums Hernia Discussion Did I injure/damage my repairs?

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    • #28085
      jzinckgra
      Participant

      This forum is an asset that helped answer questions I had previously, however I was hoping I wouldn’t have to come back:). I’ve had two small inguinal hernia repairs, left side in 2017 fixed with lapro and right side fixed with open mesh repair in 2019. I’m an active cyclist and workout in the gym.

      Both repairs have provided mostly pain free experience. Occasionally, I will get a couple days here and there where one side or the other has what I would call a flair then goes away. Last weekend I was using my chainsaw cutting down some trees. I cut some of the trees up into smaller 4ft sections and carried them a short distance from the woods to driveway. These pieces probably weighed ~50-60lbs, not that heavy for me. I try and make sure I don’t lift stupid heavy things anymore or create massive straining, however while I was carrying the wood pieces out I started feeling some pain on last year’s repair. I finished what I was doing, but for the last several days, I’ve had that pre-surgery repair feeling of dull off and on pain with some dragging. Even the left side that was fixed three years ago has been a bit sore. I find it hard to imagine that I caused a recurrent hernia in both repairs, but anything is possible. Walking up last several mornings has been fine, but as soon as I’m up and about walking around the pain starts. It’s not sharp pain, but that nagging dull to colicky type ache.
      I see no visible bulging on either side, but am a bit worried I may have injured myself. Could this just be scar tissue that has stretched? I can’t fathom having to have more hernias and surgeries. Two was enough for me. Thanks.

    • #28098
      jzinckgra
      Participant

      Dr. Reinhorn who conducted surgery said to give it another week then do an in-person assessment. He thinks it’s likely a core muscle injury.

    • #28099
      Good intentions
      Participant

      Tissue remodeling after the initial surgery and implantation can go on for years. On top of that is the persistent foreign body reaction that the mesh causes. Ideally some sort of comfortable middle ground is found between the two, with the individual mesh fibers being encapsulated in a way that allows your body to function properly

      Your first thought seems most likely. You stretched the tissue in and/or around the mesh. The mesh and the tissue that has filled in its pores is not as flexible or elastic as the tissue around it.

      Search “wound healing”, “tissue healing” and/or “tissue remodeling” on the internet and you’ll find a bunch about what’s happening in there. Probably best to let the tissues heal and/or rebond to the mesh if some has been pulled free. Since the mesh is placed on the muscles of your core, “core muscle injury” would be technically correct.

      Good luck.

      • #28243
        Thunder Rose
        Participant

        Dr. Reinhorn is a big fan of the Nyhus repair. Since your mesh is large for an open repair that’s probably what you have. With the Nyhus repair the mesh is in the posterior space normally accessed in a laparoscopic or robotic repair. It seems likely your PCP hasn’t encountered this type of repair before and may be misinterpreting what she felt.

    • #28100
      jzinckgra
      Participant

      GI, thanks for your reply.

    • #28101
      Alephy
      Participant

      The ultimate mesh if it will ever exist will be the one that minimises scar tissue growth in my opinion; this is a major downside of the implants….I am wondering what kind of PT athletes do after the surgery to minimise the formation/impact of the scar tissue, although the process I guess cannot be stopped?

      I find it really outrageous that many surgeons still claim that the mesh is “inert” and does not cause any reaction (some told me this to my face during consultation!)

    • #28229
      jzinckgra
      Participant

      Lucky me, I had my annual physical with my PCP today and she said she could feel a hernia just below the repair I had last year. Can’t say I’m surprised based on recent nagging pain again, but very disappointed. The repair was 16 months ago. PCP thinks the hernia is pressing just below where patch likely is. Not sure if patch moved over last several months or possibly it wasn’t placed optimally, but will call surgeon next week. Given this was an open shouldice repair, can this be fixed with another open or must it be lapro?

    • #28230
      Alephy
      Participant

      I am confused, did you have a mesh repair or a Shouldice?

    • #28231
      jzinckgra
      Participant

      Sorry, it was mesh repair

    • #28238
      jzinckgra
      Participant

      Juts to clarify, I had mesh repair not shouldice. Anyways, I called surgeon and they obviously need to see me in person to check for recurrence. Kinda stinks as they are 2.5hr away from me, but I realize this is the only way to know. I am starting to question my PCPs diagnosis thinking that maybe what she felt when I coughed was the hernia pressing against the mesh and not on the outside perimeter of mesh. As I said, I do not have visible buldge. The mesh size used was ~4×6″ and given I am a lean guy (6’1″, 155lbs), it seems hard to imagine the hernia would be poking out below the lower perimeter of the mesh. If this were the case, it would practically be at the base of penis, which seems very unlikely and isn’t where it hurts anyways. Today I feel totally fine. It just waxes and wanes from one day to the next.

    • #28239
      Good intentions
      Participant

      The hernia sac can travel quite a distance. It almost like a liquid that just follows the path of least resistance. Imagine the path it follows to get in to the scrotum, and the amount of material that can end up in the scrotum. Softball size is not uncommon. I think that hernia sacs getting underneath a mesh implant is a common cause of recurrence.

      You said 4×6 inch piece of mesh, which is large for an open repair. But there are many many different types of open repair. And it is not uncommon for mesh to move, and shrink, that’s why they use such big pieces. Sometimes it just keeps moving until it balls up.

      Do lots of research before you see any surgeon. The “standard” for mesh pain is neurectomy, often as a preventive measure. It’s not supposed to be but there is incredible leeway in what a surgeon can do in hernia repair.

      Since you’ve had fairly good results so far it would be a great shame to slip down the slope to chronic problems. But you are right on the edge, I think. Make sure that you understand what your surgeon plans to do and that you trust their track record.

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