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Lingering problems after possible scar tissue break
I had a right inguinal hernia repair using mesh and tacks back in 2008. From time to time with various activity I have had hernia-like pain of which my surgeon said was probably a tear in scar tissue. He suggested 3-4 weeks of Aleve along with rest and this seemed to do the trick. Last March I had this happen again and went with the same regimen as before. I felt everything was getting back to normal so I took a jog. That evening while in bed I rolled over and felt a tearing pain in the upper part of my groin. It felt as though my skin was stuck together with glue and someone was prying it apart. From that point on I have had a relatively constant pain in my groin area with any sort of exertion. Upon any moderate exertion I have a pain just under my belt line (this being a new pain and something I never felt with my original hernia or any possible times breaking the scar tissue) and also tenderness in my groin and sometimes testicle pain. I had the physician who originally diagnosed the hernia examine me and he said I felt solid on all accounts. I was sent for an x-ray and an ultrasound and nothing was found on either, no hernia and nothing was said about the mesh or tacks being out of place. The pain isn’t a problem itself as it’s more an annoyance than true pain but it is limiting my activity and it’s getting more and more difficult to keep my weight in check due to aggravating the area when I exercise. Any insight into this would be greatly appreciated.
Thanks!
Kevin -
7 Replies
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Lingering problems after possible scar tissue break
As far as we know, exercise involving core strengthening and without rapid movements are safe for hernias.
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Lingering problems after possible scar tissue break
Thank you Dr. Towfigh for your response. The pain I am having wont need any sort of treatment as I am lucky enough for it not to be at a high level. However do you think that continued exercise will make this worse or do any actual damage or is it something I can continue and learn to live with the discomfort when it appears? My biggest concern is whether I am doing any damage to the hernia repair. Thank you again.
Kevin
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Lingering problems after possible scar tissue break
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Lingering problems after possible scar tissue break
I have seen this with patients and have theories about why it happens but no scientific evidence.
All synthetic mesh shrink to some extent. Also, synthetic mesh is not as compliant as normal muscle, as Dr Goldstein mentioned. So it does not stretch with activities.
I feel that once the mesh is adherent to the muscle, with ingrowth, if it’s already tight, then the patient might feel pain, pulling, and this is from a sheering effect.
No good non surgical treatment for this. I have injected steroids into the mesh:muscle region and in some patients that has helped.
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Lingering problems after possible scar tissue break
Thank you for your response Dr. Goldstein. Yes I did have a laparoscopic repair from a surgeon in Cleveland who had done over 800 procedures like this at that time. The pain does seem to be self limited to the affected area and, for some reason, referred pain in my lower back, which I felt with the hernia before repair. I don’t think I have any real nerve problems because I can ignore the pain due to it not being very significant. I have noticed that when I play golf it initially irritates the area but the next day it feels better than before. It’s like the swinging motion stretches the area and afterwards I get relief. My real question would be at this point is this something I can somewhat ignore and continue my exercise routine as long as the pain doesn’t get worse or would I need to seek treatment? Also, is there any sort of stretch or exercise I can do to help with this? If this is something that is just going to be a mild irritation with no damage being done I can live with that. Again, thank you for your time.
Kevin
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Lingering problems after possible scar tissue break
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Lingering problems after possible scar tissue break
I am assuming you had a laparoscopic repair. I see this occasionally. I think what is happening is that the mesh is less complaint than the abdominal wall tissue and you can get some tearing or stretching at the interface between the mesh and the fascia. Usually the pain is self-limited, but if a nerve is involved it may persist. An injection of local anesthetic will tell you if it will respond to a nerve ablation.
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