Open surgery repair on bilateral inguinal hernia 5 weeks ago but still not good…

Hernia Discussion Forums Hernia Discussion Open surgery repair on bilateral inguinal hernia 5 weeks ago but still not good…

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    • #11733
      Spanish
      Participant

      Hello,

      Due to my addiction to sports, I was kindly forwarded from https://forum.bodybuilding.com/ to here to ask my question , so I would like to beg your help in here.

      Being proud of signing up the herniated club and to make things short, I’m from Spain (living in The Netherlands), 45 years old. Some time ago I found (well, some surgeon did), that I had a bilateral inguinal hernia (2 hernias, small). It came from the fact that I was starting to develop some pain in the iliopsoas (I guessed), not bulges coming out or anything. To make things fast (my wife is due to deliver baby soon and she needs my help due to kind of premature delivery risk), I went to m country to have a faster treatment.

      Last March 13 I had open surgery with 2 meshes. Everything was going fine, but I had a pain after almost 4 weeks. Here in Holland doctors are not exactly the best, but I managed to have an ultrasound and see the surgeon. Radiologist said, from ultrasound, a recurrence on the right, bigger than 2 cm (around 1 inch), much bigger than any of the small ones I used to have. 2 surgeons tried to feel it by touching but they said they couldn’t feel anything, so they couldn’t conclude whether I have a recurrence or not, they guessed from radiologist’s report, but couldn’t feel it by pushing me everywhere around… They said I could come back to see again in 3 months. I checked with the surgeon in Spain who did the surgery and he neglects the possibility of a recurrence, he said is too early to consider any ultrasound valuable, so to speak. He added that someone with my build, (not fat, basically) should be easy to spot a hernia right away by touching, but here surgeons are terrible and also, may be the remaining inflammation is precluding hernia from being felt, I don’t know.

      Pain has lowered, but yestaerday (18 April) I was on my 5th week after surgery, and what I’ve done so far is my average 11 km per day on the bicycle to go to work, nothing else, I’m getting depressed from refraining from going to the gym (it’s like my drug), but I don’t dare to go and do weightlifting, 3 days ago I was assembling a chest of drawers (the typical for baby, not too big) and posture wasn’t good, but didn’t require much effort, and next 1.5 days I felt some kind of assortment of pains, not too high though, but the’re there.

      I read about people at full steam with sports at my week of recovery and I see myself losing muscular mass and fitness (although my weightlifting wasn’t too much, I was on 18 MET)…

      Therefore, I would be more than grateful if someone could give me some insight. If there are any medical able to interpret ultrasound, I wouldn’t mind posting some pics from the ultrasound last week.

      Thanks a lot in advance and Best Regards

      RPG

    • #18425
      Good intentions
      Participant

      Hello RPG. “open repair with mesh” could mean many things. You should find out what method and materials were used. If you can get your surgery notes, it would also be good to know if the surgeon actually found any hernias, and of what type. Sometimes they get in there and don’t find anything.

      These are all “open with mesh” procedures:

      Lichtenstein
      plug with patch
      preperitoneal patch – e.g. Kugel
      Prolene Hernia System (PHS)
      Onstep

      I found that the repetitive nature of motions like running and bike seemed to cause irritation, for my Bard Soft Mesh laparoscopic TEP placement. You might find that stopping your bike rides will make things feel better. It might offer a clue but, of course, is not what you want for the long-term.

      Good luck.

      [USER=”2847″]Spanish[/USER]

    • #18426
      Good intentions
      Participant

      Hello RPG. This might be a double post, I got blocked on my other one.

      You should get more details about your surgery. There are many different types of “open repair with mesh”.

      Try stopping the bike rides and see if things get better. I found that repetitive motions like running and biking caused irritation. It will be a clue, even if it doesn’t solve your problem.

      These are all “open with mesh” procedures, in the next post. I’m trying not to get my post blocked. Good luck.

    • #18427
      Good intentions
      Participant

      Lichtenstein
      plug – patch
      preperitoneal patch – e.g. Kugel
      Prolene Hernia System (PHS)
      Onstep

    • #18428
      Good intentions
      Participant

      The materials and methods I showed above are different and probably give different results.

      Good luck. [USER=”2847″]Spanish[/USER]

    • #18440
      Spanish
      Participant

      Hi Cood intentions,

      I think I posted the topic before, but I started to edit several times and the system took it for spam I was popped out, so I had to rewrite…

      Anyway, thanks for the help. Actually, I was told I had 2 hernias, small, and the surgery would be opn, nothing else. I don’t know whether they were direct or indirect. I didn’t know if surgery was applying any of the techniques you unfold. Health system in Spain is one of the best in the world, but it’s like a black box when it comes to learn the specs’procedures, they never say. Anyway, will it make a big difference one of the other procedures? I had 2 meshes and that’s all… I can try to ask the method used…

      One question, and knowing that you’re not a doctor, but could give useful insight, do you think the repetitive movements leading to irritation would make develop any injury, or irritation is just a symptom with no further damage? I could take car for work, but here is not like the States, the country is designed against traffic, and optimized for bikes, I save time by biking…

      Thanks again, actually

    • #18443
      Good intentions
      Participant

      I don’t know. Many surgeons will just recommend more pain medication. It’s unclear, so better to be safe, I think, than find out you’ve been causing more damage. Some devices, like the plug, have a known history of moving and “eroding” local tissue. I don’t want to scare you but that’s why knowing what you have might be important. Maybe you could ask one of your Holland doctors to contact your Spain doctor. Doctor to doctor. Or, if you post the name of the clinic or the surgeon there might be information available abut their preferred method. Some surgeons use only one method. “One size fits all”.

      https://twitter.com/Herniadoc/status/1021561699290116097

      At this point you are kind of on your own. Your surgeon has already decided that you don’t have a recurrence.

      I would use the weekends to try different things to see if they have an effect. Keep track of your activities to see if there is a correlation with your problems.

      I think that the stories we’re all told at our hernia diagnosis, and that we see on the web sites of clinics around the world about being stronger than ever and able to be back to full strength, pain-free, within weeks, are the “ideals”, what is hoped for. Not the reality. It’s just the way things are these days.

      Good luck. You’re still early in the “settling-in” process.

    • #18444
      Spanish
      Participant

      Tanks a lot Good intentions,yes, I can try what you propose, after all, as you say, I’m in the early settling-in stage, my first worry is to have a diagnose in Holland about the recurrence, I just can’t believe they say you have a recurrence because of the radiologist’s report (they didn’t even see the images), but we’re not sure as we cannot spot it upon touch, what the hell, no 100 % diagnose on hernia?

      Yesterday I started running slowly in the gym, just 6 km at 13.1 km/h (8.1 mph) average, some arm bicycle and elliptical rower, to burn a few 900 calories, and today don’t have any pain, may be a good sign…

      Thanks again for your time and the link!!!

    • #18450
      Spanish
      Participant

      BTW, my surgeon told me today that the technique was Lichtenstein…

    • #18455
      Spanish
      Participant

      Sorry for insisting, today a surgeon confirmed a recurrence on the right, as I suspected. they will reoperate with laparoscopic techinque in 3 weeks. I know now I have higher risk of recurrence again, I wonder how many months of bed recovery should I take. My idea is being in bed 3 – 6 months without moving at all, will it guarantee no recurrence again? I’m really worried as it will be another surgery on to of a failed one and I have read that once you have recurrence, normally you never get rid of hernia.

      Thanks a lot in advance and Best Regards

    • #18481
      Good intentions
      Participant

      [USER=”2847″]Spanish[/USER] I hope you’re doing well. Here is a link to a facility in Germany, started by Dr. Muschaweck. I saw your posts on the other web site and I think that this is the one they were talking about. It’s close, maybe you can get over there and get evaluated.

      https://www.hernia-centre.com/

      It was mentioned in this Topic, below. I’m not suggesting that you need mesh removal, but they would have a broader view than many clinics. More experience.

      https://www.herniatalk.com/11058-my-successful-mesh-removal-story

      Good luck.

      • #21725
        Colt
        Participant

        Was it repaired with mesh or with out

    • #18535
      Spanish
      Participant
      quote Good intentions:

      [USER=”2847″]Spanish[/USER] I hope you’re doing well. Here is a link to a facility in Germany, started by Dr. Muschaweck. I saw your posts on the other web site and I think that this is the one they were talking about. It’s close, maybe you can get over there and get evaluated.

      https://www.hernia-centre.com/

      It was mentioned in this Topic, below. I’m not suggesting that you need mesh removal, but they would have a broader view than many clinics. More experience.

      https://www.herniatalk.com/11058-my-successful-mesh-removal-story

      Good luck.

      Hi Good Intentions,

      I tried to reply years ago but apparently most of the messages I reply they’re taken as spam and if I don’t check, they aren’t published. A possibility is this German clinic, it’s 750 km away, but it should be worth it, especially after reading this guy’s experience. In my case, trating a recurrence is something really serious. In Holland, the most corrupted country in the EU and having one of the most underdevolped health system, I am offered to have a laparoscopy in weeks by the expert in hernias in the hospital, i.e. a student. Go figure.

      Thanks again for the help!!

    • #18539
      Good intentions
      Participant
      quote Spanish:

      In Holland, the most corrupted country in the EU and having one of the most underdevolped health system, I am offered to have a laparoscopy in weeks by the expert in hernias in the hospital, i.e. a student. Go figure.

      Thanks again for the help!!

      That is disturbing that you think that.

      The HerniaSurge group is based in Holland, and they are behind the big push to promote a new set of “International Guidelines for Groin Hernia Management”. There is some question abut how they decided to designate themselves as the global authority on hernia repair but they have a growing following. Odd that they would come from the situation you describe..

      http://herniasurge.com/

      If I were in your situation I would go to Germany. I almost flew over there myself when I was having problems.

      Good luck.

    • #18545
      drtowfigh
      Keymaster

      If you do have recurrence from a Lichtenstein, and that’s the only reason for your symptoms, then laparoscopic repair is the best next approach.

    • #18569
      Spanish
      Participant
      quote Good intentions:

      That is disturbing that you think that.

      The HerniaSurge group is based in Holland, and they are behind the big push to promote a new set of “International Guidelines for Groin Hernia Management”. There is some question abut how they decided to designate themselves as the global authority on hernia repair but they have a growing following. Odd that they would come from the situation you describe..

      http://herniasurge.com/

      If I were in your situation I would go to Germany. I almost flew over there myself when I was having problems.

      Good luck.

      Well, Holland is great to brag about everything they can, I was a researcher in may be the best Research Oncology Centre in the world, my bosses were regarded as the best in radiation oncology, but if you have a cencer in Holland, the system will go to the cheap solution, not the healing one if a paliative treatment is cheaper. The main value in Dutch society is money. I have a few friends in their thirties who died from non treated cancer… conclusion is: they’re good at research and selling the product, but terrible at applying anything that does not involve making money, such as applying a expensive treatment far more expensive than your insurance policy contribution.

      Thanks again and Best Regards

    • #18570
      Spanish
      Participant
      quote drtowfigh:

      If you do have recurrence from a Lichtenstein, and that’s the only reason for your symptoms, then laparoscopic repair is the best next approach.

      I guess so, but do you think a doctor still on training is wise to choose? I heard laparoscopy requires experience and on top, in my case, fixing a recurrence would mean adding difficulty and therefore, would demand extra skills, please correct whether I’m wrong, my main worry is having a second attempt and not getting it properly repaired. I never knew that a hernia is as common surgery as difficult…

      Thanks and Regards

    • #18578
      kaspa
      Participant

      You’re right, hernia so common, surgery so difficult.

      I think your repair is too early to try anything there.

      Perhaps you should read Baris account in the forum. After failed attempts to have his hernias repaired, he eventually went to Shouldice Clinic in Canada and they told him that they only reoperate after 1 year to allow for tissue healing.

      Inguinal hernia repair with absorbable stitches – Hernia Talk
      https://www.herniatalk.com
      Hi, everyone!

      I’m supposed to have an inguinal hernia repaired in August or September, and my doctor wants to use a mesh, but I won’t allow it. I’m here because I

    • #18582
      idoncov
      Participant

      I suggest that you speak to Dr Brown from Fremont, CA. 650-703-9694. He’s very approachable. You need to find a doctor who does not consider the mesh repair to be an option. There aren’t many these days.

    • #18588
      drtowfigh
      Keymaster

      [USER=”2847″]Spanish[/USER] you want a surgeon to have had laparoscopic experience for recurrent hernia repair after failed Lichtenstein. However, such a repair should not be that much more difficult than a primary laparoscopic repair.

    • #18603
      Spanish
      Participant
      quote kaspa:

      You’re right, hernia so common, surgery so difficult.

      I think your repair is too early to try anything there.

      Perhaps you should read Baris account in the forum. After failed attempts to have his hernias repaired, he eventually went to Shouldice Clinic in Canada and they told him that they only reoperate after 1 year to allow for tissue healing.

      I’ll have a look, thanks for the advise!

      Regards

    • #18604
      Spanish
      Participant
      quote idoncov:

      I suggest that you speak to Dr Brown from Fremont, CA. 650-703-9694. He’s very approachable. You need to find a doctor who does not consider the mesh repair to be an option. There aren’t many these days.

      Thanks a lot, but alas I’m now in central Europe, no chance for me and my hernia to go there for the repair… :-/

      Regards

    • #18605
      Spanish
      Participant
      quote drtowfigh:

      [USER=”2847″]Spanish[/USER] you want a surgeon to have had laparoscopic experience for recurrent hernia repair after failed Lichtenstein. However, such a repair should not be that much more difficult than a primary laparoscopic repair.

      Thanks a lot Doctor, so you mean that previous open Lichtenstein surgery should not interfere with a new laparoscopic approach as it should be done from the back of peritoneum, right? In fact, in Holland, they told me that they would keep the first mesh that is sewed (supposedly because I’m not so sure) to the front of peritoneum. The new laparoscopic one would be attached to the back, right? If so, I have heard horror movie stories about people complaining about back mesh rubbing against bowels and leading to intestine diseases, chronic pain, irritation, etc, what is the chance to get this? How can this be avoided, may be experience plays a role on this sede effect.

      I would be more than grateful if you could enlighten me on it.

      Many thanks in advance!

    • #18610
      Good intentions
      Participant

      First, you need to know if it’s a recurrence or a different problem. If it’s a mesh reaction problem then more mesh will not help. You’ll still have the problems from the Lichtenstein procedure mesh, plus, possibly, new problems from the laparoscopic mesh placed on the other side.

      The chromic discomfort and pain from mesh commonly comes from the irritation of approximate tissues by the mesh itself. Oftentimes the mesh is still “perfectly” placed, but it is inflamed and edemateous. Not rubbing on things it’s not supposed to. It’s where it should be, no recurrence. No fixation to cause problems. But the discomfort and pain exists. That is the problem that many surgeons can not get past – where is the cause of the pain? “It can’t be the mesh.” Even though the evidence is right in front of them, they can’t see it.

      You should try to get more details on the actual material used and the procedure, if you can. I think that some doctors describe any anterior placement via anterior approach a “Lichtenstein” procedure. You might have a plug and patch in actuality.

    • #18612
      drtowfigh
      Keymaster

      Laparoscopic mesh placement is not near or against the intestines.

    • #18625
      Spanish
      Participant

      Thanks Good Intentions and Dr Towfigh… I see, may be to know the status of things the best option is to have an MRI so it can be seen what is done, and how is the situation?

      Thanks and Regards

    • #18889
      patient
      Participant

      Hi [USER=”2847″]Spanish[/USER] , hope you are felling better and I wish you found a good doctor to work with you. Let us know if you find a better doctor and what is his approach, wish you my best!

    • #20463
      Spanish
      Participant

      Heloo!

      Sorry for not having posted since last time, I wanted to wait a wee longer to see how the whole thing evolved and I’m having increasing pain on the right, especially in the spermatic port which makes me think that definitely there’s a recurrence.

      I went to Spain and a surgeon said I might have a protrusion that does not mean that is a hernia, I made a MRI there and conclusion was that there’s no recurrence. this happened in August and so long as I do not trust any surgeon in where I live, i.e. Holland (the experts are students, go figure), and I have a 7 months old son, I really have to find a good place. My wife is from Taiwan and I will spend 2 weeks in Xmas with family, so I will go to this place:
      https://joshuahernia.com/?lang=en

      Does anybody know about it? Apparently it has a good reputation, is a meshless technique, but I don’t know…

      Thanks a lot in advance again and Best Regards

    • #20466
      Good intentions
      Participant
    • #21660
      Spanish
      Participant

      Hello,

      I have some update. I went to a different place (), which is the private clinic of Dr Andreas Koch (http://www.chirurgie-cottbus.com/index.php/startseite.html). They saw left part is ok, but right part has a recurrence although not alarming, so to speak… It’s a meshless Shouldice based procedure. Do you think I should go for it?

      In treatment plan they propose a complete mesh explantation, also a
      neurolysis of the inguinal Nerves, e.e. ileoinguinalis, ileohypogastricus and
      genitofemoralis, lysis of the spermatic cord and restoration of the
      inguinal floor with a component separation of the intern oblique
      muscle and the transverse muscle without mesh or with a
      reinforcement with long term resorbable mesh.

      Do you think this is ok? Is it necessary the neurolysis and the lysis of the spermatic cord? Does it imply losing of sensitivity and/or sexual impotence

      Thanks a lot and Best Regards!!

      • This reply was modified 5 months, 1 week ago by Spanish.
    • #21662
      Good intentions
      Participant

      That seems like too much to do for the problem that you’ve described. Of the few surgeons that remove mesh most just remove the mesh, then wait for the body to adjust before attempting to repair any hernias. I think that you are well past worrying about the type of meshless repair. Get the mesh out with minimal damage, that should be your priority.

      Dr. Koch seems to be associating your pain with a nerve problem when it might be just the mesh. Read the recent discussion about nerve removal, linked below. It is not recommended except in cases where there is very high confidence that the nerve cannot be saved. Triple neurectomies are the ones that people have reported terrible aftereffects from.

      Nerve removal – how is this an acceptable procedure?

    • #21669
      deeoeraclea
      Participant

      @spanish

      I didn’t have exactly the same procedure as you (I have a laparascopic hernia repair with polyester progrip mesh). But, your symptoms are very similar to what I felt. I was fine about 2 weeks after surgery and had returned to heavy squats and deadlifts. But, then, about 4 weeks after surgery I started having a lot of pain in my abdomen in the area where the mesh was located. I was in quite a lot of pain from then until about 5 months after surgery. During this time exercise made the pain considerably worse. Eventually, around the 5-6 month mark, the pain subsided to the point where it no longer dominated my life. Unless a doctor identifies a nerve problem, I think you will be fine after some time. But, it probably is going to take longer than you want it to. Sorry!

    • #21670
      Spanish
      Participant

      Thanks a lot for you insight Good intentions and deeoeraclea!

      This clinic I went in Germany is a team specialized in sports hernias and they do surgeries to professional footballers, etc… How come they can do these procedures when will affect directly to sporters? What the hell? I also pointed out the surgeon that I do not care about pain, I’m an athlete, not living off it though, but I’m used to pain, I do not care about pain, I just want my hernia (recurrence) fixed, I want to preserve my functionality, that’s prio 1… He told me about the mesh removal + Shouldice hernia repair, but then once I had the treatment plan I was scared about the neurolyses, after reading the link from Good intentions it seems that even the nerves to be cut are also involved in motor system. I don’t want to hurry again and I will cancel the surgery with this Dr Mengele and will try to do it in Taiwan (https://joshuahernia.com/?lang=en).

      Thanks again guys!!

      • This reply was modified 5 months, 1 week ago by Spanish.
      • #22226
        Spanish
        Participant

        My message #21670 has some extra text I NEVER WROTE:

        ” I don’t want to hurry again and I will cancel the surgery with this Dr Mengele and will try to do it in Taiwan (https://joshuahernia.com/?lang=en).”

        If I never wrote that insulting line to a Dr that is supposed to intervene my hernia (I would be stupid), obviously someone with admin rights has added it I don’t know wwith what intention.

        I don’t know wen it was done, as the edited message reached Dr Koch and I learnt it today from his clinic (I never reread what I write in the forum), I will take the appropriate measures.

        • This reply was modified 4 months ago by Spanish.
      • #22228
        Good intentions
        Participant

        I don’t think that Dr. Koch reads the herniatalk.com forum. There is no route to Dr. Koch’s office from here. How would they know what was written on the forum?

        Maybe somebody has been on your computer or phone. Good luck.

      • #22229
        Spanish
        Participant

        Well, I tried to postpone the surgery appointment I have with him due to coronavirus (due to the situation in Europe I think it’s wise), and his assistant told me that some user informed him that I was calling him nazi and they cancelled my surgery, so go figure. I can find other competent surgeons, I’m not sold out, but I will not put up with any hidden coward who for any reason wants to leave me like someone insulting his own surgeon.

      • #22231
        Good intentions
        Participant

        That is a shame, and bizarre. Could it be someone from the bodybuilder.com forum? I know that you post over there also.

        I bet that Dr. Koch himself might understand what happened. You have been talking to someone in the front office. It might be worthwhile to try to get past them.

        Good luck.

      • #22266
        Spanish
        Participant

        Nono, it was the assistant who told me that Dr Koch himself was offended because of what “I said” here, according to assistant, obviously. So the decision was taken by Dr Koch.

        I’m really quite surprised that:

        1.- Dr Koch cancels the surgery based on what a user says in a forum. As I explained, I never would’ve said that about him and after call them about postponing surgery (but keeping it). Tnis is really childish, it sounds like he wanted to cancel the surgery and held on that excuse.

        2.- They already canceled the surgery without notifying me, whatever reason they would use. What if nothing had happened with the virus and I had gone there and found that they canceled the surgery? He said about the cancelation only when I proposed to postpone the surgery last week. The message was edited long time ago. So unprofessional.

        3.- I replied to assistant explained what I said here, that someone must have modified my message (you say someone from bodybuilder, but it has to be someone with admin privileges here in this forum too). I never received any answer from this unprofessional assistant called Nahom Welldeiesus, shame on him, really.

        May be they think they are superior as they are Germans and I am only Spanish. Shame on Biohernia, the most unprofessional clinic I have ever met. Not to mention the deontological ethics of this institution.

        • This reply was modified 3 months, 3 weeks ago by Spanish.
    • #21673
      Alephy
      Participant

      I think the best way to avoid a recurrence is to remain fit and slim…especially after a certain age your training schedule must include exercises aimed at keeping strength and elasticity of the muscles and fascia…I also would think twice before touching the nerves in a permanent way (I am surprised a surgeon would suggest this from the start). Btw reading about your original surgery I would not call that an example of a good health system: you were not in the loop on the procedure before or after and you weren’t told about the risks or complications…

    • #21675
      Spanish
      Participant

      Alephy, thanks for your answer, I enquired the clinic about cutting nerves but what they say is “taking care of your nerves and replacing them outside the suture line”… Replacing them? How come?

      About the health system, in fact in Spain the public health system is considered the second best in the world for covering everything with no cost at all and many other things. My surgery was made using my private health care insurance in Spain I have that is totally apart from the social security, that prevents queues and is more handy when you live in a country like holland that treat cancers with paracetamol. I have to say that I was unlucky wth this surgeon I had, living abroad wouldn’t make sense to go to the loop within the public system as you mention…

    • #22299
      Good intentions
      Participant

      That’s a shame Spanish, but maybe it’s best in the long run. What if you had complications? Would Dr. Koch help then?

      It’s interesting that Naholm appears to monitor and read the posts on this forum, and keep his surgeons informed. But does not participate even though he and his company have been discussed in depth.

      Biohernia – Hernia surgery without mesh

      • #26437
        Spanish
        Participant

        My first intention was the Taiwanese clinic, that has better records and obviously now after all this I see them more professional. I tried the German clinic first as they’re supposed to have good reputation and they promised to remove the mesh, and most importantly, it’s close to where I live now. Yes, this Noham unprofessional not only he played a big racist role here, but also a coward attitude by gossiping messages in forums and always hidding. In the EU you cannot cancel a surgery appointment, not notify it and accuse a patient of insulting a doctor in a forum.

        I’m also still waiting to the responsible to this forum to clarify why my message was edited, incurring in a crime of identity impersonation.

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