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hernia specialist in New Hampshire
I am seeking the name of a hernia specialist in New Hampshire. I have seen two surgeons. One recommends a laparoscopic repair of a small inguinal hernia on left side. The other recommends Advance Preperitoneal Hernia repair. They both use mesh. I am a thin small boned woman. I have many questions and concerns about the mesh. I am also starting to develop symptoms on my right side.(I think?) Mostly upper leg and hip area. I do not have a bulge on either side. My original pain started on my left side. Lower abdomen. About an inch below bellybutton and to the left. I did not experience any groin pain in the left until I had the dynamic ultra sound. Since then my groin has bothered me, but it has been about 2 months since ultra sound and it is starting to go away. I am concerned that I was not checked on the right side at the time of the ultra sound. I also want a more comprehensive evaluation of both sides prior to surgery. Several doctors looked at my CT scan and did not find a hernia. After the dynamic Ultra sound, the first surgeon I saw could locate the hernia because the US confirmed it. I think I need an MRI, but requested one months ago from my Primary Care when the CT scan didn’t show anything. I kept getting shot down. I am hoping to find a hernia specialist in New Hampshire that has seen occult hernias in women and can give the level of care that Dr. Towfigh gives her patients. I do not have excruciating pain/my original pain has lessened and I am wondering if I really need the surgery. Since it took over a year to figure out what was going on with me, I started Physical Therapy to address my original pelvic pain. First surgeon really didn’t think it was a hernia, and did the US to rule it out, but there it was. I am wondering if exercises and a wait and see approach would be sufficient, but I really need a hernia specialist to determine that. If surgery is to improve quality of life, I feel that mine has improved over time. But I want to be safe and do the right thing. To summarize, this is the information I am seeking:
1. Hernia specialist in NH (or as close to NH as possible)
2. More comprehensive evaluation such as an MRI to determine if I have more than one hernia and the size/location etc.
3. Am I a candidate for exercises instead of surgery?
4. One other thought, I have had 2 laparoscopic procedures done for endometriosis. One at age 30 the other at age 40. I am now 52. Am I still a candidate for lap surgery for hernia repair? Just wondering about scar tissue.
5. Also, for peace of mind, I really want to see a hernia specialist and one that has treated women.
Thank you! -
9 Replies
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hernia specialist in New Hampshire
Hi there.
Did you end up having a hernia and a repair to follow?
Curious to know how you’re doing. -
hernia specialist in New Hampshire
Thank you Dr. Towfigh. I had already heard back from Dr. Adrales and she wants me to go for more tests as well. She wants me to see my PCP to reassess the hernia as it is very small on exam and on the ultra sound and it shouldn’t be causing me to have the bowel and bladder issues or the hip issues. She mentioned an MRI to look at the hip. In any event my PCP will be informed of all that I have found out from you (kinds of testing for hip problem) and Dr. Adrales. My symptoms are not straight forward. (If only I had a bulge…lol) I will keep you posted and I am so thankful to have Dr. Adrales close for my surgeon!
Linda
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hernia specialist in New Hampshire
Hmmmm. Certainly your symptoms are not typical. Dr Adrales is a superb hernia surgeon so I trust that she’s right about your hernia. But you may want to play it safe and make sure you don’t also have a hip problem. That involves a hip series xray followed by an examination and evaluation by an orthopedic surgeon with possible need for an MR arthrogram of your hip.
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hernia specialist in New Hampshire
Hi Dr. Towfigh,
I have a few new questions. I may have incorrectly sent this same note yesterday (so if this is redundant I am sorry).
I am scheduled for surgery on April 21st with Dr. Adrales for a subtle/small left inguinal hernia. She is doing a lap repair with polyester mesh. I am thin and petite. I am anxious about the surgery because my journey to figure out what was wrong took a long time and many doctors. I continue to have many questions about my hernia.1. My original symptoms caused pain in my lower abdomen left of my bellybutton and down about an inch. My abdomen felt really strange and uncomfortable when I had to urinate or with a full bowel. (There was pressure) It also throbbed and with certain movements pinched. Sitting for prolonged times made it feel like there was pressure in the left side of the abdomen. I also felt a strange sensation that traveled down from my rib to the abdomen only on the left side.(kind of like a flutter) In addition, when walking briskly, I felt a pinch in my buttock. My confusion is that my hernia is in the groin and I never had groin pain until I had the dynamic ultrasound. After that ultrasound I continue to have groin pain. My symptoms in my abdomen and my groin come and go depending on my activity level. When I do a core strengthening exercise in which I put my feet up on a yoga ball and do a bridge it seems to activate things. If I am the slightest bit constipated, I can feel the pressure. When I keep this in check I feel great. Also, when doing the hip abduction/adduction with knee fallout, my adductor muscle that goes into the groin bothers me. So my question is, is my pain/discomfort all related to the subtle/early inguinal hernia or could there be something else in my lower left abdomen that is also causing the symptoms as well? Dr. Adrales said that she felt a mild weakness in my left inguinal ring.
2. The PT to strengthen my adductor muscle seems to have cause pain in my left hip. I have trouble sleeping on my left side. It wakes me at night and I reposition. I also, notice the pain when walking briskly and going up and down stairs. Also, the hip flexor stretch that I was doing during PT seemed to go up my buttock and into my lower back. I still have some discomfort from it. My question is, should I be evaluated for this hip pain prior to surgery? Would going to a chiropractor prior to surgery be a good thing. Could this hip pain be related to the hernia? I plan to let Dr. Adrales know about the hip pain and lower back pain as it has continued for three weeks after PT ended.
I really appreciate your expertise in regards to my questions. I have been learning so much about hernias in women but I continue to be baffled by my symptoms which makes me anxious.
Thankfully,
Linda -
hernia specialist in New Hampshire
Pelvic pain during intercourse is occasionally due to pelvic congestion (varicose veins in the pelvis). An ultrasound and/or CT with contrast is the diagnostic test of choice.
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hernia specialist in New Hampshire
Hernia-related pain does occur during intercourse and with orgasm in men and women. In my opinion, I do not believe inter course is actually doing more harm.
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hernia specialist in New Hampshire
Hi Dr. Towfigh and thank you for getting back to me. I am scheduled to see Dr. Adrales on January 7th. In the mean while, my hernia symptoms have been getting better due to a few changes that I have been working on. I make sure that I don’t get constipated and I have been doing some core strengthening exercise. But I did notice one thing. After intercourse, I feel some discomfort in my lower left abdomen. I am wondering if this could be from the hernia or if something else is going on. It is like a dull ache that lasts one to two days. I am assuming that the nerves are reacting but I thought I would check with you to see if this is normal in a woman with an occult inguinal hernia. Please inform…Thank you. Linda
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hernia specialist in New Hampshire
I agree with Dr. Towgigh. If you are unable to find a hernia surgeon in NH, my practice is focused on minimally invasive hernia repair and is located in Massachusetts. You can find my info at http://www.herniamd.com
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hernia specialist in New Hampshire
1. Try Dr Gina Adrales at Dartmouth. She is a talented surgeon with interest in women with hernias.
2. MRI is recommended if Ultrasound is not diagnostic. If trappings shows hernia, no need to do further imaging. In fact, my research paper “role of imaging in the diagnosis of occult hernias” published on JAMA Surgery this week. Show this to any entity or person who refuses to order MRI to help you.
3. Abdominal core exercises may improve your muscle strength around the area of you hernia and improve
Hernia symptoms.
4. Yes! Your prior laparoscopic operations do not prevent you from having laparoscopic hernia repair.Talk to your surgeon. For thin petite women, I do not recommend mesh repair unless it’s done laparoscopically and with lightweight mesh. Other option is non-mesh open repair.
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