Occult hernia in males

[eagleeye]

I have not made a lot of progress. I have been in contact with Dr. Meyers office after checking with several New England Doctors. He can help, but my HMO will not have it. I will keep you posted. This is a long journey.

[drtowfigh]

If you Dr. Meyers’ tissue repair resulted in pain, without an obvious hernia, sometimes there are microtears or tears resulting in an unstable repair. Supporting the repair with mesh may be helpful. Choice of mesh will be important.

[eagleeye]

I should note that treating pain has only made the problem worse. After pain treatment (like nerve ablation of lidocaine) I move more confidently, and am left in more pain than when I started.

[eagleeye]

After months of waiting, I have had a couple of talks with a Dr. in Massachusetts. Diagnosis is difficult. An MRI I had on October says that I have nothing that contributes to groin pain. I feel like the repair done by DR. M in Philly gave out. My pain is on both sides, and Currently, my Dr. will do a repair on the left side, but I am not sure that makes sense, as I do not want to go back for the right side. Let me be clear, This is not a hernia, but some sort of painful damage to the groin. Sadly, I am left with nothing more than my symptoms to go on.
I am convinced that there is an injury, no matter how difficult to find, and not just a pain syndrome. The pain is rather specific. I am in a lot of pain at this point.
Lifting, slight stretching, coughing, carrying some weight (as in grocery shopping or using a camera), climbing inclines, fast walking all exacerbate the pain (and that can last for weeks)
I am in a holding pattern. I honestly believe this can be repaired, but I am not sure I should commit right now.

[eagleeye]

Occult hernia in males

Chaunce123, the pain is very similar to the pain I had in the past.

Thank you Dr. Towfigh for your clarification about Dr. Grishkan.

[drtowfigh]

Occult hernia in males

Dr Grishkan does use mesh

[eagleeye]

Occult hernia in males

I live in Western Massachusetts and funds are limited. Dr Grischkan in Ohio is a possibility, because I have friends there, but he does not use mesh. This time around, I think I need mesh.

[Chaunce123]

Occult hernia in males

eagleeye, is your new pain the same as it was before? To me that would be the biggest indicator that the same problem is back, and thus addressing the same problem would be effective.

Did you originally have a hernia or was the pelvic floor repair for athletic pubalgia or a fascial tear? I think ultimately the repair is similar with Dr Meyers but I wonder if the original problem could impact a diagnosis for recurrence due to the difficult nature of determining a sports hernia. Just thinking out loud as a fellow patient here.

You might want to try requesting an ultrasound with valsava as well, particularly if you didn’t know to strain/bear down during the initial MRI test. I have read repeatedly that hernias are frequently overlooked on imaging tests so it would not surprise me if it was missed. An ultrasound is also fairly cheap from a cost perspective.

I wouldn’t worry too much about sharing a general location on the forum, a city or state is usually sufficient to find a nearby doctor or a few possibilities in the general region. If you’re looking for doctors specifically with knowledge and experience with sports hernias, the following lists may be helpful to you:

– Dr Meyers at Vincera in Philadelphia

– Dr Boyarsky in New Jersey

– Dr William Brown in Fremont California

– Dr Ulrike Muschaweck in Munich, Germany and London UK

– Gilmore Groin clinic in London UK

And some other well known hernia doctors spread around the country, which may be helpful for investigating a sports hernia or an occult hernia:

– Dr Towfigh in Los Angeles California

– Dr Chen at UCLA in Los Angeles California

– Dr Bruce Ramshaw in Knoxville TN

– Dr Yunis in Sarasota Florida

– Dr Grischkan in Ohio

Anyway, just throwing some names and locations out there, perhaps one is near you. Otherwise you can check the American Hernia Society website for surgeons interested in the broad topic, perhaps calling their offices can reveal more information https://americanherniasociety.org/

Good luck and keep us updated on your diagnosis and decisions.

[eagleeye]

Occult hernia in males

How do I send you my location without posting it on the forum?

I just had an MRI that had “No evidence of hernia or sports hernia.” It was an MRI with a Valsalva maneuver, however, their instructions were to “pretend I was having a baby.” Only after the MRI did I discover what the suggestion was for. The word Valsalva was never used. My doctor is a terrific hernia surgeon, using robotic and laparoscopic procedures, but he is really unwilling to consider my symptoms and history as valid for repair without some really solid evidence. I do see his point.

I also have a large varicocele on the left side, and while it may contribute to the problem, my symptoms are independent of the varicocele. I have had the varicocele all my life and I do not think it is growing worse and have had many years of functionality between events with it.

Thanks for your thoughts.

[drtowfigh]

Occult hernia in males

For sure Dd Meher’s is a great surgeon and skilled with pelvic floor repair. It is also a fact that recurrence after tissue repair of an inguinal hernia is on average higher than after mesh repair. Lastly, once hernia has recurred, a mesh repair is considered standard.

I suggest you seek a hernia specialist who also performs laparoscopic surgery to consult for recurrent inguinal hernia repair. If you need help, let us know where you live so we can refer you to one near you.

Yes, men also have occult hernias. I just presented in Chicago about my experience with occult inguinal hernias. 72% were in women. Men have them and present similarly. Also, since you had a tissue repair already, a small recurrence can be masked by the original reconstruction and scar tissue.

Hope this helps.