Open surgery repair on bilateral inguinal hernia 5 weeks ago but still not good…
04/18/2019 at 5:36 pm #11733
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
04/18/2019 at 8:09 pm #18425
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:
plug with patch
preperitoneal patch – e.g. Kugel
Prolene Hernia System (PHS)
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.
04/18/2019 at 8:13 pm #18426
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.
04/18/2019 at 8:13 pm #18427
plug – patch
preperitoneal patch – e.g. Kugel
Prolene Hernia System (PHS)
04/18/2019 at 8:17 pm #18428
The materials and methods I showed above are different and probably give different results.
Good luck. [USER=”2847″]Spanish[/USER]
04/19/2019 at 6:13 am #18440
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
04/19/2019 at 7:20 pm #18443
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”.
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.
04/20/2019 at 9:35 am #18444
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!!!
04/23/2019 at 10:49 am #18450
BTW, my surgeon told me today that the technique was Lichtenstein…
04/24/2019 at 3:15 pm #18455
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
05/01/2019 at 2:45 am #18481
[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.
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.
05/06/2019 at 8:30 am #18535quote Good intentions:
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!!
05/06/2019 at 11:08 pm #18539quote Spanish:
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..
If I were in your situation I would go to Germany. I almost flew over there myself when I was having problems.
05/07/2019 at 3:32 am #18545
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.
05/09/2019 at 6:40 am #18569quote Good intentions:
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
05/09/2019 at 6:43 am #18570quote drtowfigh:
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
05/10/2019 at 9:20 pm #18578kaspaParticipant
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
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
05/11/2019 at 10:19 pm #18582idoncovParticipant
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.
05/12/2019 at 2:21 am #18588
[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.
05/12/2019 at 1:22 pm #18603quote kaspa:
I’ll have a look, thanks for the advise!
05/12/2019 at 1:23 pm #18604quote idoncov:
Thanks a lot, but alas I’m now in central Europe, no chance for me and my hernia to go there for the repair… :-/
05/12/2019 at 1:29 pm #18605quote drtowfigh:
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!
05/12/2019 at 3:36 pm #18610
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.
05/12/2019 at 6:24 pm #18612
Laparoscopic mesh placement is not near or against the intestines.
05/13/2019 at 5:28 am #18625
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
06/09/2019 at 1:20 am #18889patientParticipant
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!
12/18/2019 at 7:24 am #20463
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:
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
12/18/2019 at 4:58 pm #20466
Consider Dr. Kang in Korea. Good luck.
02/04/2020 at 11:22 pm #21660
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 1 month, 3 weeks ago by Spanish.
02/05/2020 at 9:11 am #21662
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.
02/05/2020 at 8:26 pm #21669deeoeracleaParticipant
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!
02/05/2020 at 11:41 pm #21670
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 1 month, 3 weeks ago by Spanish.
03/17/2020 at 7:35 am #22226
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 2 weeks ago by Spanish.
03/17/2020 at 10:01 am #22228
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.
03/17/2020 at 10:10 am #22229
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.
03/17/2020 at 11:28 am #22231
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.
03/23/2020 at 5:04 am #22266
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 1 week, 1 day ago by Spanish.
02/06/2020 at 2:08 am #21673AlephyParticipant
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…
02/06/2020 at 5:09 am #21675
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…
03/26/2020 at 3:29 pm #22299
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.
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