Hernia surgery if small and painless? During covid?
Tagged: Shouldice inguinal
07/09/2020 at 5:05 pm #26944
Hi guys. Longtime lurker. I really appreciate all the info you have posted on this site, it’s very helpful.
I have had a painless small right inguinal hernia for the past few months, and finally have a shouldice procedure scheduled for next week. The doctor does mesh and shouldice, and he seems gung ho. I’m starting to wonder if it’s a wise idea to have a procedure, potential immediate complications that require care, and follow up, etc, at this particular time as covid 19 rages unchecked. I guess it’s a personal decision, but just wondered what any other watchful waiters thought? Also, at least it’s an option now, whereas elective surgery could get shut down again in a month….
07/09/2020 at 5:52 pm #26945AlexanderParticipant
That’s a very fair question. What state do you live in? Generally, I would say that you will be safe – the hospitals have very strict protocols in place and if they are still doing elective surgeries then I wouldn’t worry too much about getting covid. Most likely you and every other person having surgery will get tested the day before or the day of surgery and all of the staff surely will be wearing masks.
07/09/2020 at 7:32 pm #26946
I’m in Illinois, we’re doing better than most states but the numbers are slowly rising. I feel like the procedure itself will be pretty safe, but all the additional follow up visits and waiting room time, plus the risk of complications putting me in an urgent care or something, are small but not zero? I’ve also realized from this site some people wait YEARS to fix their hernias, and maybe there’s some logic to that instead of rushing into it…
07/09/2020 at 9:02 pm #26947Good intentionsParticipant
You’ll find quite a bit out there also, about surgeons who say they do the Shouldice procedure but actually do something different. Different sutures or a “modified” procedure. You might not actually be getting the procedure that gives the excellent results.
And, it’s not uncommon to go under general anesthesia expecting one thing and wake up finding that you got something else. Your surgeon will probably tell you that they will do their Shouldice procedure unless they think that mesh will give a better result.
Finally, your surgeon is probably “gung-ho” because business has dried up and he/she needs to catch up. No patients means no cash flow. Hernia repair is the cash cow of the general surgery practice. High volume and a steady supply of patients.
Be very careful of the things that you would normally be careful of even without the COVID problem. If I wanted Shouldice I’d go to Canada, to the Shouldice hospital.
07/09/2020 at 9:37 pm #26948AlephyParticipant
I think doctors (the real ones) tend to say that if the hernia doesn’t bother you and it’s not in the way with the life you want to live, then don’t touch it…so does it bother you or get in the way? There are then those doctors that will tell you that it’s dangerous because it can get strangulated, that it will get bigger and more painful, that it’s better to do it sooner rather than later, that it is easy no recurrence very low chronic pain rate etc etc: stay away from them
07/09/2020 at 10:11 pm #26949
It doesn’t hurt at all. It slips out a couple times a day, but usually reduces after I lie down for a couple minutes, so doesn’t get in my way too much. Mainly just worried that it would get worse, tho various sourc s say it’s pretty safe to wait. The procedure is definitely a modified shouldice, at least in that he doesn’t use the stainless steel sutures. I am a bit concerned he might fall back on mesh if there’s a problem, though. Would a surgeon commit to not using mesh, if they thought it was the only option or necessary? I bet most of them wouldn’t.
07/09/2020 at 11:35 pm #26950AlephyParticipant
You should ask the surgeon and agree in written form on what they can or cannot do….my 2 cents….if necessary take your time and don’t rush for it
07/10/2020 at 11:59 pm #27017JamesDoncasterParticipant
Given how serious the risk of chronic pain is from any hernia procedure (either with or without mesh), there’s no way I would opt for surgery unless my hernia was causing me pain or was dangerous.
07/15/2020 at 1:48 pm #27375DrBrownParticipant
the risk for incarceration is small, so if the hernia is asymptomatic then it certainly does not need to be repaired at this time. If you take 100 patients with an asymptomatic hernia, in 18 months about half of the patients will decide to have the hernia repair because of symptoms.
if you travel to 3rd world countries a lot, that would be a another reason to consider hernia repair at this time.
but watchful waiting is a very good decision.
Bill Brown MD
01/02/2021 at 1:24 pm #28380
How do you define “Asymptomatic hernia”? I have a slightly visible bulge but no pain.
Or means “Asymptomatic” that there is nothing (fat or bowel) going into the inguinal canal?
01/07/2021 at 5:20 am #28407Ben999Participant
Adding onto previous responses as a “hernia veteran” I would advise against it, as did my surgeon (Dr.Conze).
I was/am in the same situation with a small hernia on my right side that is slightly symptomatic (only when running/walking long distances). I was about to schedule a surgery but decided against it following Dr. Conze’s advise and I don’t regret it. Since the cancelled surgery, which was 4 months ago, that hernia has bothered me maybe two or three times.
- This reply was modified 1 week, 5 days ago by Ben999.
01/07/2021 at 5:48 am #28409
But did you have a visible lump? Mine is half of an egg-size. It doesn’t bother me neither, but still i don’t know if it is indirect (with greater risk it will go bad ) or a direct hernia. The 2 docters +1 echograph specialist I consulted didn’t precise this.
01/07/2021 at 8:59 am #28410Ben999Participant
Yes, but smaller than that. Did your doctors not say anything about incarceration risk? Did you ask?
01/07/2021 at 9:08 am #28411
RIsk is small, but there is difference between direct and indirect hernia. Due to COVID all non-urgent surgery is cancelled in Belgium. And we don’t have specialized hospitals like in USA, Canada.
01/09/2021 at 9:24 pm #28417drtowfighKeymaster
Size is not a determinant of need for inguinal hernia surgery. If you have symptoms, the benefit to your quality of life favors hernia repair. If you have no symptoms, you can safely watch it with 0.18% per year risk of complication, such as incarceration. So, it’s low. I encourage watchful waiting for most of my patients.
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