Female pelvic pain, hernia?

[drtowfigh]

Female pelvic pain, hernia?

Hi there
Please let us know how you’ve progressed and if you have found a diagnosis. We can all learn from your experience.

[drtowfigh]

Female pelvic pain, hernia?

I am not an advocate of surgical options prior to exhausting non-surgical means of gathering a diagnosis. That said, there have been situations in which my patient has been in so much pain, and studies have been normal or at least non-diagnostic, and thus I have offered exploratory laparoscopy.

The important question to ask if whether your surgeon is laparoscopically skilled in hernia repair. If a hernia is noted, is the plan to repair it laparoscopically or to convert to an open repair. If an open repair, does your surgeon plan of placing mesh or not? All of these are valid options, but you should know the plan of care ahead of time.

Also, as has been mentioned many times on this discussion board: if exploratory laparoscopy does not show an obvious hernia, and there is clinical suspicion for a hernia, then it is imperative that the peritoneum (lining of the abdomen) be taken off the muscle and the muscle of the abdominal wall be directly visualized to truly and completely rule out an occult/hidden inguinal hernia. This phenomenon is more commonly seen among women, which is why I am stressing it for you. The plan must be to take down the peritoneum along with the associated fat and visualize the hernia orifices (holes) as fat may cover the holes and small hernias (which can cause pain) may be missed.

There is low risk of injury to nerves with laparoscopic exploration, though there is risk. There is also low risk for adhesions from laparoscopic exploration.

[Jlteam5]

Female pelvic pain, hernia?

Thanks Dr. Towfigh. I went to see a surgeon today and he offered to do a Laproscopy to see if there were any hernias. He felt a standing ultrasound wouldn’t benefit much. He review my MRI’s and didn’t see anything. This laproscopy would be purely investigational. He would repair any hernia with mesh. What are the risks of this? Is there risk of damaging genitofemoral or illinguinal nerve or risk of adhestions even if nothing is found? I guess what I’m asking is if I don’t have any hernia to repair is this procedure pretty safe? Does the blowing up of abdomen with air have any risk of damaging nerve or adhesions or only problems at the site of incision through belly button. Thanks so much. I really am struggling with the decision to do this or not.

[drtowfigh]

Female pelvic pain, hernia?

Clitoral pain is not usually hernia-related. It is more consistent with pudendal neuralgia, which is a very difficult diagnosis to make and treat as there are very few specialists in the nation. Michael Hibner in Arizona is the nation’s leading expert.

Alternatively, labial burning without clitoral involvement can be due to a small hernia. This is due to irritation of the ilioinguinal nerve by the small hernia. A hernia specialist, especially one who is aware of the concept of occult inguinal hernias, can help rule this out. MRI pelvis with valsalva or a well done hernia ultrasound will help rule this out.

Reach out to Dr Matt Morgan in Pella, Iowa. Also Dr Luis Jose Garcia at University of Iowa. They are both savvy hernia specialists that may help you.

Gynecologist a who specialize in vulvodynia may also be helpful to determine causes.

[Chaunce1234]

Female pelvic pain, hernia?

jlteam5 – Could be a Bartholin’s gland cyst. A gyn doc could help sort that out. Also, you can find surgeons interested in hernia repair at the Americas Hernia Society website. Hope this helps! If I hear of any Iowa general surgeons I’ll let you know. DE