How to judge hernia size?

Hernia Discussion Forums Hernia Discussion How to judge hernia size?

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    • #30407
      Mtncamper
      Participant

      I have read a lot about watchful waiting but that you shouldn’t wait until hernia is large as it can become more difficult to repair. So how big is big when it comes to inguinal hernias?
      Thank you

    • #30408
      William Bryant
      Participant

      Yes it’s not easy that one. Thanks for asking as I’d say mine was medium but Dr and consultant refer to it as small!??

      Also is it the bulge or the hole they look at?

      Shouldice asks and grades along lines, from memory, of

      grape
      Golf ball
      Egg
      Tennis ball
      Grapefruit

      They won’t operate if it’s too small with no bump or too big such as grapefruit size I guess

    • #30409
      Mtncamper
      Participant

      So, in that list of objects, which would you say is medium?

    • #30411
      William Bryant
      Participant

      Probably golf ball and or egg… I’m not sure all of those are listed on the shouldice questionaire.

    • #30412
      William Bryant
      Participant

      Ah the shouldice categories are

      Walnut
      Hens Egg
      Grapefruit

      Hope that helps

    • #30413
      William Bryant
      Participant

      Dr Kang, in South Korea, by the way, will I believe perform tissue repair regardless of size.

      But most surgeons who offer tissue repair do say mesh might still be used if they find it necessary during operation.

      I think a poster here found that to their cost during operation in Germany.

      It’d be an idea to check as it does seem possible to go in expecting tissue but to come round to find mesh.

      It’s probably unavoidable in some cases though

    • #30414
      Mtncamper
      Participant

      I appreciate the info. Are you watchful waiting as well? It seems that with the pandemic, it is hard to get in for elective surgery recently.

    • #30415
      William Bryant
      Participant

      Hello Mtncamper
      I am sort of doing watchful waiting as in UK the wait to see NHS consultant is about a year or more now due to covid. I do think about overseas but so far not decided between Dr Kang South Korea, Shouldice Canada, Dr Desarda India,USA Dr Yunis or Dr Thomas or surgery in Germany.

      But…the itchiness is getting on my nerves and I worry about hernia going in to scrotum. No ones really explained why testicle itche so much.

      Plus I’m not sure if it’s direct or indirect!

    • #30433
      Mtncamper
      Participant

      William, sorry for the slow reply. Also sorry to hear that you are in limbo of sorts while trying to navigate the hernia surgery in the pandemic dilemma.

      I do not know if mine is direct or indirect either.

    • #30434
      drkang
      Participant

      Hi,

      Indirect hernias come out toward the feet and direct hernias come forward. Therefore, when coughing in a supine position, direct hernia still bulges easily, whereas indirect hernia bulges less or not.

    • #30435
      William Bryant
      Participant

      Thanks Dr Kang

      Is it possible to have both? On same side? Close together?

    • #30436
      drkang
      Participant

      Yes. Then, it’s a pantaloon hernia.

    • #30437
      William Bryant
      Participant

      Can you repair pantaloon hernias with natural tissue

    • #30438
      drkang
      Participant

      Yes, of course. Since 2012, I have performed pure tissue repair on all inguinal hernia patients without exception. And pantaloon hernia is not rare.

    • #30439
      Mtncamper
      Participant

      Thank you for your reply Dr. Kang! Do you have any plans to travel to the US to do surgeries?

    • #30440
      drkang
      Participant

      Sorry!
      I have no US medical liscence, unfortunately.

    • #30441
      Mtncamper
      Participant

      Ok, wasn’t sure how that worked. Well thank you for all that you do for the hernia community.

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