Looking for advice, no idea what to do re. asymptomatic inguinal hernia

Hernia Discussion Forums Hernia Discussion Looking for advice, no idea what to do re. asymptomatic inguinal hernia

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    • #11418
      hhernia
      Member

      Hello,

      I’ve come to this forum to look for someone advice to help me with my problem. I am 20 years old with a small, asymptomatic left sided inguinal hernia (United Kingdom btw). For the majority of a day, a lump can not be found but after standing for more than an hour becomes present. At its largest, I would describe it as the size of a cherry. I would post a photo but unsure as to whether that is allowed here… It is reducible and my groin looks completely normal after lying down.
      I first noticed it on the 23rd of April this year after lifting weights one morning. I am in good physical condition, no weight issues or underlying health concerns.

      The dilemma is that I have been offered surgery but not completely electively. I have been offered open mesh repair. In my untrained medical mind, it seems illogical to undergo surgery on such that does not affect my life in anyway. However, I am concerned about the long term and am seeking advice on the best option for myself.

      My GP could not find the hernia himself (I believe this to be a result of having a morning appointment so the hernia was not apparent), but referred me to a surgeon on the weight of my description of a lump that disappears with lying flat. The surgeon struggled to find it too, but after seeing a photo was happy with the diagnosis. He mentioned severing three nerves as part of the operation to reduce risks of groin pain, is this common? I feel somewhat apprehensive of losing such nerves when I am in no pain atm.

      I regularly swim and find that the hernia is not visible after this, much like after lying down.

      For me, this is not causing any physiological problems in my life, more mental due to being aware of the risks of not having it sorted. Would it be an option in my case to take up watchful waiting and have diagnostics tests to determine the contents of the hernia so I can understand more the relative risk of my case.
      My biggest fear is that by having elective surgery, my life will never be what it used to be all because of a problem that never bothered me. However, I do understand the contrary. Thus, I am left in a pickle with no idea what to do and my thoughts consumed by hernias!

      1) How necessary do you feel it is for me to have my hernia repaired, given its size and asymptomatic nature? Is the risk:reward ratio enough to warrant intervention?
      2) Is surgery the only option in my case?
      3) Without intervention, how would you anticipate my case to develop? (Will the hernia likely increase in size/become painful or could it remain the same)
      4) What is the risk of strangulation like for a hernia of a size/nature like mine?
      5) If you were me, considering age and circumstances, what would you do?
      6) Is there any benefit to undergoing elective surgery early, while the case is still asymptomatic and small?

      Thanks for any input in advance, you can’t appreciate how much it means to me. Bless you all,

      W

    • #16665
      Good intentions
      Participant
      quote hhernia:

      it seems illogical to undergo surgery on such that does not affect my life in anyway. However, I am concerned about the long term and am seeking advice on the best option for myself.

      He mentioned severing three nerves as part of the operation to reduce risks of groin pain, is this common? I feel somewhat apprehensive of losing such nerves when I am in no pain atm.

      My biggest fear is that by having elective surgery, my life will never be what it used to be all because of a problem that never bothered me. However, I do understand the contrary. Thus, I am left in a pickle with no idea what to do and my thoughts consumed by hernias!

      1) How necessary do you feel it is for me to have my hernia repaired, given its size and asymptomatic nature? Is the risk:reward ratio enough to warrant intervention?
      2) Is surgery the only option in my case?
      3) Without intervention, how would you anticipate my case to develop? (Will the hernia likely increase in size/become painful or could it remain the same)
      4) What is the risk of strangulation like for a hernia of a size/nature like mine?
      5) If you were me, considering age and circumstances, what would you do?
      6) Is there any benefit to undergoing elective surgery early, while the case is still asymptomatic and small?

      Take the time, at least, to really understand as much as you can, about your hernia, but more importantly, about the hernia repair field in general. Not all surgeons are the same. There are surgeons who really understand hernias and hernia repair very well, and there are others who are basically reading an instruction manual. The surgeon who wants to do a triple neurectomy from the start should be avoided, I think, since he is taking unnecessary risks with your quality of life. Triple neurectomies are used as an attempt to cure hernia repair pain, not as a preventive measure, from what I’ve seen, and the procedure has its own side effects and risks. I would avoid that surgeon, he doesn’t seem to understand the risk of what he’s suggesting.

      Your thought that this could be a life-changing decision is right on target. There is benefit to having it repaired while it is small, if the right option is chosen. The problem is that if you get one of the instruction-manual surgeons you will probably get a one-size-fits-all type of repair, meant for large, medium or small defects. A large piece of mesh to cover the defect and any other possible future defects. And, apparently, even a triple neurectomy, even though there is no pain. That alone seems unconscionable and almost unethical.

      Doing things that increase abdominal pressure, like the Valsava maneuver while lifting heavy weight, or making a hard tackle in football (soccer) can cause the hernia to get larger. Playing soccer is what caused mine to grow. So I would avoid those things while studying the possibilities. The fact that your hernia reduces itself is a sign that nothing is being constricted, or in immediate danger. You’ll know more as you read about what it is that is actually being extruded, like fat and omentum.

      At age 20 I would make every effort to find the right surgeon and get the right repair. Your body isn’t even finished growing. The wrong repair can affect sexual function directly, as it did in my case, or indirectly, just by constant pain. You can get very messed up. Don’t try to save money or stay close to home. Consider traveling out of country if necessary.

      Most of this has been covered on the site, Read through the topics and you’ll see what could go wrong and how to find the right surgeon. Good luck. Don’t be swayed unless your surgeon can prove that they have good results for people like you who are doing what you plan to do.

    • #16667
      John Fortem
      Member

      My hernia is retractable as well. When I lay flat on my back, about an hour later it goes completely back in. So I usually go to bed with a hernia and go up in the morning without a hernia. It can take anywhere from a couple of minutes of walking around to several hours before it begins to bulge out. The longest I have gone without the hernia is 3 full days. Not having it bulge out was a great feeling. But when it starts to bulge out eventually it can be discomfortable, but not so much painful.

      Of course, I would also much rather have it repaired. But there is not a perfect solution for it. Just like you, I was only given the option of mesh repair. Mesh repair is the new normal all over the world. I really resent the idea of a piece of plastic inside my body that holds my intestine in. So I said no to the surgery. I am glad that I said no at the time. I am much better informed now, and if I had to go for surgery now I would take my chance at non-mesh repair, using my own tissues to hold my intestine in. But these surgeons are not easy to come by.

      The best advice I can give you is to do your research. There is definitely much more to this than what your GP or a general surgeon will let on. But given your age, and the fact that your hernia is asymptomatic watchful waiting is definitely an option. I also got my hernia in my 20s, and I have had it for about 8 years now. It did increase in size slightly. But it’s not the size of a football. If it was the size of a cherry at the beginning, it is now the size of a golf ball maybe. And then there are also those days where it is completely tucked in and is zero-sized.

      The important thing is not to stop questioning…

    • #16669
      Chaunce1234
      Member

      “watchful waiting” is often a valid approach to hernia management if a hernia is not bothering you. Many people have small non-problematic hernias their entire life and never get them fixed, and many aren’t even aware they have one.

      At the very least do extensive research before you make any decision, and be comfortable with your decision. The biggest risk of groin hernia surgery is chronic pain, it is your groin and full of nerves.

      If you want a second opinion, search around on these forums and you should find some options for well-known hernia surgeons in Europe and the UK. Germany has Dr Ulrike Muschawek and Dr Andreas Koch, for example, and I believe both of them consult in UK as well.

      Good luck and keep us updated on your case.

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