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Muschenek Method? Dr. Echo in Houston
I saw Dr. Echo about a year ago, I live in Houston, TX. I found him because I was searching for a hernia repair surgeon who does it without mesh. He told me he studied in Germany and learned the Muschenek method. We discussed it, but he said he cuts the genitofemoral nerve in the process. I am concerned about this as I have heard that cutting a nerve can result in a neuroma. He also does other surgeries – his practice is not limited to hernia surgery. I believe his background is plastic surgery, so I’m sure he is skilled at what he does. But I am concerned about the cutting of the nerve and about this method, as well. Can anyone shed some light on this? I was also reading somewhere (perhaps in my search efforts on this forum about the Muschenek method) that the doctor in Germany only cuts this nerve about 30% of the time? I am wondering why it is routine in Dr. Echo’s practice. I’ve been just waiting to see how my hernia does – it mostly does not bother me – unless I try to do any exercises engaging the core. And it is popping in and out more often now, which is really bothersome. Sometimes it is sore. But I am weighing the inconveniences and mild discomfort I have now compared to what I may face if I have a surgery that results in more pain. If anyone has any experience or knowledge about this method, please give me your thoughts. Or if anyone specifically has seen Dr. Echo, I would love to hear your experience. Thanks everyone on this forum for your knowledge!
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9 Replies
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Thanks for posting Andrew… What effects did it have on you, if you don’t mind me asking and don’t mind sharing.
I can’t see why, non mesh has to cut nerves. Can anyone explain?
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@Katherine. It was me. Muschaweck surgery including cutting GFN ruined my life. You can search my user name here and I also posted as Steve Smith in the Sports Hernia/Core Muscle Injury group on Facebook as I didn’t really want to post my medical history with my real name. In summary, after first hand experience and tons of research
– only get surgery if you absolutely need it
– don’t have your nerves touched, let alone cut. If you have nerve pain try other things first – blocks, pulsed radio frequency, etc
– minimal repair is misleading – it’s a big cut, nothing minimal about it
– surgeons don’t know for sure what the outcome of cutting the nerves are with the certainty they claim
– the course and function of the nerves isn’t as universal as the textbooks suggest and the claim that they are sensory branches and not responsible for motor function is simply untrue.I’ve probably also been unlucky but I have come across others who have had this procedure and have done badly. PeterC who also posts here has had not a dissimilar procedure and I have similar symptoms to those he described in his last post.
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I think as far as cutting the nerve is concerned, you may want to read other posts…one person from the UK has had sever issues after a similar surgery…I am not sure for the average person but for an athlete it may have strong implications….
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Katherine:
Out of curiosity when you first posted earlier this year I decided to do a search for surgeons in Texas that do hernia repairs and found Dr. Echo’s website. At the time if I recall correctly his website mentioned that he does the Shouldice repair just as Eu’s link indicates. It is interesting that he did not mention this repair to you. Maybe he believes your hernia is best suited for the Muschaweck repair but what do I know.
The following discussion if you have not already read it indicates that Dr. Brown has now retired. There is also information about Dr. Yunis that you may find interesting.
https://herniatalk.com/forums/topic/serious-need-of-finding-the-top-doc-for-mesh-removal/
I hope you are able to find a surgeon that you are both confident and comfortable with to repair your hernia.
johnso
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Hi Eu, thanks for that link. As I said, I had seen him previously and he said he did the Muschenek method which involved cutting of the genitofemoral nerve – but perhaps he has changed his method since I saw him. Perhaps it’s worth another visit. I can’t really afford to travel to see a surgeon (my only options would be Dr. Brown in California or Dr. Yunis in Florida as they take insurance. I would love to see Dr. Towfigh, but she doesn’t take my insurance. In additional to financial constraints, I have other health and chronic pain issues that make it very difficult to travel.
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Kathrine, Dr Echo’s website states that he does the Shouldice repair https://www.anthonyechomd.com/services/no-mesh-hernia-repair. I am sure he a good surgeon, but it does not look like he is particularly focused on the hernia repair.
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Hi Andrew1982 – I am so sorry this happened to you. You and PeterC are good examples of why I haven’t had this done. You may have read my other posts (or not), but I had surgery on a rare spinal nerve condition. The surgery was actually considered “experimental” by insurance and they denied it initially until the surgeon fought back enough they approved it. In the surgery, to access the spinal nerve roots, he did a sacral laminectomy and cut a large portion of my posterior sacrum out. He covered it with a reabsorbable mesh (supposed to dissolve in 2 years). However, there are several issues with this – this mesh turns into a thick scar tissue and binds other tissues and potentially nerves in it and the second issue is the manufacturer of this product never intended it to be used in the spine and it says that on their website. And this reabsorbable mesh is made of some type of “acid” and even after absorbs causes foreign body reactions (after all, it is still there, just in a different form). There have been a number of people who had this same surgery, by this same surgeon and have (like myself) developed adhesive arachnoiditis, autoimmune conditions, etc. We all honestly should do a class action lawsuit against this man. But…. that is why I am scared half to death of hernia surgery and when I read about cases like yours and PeterC’s, I think I should just continue to live with the discomfort that I have. The problem is PT is the best solution for the other multitude of issues I have because due to chronic pain, my body has literally turned into just skin and bone (no muscle) over the years since the surgery. But if I do core work, it really disturbs the hernia. I don’t think the pain in my hernia is nerve related – it pops in and out and just gets a bit sore – so why cut what they don’t need to??? Nerves do regrow and then can cause issues later on. And, even if a nerve is just sensory and not motor (which as you said, they don’t always know for sure), who wants numbness where there was ever numbness before? And then when the nerve regrows with a neuroma, you get pain instead of numbness maybe a year down the road. Some of the symptoms it appears you and PeterC have are because you are male, but the GFN innervates other “private” areas in females even if we don’t have testicles! Have you tried going to a surgeon like Dr. Towfigh or Dr. Yunis or perhaps another one that deals with failed surgeries? I wish that this did not happen to you, but I appreciate you sharing your outcome with others so they will at least be prepared that this is a possibility. Something doctors just don’t seem to share. Doctors like to focus on all the good reasons to have surgery and minimize the side effects. But if just 1 in 1,000 turn out poorly, that 1 in 1,000 has had their life ruined.
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Alephy, do you recall who was the poster with the issues following cutting of the nerve? When I talked to my hip surgeon, he highly recommended Dr. Echo and that’s how he came back into the picture. But I told my hip surgeon I had reservations about the cutting of the nerve and he said that Dr. Echo does everything he does during the surgery to prevent a neuroma from occurring (he mentioned tucking it into a muscle??) . I do recall Dr. Echo saying that he cuts this nerve because it is a nerve that has the potential to cause pain post surgery, so he cuts it to avoid that issue. But I would think that until you are opened up, how do they know if the nerve will cause pain or not? If they have to cut it once they are in, that’s one thing – but presuming ahead of time that it is necessary doesn’t make sense to me.
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Hi Johnso,
Thank you for sending the link. I think I just need to visit Dr. Echo again for clarification. I remember him telling me that he specifically learned the Muschenek method in Germany and that he cuts that one nerve. Maybe he does both methods? He seemed knowledgeable – maybe a bit arrogant. But I find that in a lot of surgeons. I am so sad to hear Dr. Brown has retired. I actually sent him a picture of my hernia when I was considering repair (since he did take Medicare), but just not sure how I could survive the trip – not to mention the cost of travel. I think Dr. Yunis would be a bit closer, as long as he takes my insurance. I had previously looked at the video you sent between Dr. Towfigh and Dr. Yunis and think they are both just amazing doctors and wish I had it in me both financially and physically to travel. Right now I’m dealing with other issues, too – hip labral tears. So, my ortho wants me to do PT – so I guess I need to do that first before the hernia surgery (if I do indeed go through with it). It’s a very hard decision to make – I have serious PTSD from my failed back surgery – it was such a huge mistake and that fear of making another huge mistake stays with you forever.
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