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Discomfort after 1.5 years of my inguinal hernia surgery, possible root causes?
Hello all. I had a double-sided TEP inguinal laparoscopic hernia surgery in September 2019. My surgeon placed a mesh to fix both hernias. It took me one year to become 100% pain free. After one year, I was very happy to become pain free. However mid of December 2020, I woke up one day and felt pain on right side of my groin close to the surgery area. It was like something torn inside. I had a pulling sensation and feeling discomfort when I was sitting. FYI, since hernia surgery, I am not doing any sports, just walking like 5 km per day. I also paid a lot of attention for not to lift any heavy things. The day before this problem happened, I was not doing any sports or lifted something. I waited three-four weeks to see if I am getting better. I did not have the symptoms, when I had my hernia. There is no lump, no color change on my skin, touching my skin is time to time tender, but not all the time. No pain if I push my skin in my groin and surgery area. I have no pain when I lift items, or when I cough or sneeze. After two months, I had slight improvement, but not fully recovered. I went to my GP. He checked me and he said he did not believe I have a recurrence and said most probably I have a tendon or muscle problem in my groin. I was a bit skeptical, as I am not doing any sports, so how I can damage my tendons or muscles. He advised me to go to a physiotherapist. I could not get a direct contact with my surgeon, as I had my surgery in my home country and now living in a different country and I could not travel due to restrictions with pandemic. Now I am going for PT for 4 weeks, and my PT started to say he thinks I am not having a tendon or muscle problem, because most of the things he had tried to diagnose me, I am pain free and I am not showing too much progress. For the moment, my complaints are, pulling sensation on my right groin close to surgery area, discomfort while sitting, discomfort while lying on my coach sideways and feel need to separate my legs. I got the impression that when my right groin area is squeezed, (like when I am sitting, lying sideways my legs are together) I feel discomfort more. Couple of strange things. I feel pulling sensation less or almost not, when I am wearing my jeans, but with loose clothes like my pajamas I feel most. Also, when I am walking, after around 20 minutes, on my right side I feel itchiness under the skin coming inside my body. When I complete my daily walking session, it disappears in 5 to 10 minutes. This was not happening in the beginning. It is there for last 10 days. I do not have any radiating pain problem, and my PT believes I do not have a nerve issue. He advised me to go back to my GP, as he believes I do not have a problem with my tendons or muscles. I am suspicious of maybe a mesh shrinkage, displacement or folding. My second suspicion is somehow I have pulled, damaged the scar tissue there. I am not sure what my GP can do if I will go back during this pandemic time. Now I am approaching to four months timeline with this problem and to be honest, I think like I am 30% improved to the initial condition. There is some improvement but not so much. I know it is very difficult for doctors here to help me online, without seeing me, but looking forward to hear opinion of some doctors here or people experienced similar things about how likely the things I am suspicious might happened. I hope it will resolve by time, but the speed of recovery makes me pessimistic. I am afraid, I am joined to the people having chronic problems with their meshes. I really appreciate some feedback and thanks in advance everybody for your opinions, much appreciated.
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2 Replies
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Most patients who have symptoms 1+ years after an otherwise fine hernia repair or recovery have a hernia recurrence as the cause of their symptoms. The next step is accurate imaging to identify the hernia repair and look for recurrences.
If you saw me, I would order an MRI. Every surgeon handles this differently.
Most mesh-related chronic problems start within days to months after surgery and not 1-½ years later. Perhaps this is helpful.
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Dear Dr. Towfigh, thanks a lot for your reply and insight. To be honest I did not think about recurrence due to several reasons like, I do not have the symptoms I had when I have my first hernia like continuous pain, time to time sharp pain, pain when coughing and sneezing and lifting heavy things. Also when I had my first hernia, my situation got worse with time and now it is getting a bit better, but very slowly. I think it is best to go back to my GP, as you advised to ask for imaging to see if my previous repair is good and/or if I have a new hernia. He did the physical examination, which is pushing a point near my scrotum and ask for coughing, and said I do not have any hernia this time. However I do not trust this technique that much, as when I had my first hernia, he could not diagnose the hernia on the left side and that was found after ultrasound, before my surgery. I still would like to think this could be a temporary problem related to the scar tissue around that area rather than a recurrence. You mentioned it will be very unlikely to have a mesh-related chronic problem at this stage. Looks like best will be asking for an imaging analysis to be sure.
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