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Non-mesh chronic pain
If someone could help me, I would be really appreciate
My english is not very good, so I am trying my best to explain my problem.
I had left hernia surgery exactly one year ago, the method of surgery was Bassini, before surgery I didn’t have any bulge or anything visible, but I had strong pain that prevents me from sleep. Immediately after removing stitches just on touch I had strong sharp pain below the scar, and numbness too. After 2 months numbness below and around scar subsided, but pain persisted. Around 4 months after surgery, I started to feel tingling inside and back of thigh that goes through calf. After surgery there is a little bulge below scar and around scar. I realize that when I sit a lot because of work, the pain gets worse. I don’t have problem or pain with ejaculation, but after few hours after ejaculation it begins to pain stronger in area below the scar, and that persist for few days, and pain than reduce, but is still there. Also after swimming or being active looks like it help for a while and hot water too, but pain comeback after few hours. Pain killers don’t work. I am taking also high doses of vitamin B6 and B12. My biggest issue is sleep disturbance. I am 25 years old male, my BMI is 22,2. My question is, is there a chance that pain will subside as time pass on? Thanks -
7 Replies
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Would @drtowfigh care to elaborate about Bassini? Does Bassini inherently have risk for chronic pain–apart from other methods? Here’s a recent glowing research study on Bassini success: https://www.sciencedirect.com/science/article/pii/S2405857221001066#!
[Bassini inguinal hernia repair: Obsolete or still a viable surgical option? A single center cohort study]
Incidentally, the authors are based in Virginia apparently doing tissue repair there and so a viable option. -
Dr Towfigh wrote $Just want to remind patients that non-mesh inguinal hernia repair is not a benign operation. There are risks with it as with any other operation. And also that there is risk of chronic pain after tissue repair, such as Bassini.”
Yes I’d almost forgot tissue repair is not a guaranteed success. Timely reminder. Even if I’ve only seen the post a year later.
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Hello all, I just wanted to give update and share my experience with you. After my initial post on forum I went to neurologist who gave me Lyrica for nerve pain. It didn’t worked i didn’t notice any better. Before Lyrica I tried with variety painkillers, also not working.
I had revision surgery one year ago. Revision was not performed by the same surgeon that primary operated.
They performed exploration and triple neurectomy. Because of some weakness if I remember well of ”posterious wall” that will eventually lead to recurrence, they removed all stitches and put LW mesh. They also told me that there is fibrosis on spermatic cord, which was risky to remove because of potential damage to testicle.
Now one year after revision, i feel slightly better than before revision. The biggest difference is less pain and sensation in thigh, but on scar area pretty much the same. There is still the same problems as described above.
For those who ask if mesh can be “feeled”. I personally didn’t notice any difference like foreign thing in body, or something else that is difference from tissue repair. As before I still feel better while moving and being active like swimming,than being sedentary. Also as before, after sleeping when woke up I feel inside the scar area like tightness that subside after moving. Massaging area around superficial inguinal ring fist cause discomfort but after few minutes discomfort subside and I feel temporary relief.A few things is not clear to me. After triple neurectomy I didn’t experience any more numbness than i feel before, and that numbness is about one inch in diameter at superficial ring. Still have the same feeling on touch on thighs as before neurectomy.
Also my cremasteric reflex still working. Can it work if triple neurectomy is performed?
Can a fibrosis on spermatic cord that is not removed causing my problems or is triple neurectomy somehow failed?Please @drtowfigh @DrBrown and all others I would apreciate if you can reply me. Best wishes to all
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Just want to remind patients that non-mesh inguinal hernia repair is not a benign operation. There are risks with it as with any other operation. And also that there is risk of chronic pain after tissue repair, such as Bassini.
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Stefan.
The pain is probably not dangerous.
Hopefully the pandemic will resolve in the near future and you can return to see your surgeon.
Regards.
Bill Brown MD -
Thank you doctor for response! I know that without examination, and ultrasound can not be seen what it is. Problem is because of COVID pandemic, the hospital where I had surgery is now COVID hospital, so I can’t go for examination, but in theory, one year after surgery, can it be collection of fluid that pressure nerve that causing me pain, because I still have a bulge below the scar, of course if it isn’t recurrence. Best regards!
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There is a chance that the pain will improve with time.
Your surgeon needs to examine the operative site. Often the etiology of the pain can be determined with a simple examination.
Also:
Ask your surgeon to order an ultrasound. That will help determine whether or not you have another hernia.
Ask your surgeon to block the ilioinguinal and the iliohypogastric nerves. That will help determine whether or not you have an entrapped nerve.
Ask your surgeon to perform a cord block, that will help determine if there is a problem with the spermatic cord.
Regards.
Bill Brown MD
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