Pain after squats

[ajm222]

@drbrown

Sounds like you’d say removal based on discomfort or tightness and foreign body sensation but very little to no pain might not be wise. Is that fair?

[DrBrown]

@aldpeev
Removal of mesh is not an easy operation and the results are mixed.
My advice is that if you can do 90% of what you want to do, then strongly consider leaving the mesh in.
Regards.
Bill Brown MD

[ajm222]

my understanding is that if you had your mesh inserted via open method, it would need to be removed that way. removing mesh in an open fashion usually results in at least some nerves having to be cut. not typically the case if mesh was placed and removed laparoscopically or robotically as the mesh is behind the muscle and away from the major nerves. people seem to have a variety of different experiences when it comes to nerves being cut. for some it’s great, and for others it can be very bad.

nerve involvement and nerve pain typically i think manifests as sharp, shooting type pains. mesh pain or discomfort from scar tissue i think is more deep soreness and tightness.

[aldpeev]

Thanks for the replays! Today I was okay with mild pain in the surgery area and I’m still researching mesh removal and possible problems. One thing that comes to mind is the difference between entrapped nerves and just mesh pain and what actually causes the pain in the surgery area. The stiffness of scar tissue and mesh combination? One of the biggest concerns about mesh removal is cut nerves for me.

[Alephy]

I wonder whether one can differentiate between scar tissue problems and the mesh itself….from reading the forum it seems those who had mesh removal were fine afterwards, with the scar tissue stopping the hernia from recurring…the problem with inguinal hernias is they occur in a place that is key to movement so anything static can cause lots of problems….some doctors are trying to find a way to regenerate healthy tissue at the same time avoiding any static hurdle in the area

[mitchtom6]

Hey aldpeev, sorry about your experience.

Having been through something similar, I think you will be fine with a bit of rest. I have had bouts of testicular pain following physical activity, which was very distressing. My first though was that I had a recurrence. However, I visited many doctors and they couldn’t detect one. Eventually, it resolved with time. For instance, I did some rowing a few months ago and had testicular pain afterwards with bending. It was very concerning, and I wondered if I could ever exercise again. However, I took a few weeks/months off and it settled. Recently, I cautiously resumed rowing again and I haven’t had that issue.

Backstory: I was doing fine for 5 years after my mesh repair. Regrettably, a stair running routine caused discomfort in my lower abs/groin, and then a few days later, I crossed my legs on the couch and felt a rip. I have had chronic pain and spasming ever since (about 1.5 years now), although it has gradually been lessening in intensity. Most of the doctors have suggested that it is a mesh complication. Yes, you can have mesh issues years/months down the road as I can attest.

I would suggest something specific: avoid “high knee” activities, such as excessive stairs, or kickboxing, or marching-style movements, or hurdles. It seems that this sort of activity puts undue stress on the repair. That I how I ended up with my condition. I now take daily meds to cope with the pain. In fact, I was just icing my groin this morning.

Take care and I wish the best for you, my Eastern European brother. I think you’ll be alright with some rest and some activity modification.

[ajm222]

my pleasure. i’m not sure exactly what the surgeons are suggesting regarding the spermatic cord or what might actually be going on. but i do know that as scar tissue grows it’s possible to have issues later on in recovery. scar tissue formation and scar tissue “remodeling” over time as your body heals and continues dealing with the mesh and the scarring means changes can take place over longer periods of time. most people with problems have them from the beginning, some develop issues after the first few months. and there are the occasional patients who are fine for years and then something happens and they start having issues. it seems unpredictable. again, “most” people are fine and stay that way, even if they have some bumps in the road along the way. i think you’ll just have to keep an eye on it. if things continue to improve, i would expect you’ll be just fine. but if they stay the same or get worse, then it might be time to find a real expert who deals with patients that have mesh complications or who also does lots of mesh removal and has seen a lot of complications.

i myself have had some testicular pain on and off. as mentioned before, it seems to get worse when i am stressed or if i worry specifically about mesh-related pain. so it feels for me some of it might have an emotional or psychological component. i also did have a vasectomy years before the mesh, and i’ve been told that that surgery can also occasionally cause problems on and off. it’s so hard to know for sure. and i think mine has just generally gotten better over time. the fact that it hasn’t gotten worse to me is a good sign. i also had a lipoma removed from the spermatic cord at the time of the mesh surgery as well, so that could play a part. having a lipoma on the spermatic cord is a very common thing with hernia patients.

[aldpeev]

@ajm222 Thank you for the great post ! Today was okay and I really hope nothing bad happens further. Is it possible to dislocate the mesh after this long time? My surgeon is categorical that after 3 months it is  impossible to happen. Then why did I have those problems ? He just said that I overloaded myself and to give it a break. Another highly experienced surgeon told me the reason for pain is compression of the spermatic cord if it’s overloaded and if I would have problems I would have them immediately not after that much time . But I have read here about folks that had no problems like me and suddenly appeared . So I really hope everything settles and will never again take the risk of injury. I really didn’t know hernia repairs are so complicated especially if there is mesh problem. I’m still open to hear the docs opinion. 

[ajm222]

Hey there,

I have had a number of issues that come and go related to my repair. The good news is that after 2 1/2 years, I don’t have much pain. I still can feel pain in the area of the repair from time to time depending on what I am doing and my level of attention to it, but it’s not a constant thing at all, and any pain is very mild. The only issue I currently deal with is just a tightness and discomfort that basically reminds me that I have something in there that’s likely pulling and tugging on things without a lot of give. It doesn’t really stop me from doing anything, but I notice it daily. Which is why I am still considering removal.

But I also know removal is no joke, and without a lot of pain I am really on the fence. Dr. Belyansky has agreed to remove mine, and I would hope the result would be good because I only have one side to remove, and it was put in robotically and would be taken out robotically, and I don’t have any nerve pain. But he’s also said things like ‘if it were a member of my family, I would probably urge you to not do it’ etc etc. Meanwhile, other removal surgeons (and even at times Dr. B.) have said that removal is safe with appropriate risks. My original hope for removal was that it could be taken out and I would be so relieved like many folks I’ve talked to, and the scar tissue would be enough to hold things in and I would never have to worry about this ever again. But I also know there are no guarantees.

So long story short I am doing fine and still wrestling with this decision. I would on the one hand love to go up one day and have this thing removed and then no longer have a foreign body sensation and the pulling and tightness, but on the other hand I’m terrified of the chance of making anything worse. It could go great, or it could go terrible. Likelihood is the former, but it’s a risk and I just can’t decide what to do.

Anyway, the general trajectory in my case has been towards less and less pain. And speaking of your issue, it sounds like many others who have done a particular movement and then had some pain. That actually never happened to me. My issues have always been consistent. But it seems for many that something like that typically resolves with time and rest as long as it wasn’t a recurrence. Probably just tearing of some scar tissue or something. I would give it a couple weeks and see if you see improvement. The involvement of the testicles and testicular pain is of course a concern, but doesn’t necessarily mean anything different. But I really don’t know. Something could have been pulled on and it’s just healing. And hopefully it heals without any additional issues or nerve entrapment, etc. I would assume the former and not get too worried unless it persists or gets worse.

I would for now assume that everything will be just fine. It usually is. I think it’s normal, especially in the first couple years, to have things like this when exercising where some young scar tissue maybe gets torn and then it heals just fine. Listen to your body. Take it easy for a bit (though keep active). And hopefully you go back to not having any issues at all. Usually if you give it a few weeks you’ll be fine.

And there is also definitely something to be said about the worry. When I worry about my issues, they really start to bother me. If I relax, most of them go away or subside to the point they aren’t really bothering me too much. It’s like the stress causes subconscious tightening of muscles in the area of focus and that of course results in soreness. It’s like making a fist. You can hold a tight fist for a moment and not feel any pain. But if you try and hold that tight fist for an hour or several hours, it becomes very sore. I think sometimes we get really obsessed with something which causes us to tighten our muscles (as a protective mechanism) but then that constant strain leads to pain which then causes us to stress and tighten even more, if that makes sense. So I would also try and relax and think positively and see if that helps. If that’s part of the issue and you can break that cycle, you might realize that’s all it was and feel back to normal.

Anyway, keep us posted.

[aldpeev]

Thanks for your reply @ajm222. How are you recently? I have read your topics and saw that you are with progrip as well. The topic about gradually improving in terms of pain after a while is interesting and I hope it is true. What do you think about my problem?  Have you ever experienced anything like that before?

[ajm222]

Yes, the progrip mesh has lots and lots of little hooks on it that help it stay in place (like velcro), the idea being that surgeons can avoid using tacks when installing it, which are often a source of pain. over a year to 18 months the little hooks do dissolve.

[aldpeev]

The pain I felt was instant in the hip adductors when squatting and then started in the testicles. Initially I had zero pain in the surgery place. That happened approximately 10 days ago. Testicle pain gradually settled to almost non existent but then started pain in the surgery place when bent down for instance. I can describe it as when you have stretched something and it’s recovering – like dull pain. Yesterday I had zero pain in my testicles and surgery place. Today I have very mild pain in one testicle ( it feels on the outer side, not the whole testicle) when walking which is not constant and mild pain in one side surgery ( like I have some kind of wound that is recovering). The hip adductors pain (or inside of the leg where it is attached to the groin) is still present tho. It’s very weird and I think there is some level of anxiety and hypochondria to it , especially knowing there is no easy solution and I’m that young.

[Alephy]

I searched the mesh type and I am not sure it dissolves over time. I think the fixation idea behind it has been discussed in this forum before, maybe try and search for it…another thing I seem to remember is that the mesh surgeons recommend a minimum period of time before they would even consider removal: before they advise on pain control (again the doctors here will be able to expand on this). How bad is the pain at the moment btw? is it constant?

[aldpeev]

No, I’m from Eastern Europe but from the research that I have done found dr.Muschaweck is one of the best in Europe for removal. Maybe @drbrown or @drtowfigh will have a clue what’s happening. Also is it true that ProGrip micro grips dissolve over time ? Is it harder to remove that type of mesh ? Just as I said I’m not thinking of removal yet and hope everything settles down but i prefer to be well informed. I have been inspected for recurrence of hernia or any complications by the surgeon of my hernia and one other, they said everything is okay and seems to me that they don’t care if there is pain, only if there is recurrence of hernia. And it is obvious why they don’t care, because it is so risky to remove it.

[Alephy]

Hopefully doctors will chime in and comment, but I would consider pain after exercising “not normal”, in the sense that it is not in line with what doctors tell patients about mesh repair; but I guess it is normal in the real world where mesh repair is NOT a routine surgery (by which I mean, with very little rate of complications). Hopefully the doctors here will be able to tell you which exams to go for, to understand if something is up other than a mesh reaction….Are you located in Germany by the way? I am also considering Dr. Muschaweck for inguinal hernia repair (and watchful waiting in the meantime)…