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Patulous bilateral inguinal canals containing fat
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The surgeon is planning to use a hybrid mesh–disappearing, with some small kevlar weaved into it. I cannot find anything more online about this type of mesh. All my research indicates that the surgeon’s skill is the most important part of the hernia surgery, and there is no way to truly find out how good the surgeon is…only indicators by # of surgeries performed and other doctors recommendations. My umbilical is small and will be sutured. I just don’t see how suturing the inguinals would be better. Sutures tend to fail more than mesh. I do get that a small percentage do have complications…it is a risk. Waiting until it becomes an emergency means I don’t get to choose my surgeon…
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Get a second opinion by seeing a non mesh surgeon.
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I’d have to agree with Good intentions here as I was one of the ones fooled by the optimistic words of my surgeon. I had my mesh implanted over a year ago and started have problems almost right away, mostly nerve issues. I plan to have my mesh removed but for anyone considering a hernia operation I would strongly suggest finding a surgeon who can perform a pure tissue repair. Most hernias are manageable and you are not doing any harm by just waiting and doing some research first. I often think to myself if I could go back to when I had my hernia and before I got the mesh I would. Sure the mesh might reduce the chance of recurrence but for people with chronic pain due to the mesh it can be devastating.
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quote Forest:I did see a hernia specialist yesterday. He does robotic, laporascopic surgery–seemed to believe my situation will be relatively easy–all three are small. I am feeling more confident after seeing him.
I can not emphasize enough, here or in my past posts, about how everybody is fooled by the comforting words. First from the device makers to the surgeons, then from the surgeons to the patients.
Your surgeon is going to implant one or two large pieces of mesh in to your abdomen. Probably two, they always find a defect on the other side, The pain you feel now will be nothing compared to the hopelessness you’ll feel if you have mesh problems. There are many stories on this forum from very healthy athletic people who had mesh problem. You have other problems in addition to mesh problems. No offense, but you are not “healthy” so your issues will probably be even worse. Talk to your urologist about how they will have to deal with the mesh if you need a prostate operation. They will have to cut through it or go around it, and your hernia surgeon is probably going to use the largest piece possible.
Do not assume that all of the surgeons talk to each other and are working together, discussing your situation, to help you. They don’t and they aren’t. They are all “specialists” in today’s world and only do what they specialize in, with very little consideration for their fellow surgeons or for your future problem.
I wish I had positive words for you but you are on the path that many people of the forum have been on. You can read through the Topics and find some of their stories from start to today, and the similarities will scare you. Comforting words from the surgeon (easy, I’ve done many, International Guidelines), pulling the trigger to get mesh implantation, regretting it. Be careful.
Good luck.
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While I am waiting for surgery, I periodically get increased aches/burning. My surgeon told me if that happens to lay down and gently massage the area…does not seem to be working thus far. I take it that I have increased fat pressure on a nerve. Anyone have any other ideas to alleviate the pain?
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Thanks Dr Towfigh,
Your comments give me confidence.
The moving around and exercise makes me nervous with the aching/burning going on…but trying to remain active.
I think we have the prostrate under control now with the alfuzosin and will do another bladder check next week. I think I am good for surgery in a couple weeks, with a final check next week.
Thanks so much.
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Fix the prostate problem first. You should reach a state where you are not straining to empty your bladder and not straining to improve the stream of your urine.
Then, if your hernias remain symptomatic, consider repair. The CT findings and your symptoms are basically that of a traditional inguinal hernia. Nothing nefarious. Risk of incarceration while watchfully waiting is low—0.18% per year.
And please do exercise and move around. Minimal movement is not necessary nor is it helpful.
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Dr Brown, thank you. Yes, I am not badly overweight, but I can definitely lose some weight. Yes, the distended bladder is being caused (most likely) by an enlarged prostrate. It wasn’t until an ER visit in which they had me do an emptying exam that I people started paying attention (yep, retaining 700 ml of urine…and otherwise that is the only symptom I had for the usually enlarged prostate questions). The urologist is addressing this now with a catheter (to decompress), and alfuzosin. Unfortunately, it took an ER visit to get some attention on the bladder–4 other drs saw it on an earlier CT scan and said asked me limited questions about it…not too happy about that. I did see a hernia specialist yesterday. He does robotic, laporascopic surgery–seemed to believe my situation will be relatively easy–all three are small. I am feeling more confident after seeing him. I definitely appreciate this website. Urologist said my issue now won’t pose a problem for surgery. The hernia surgeon said, worst case is that we may need to recathaterize you. 2 weeks till surgery.
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Dear Forest.
Have the prostate evaluated. A distended bladder usually indicates that you are not emptying the bladder well. This will make the hernias worse.
Try to lose weight before having the hernia repaired.
Be sure to ask lots questions.
Regards
Bill Brown MD -
Thank you Good Intentions–I will definitely take that to heart and keep getting the data. Hard to find good public data amongst all surgeons–just the number of hernia surgeries performed is hard to find. Not sure how many is “optimal,” let alone long term success. And as I understand, it can get tricky because those who take “easy” procedures pad their stats, while those taking hard cases may have their stats negatively influencing, despite having greater skill or experience. So while I can get the data on the surgeon I am about to go to, it will be hard to compare unless I can make appointments with a number of surgeons to get their stats.
So the pain is essentially pressure, not breaking through fascia or other material?
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The pain indicates that the material, “fat” or omentum, has already pushed through, or created, an opening. The “fat” in the canal indicates that “breakthrough” has already occurred.
The odds of intestine strangulation are low, especially if there is no intestine in the canals now. The odds of chronic pain from mesh are about one in six. Don’t get in a hurry to get this new problem behind you. Use the numbers and data available to make the right decision for the rest of your life. Mesh problems can not be “fixed”, only modified to less painful problems. Even if you schedule a procedure to get on the books continue to do research, and change your mind if you don’t feel right about it. There is very little accountability for problems with hernia repair. You will have very little recourse if you have problems. Get it right the first time.
Be very careful when listening at your consultations. Don’t get persuaded by confident words if they can’t be verified. Don’t confuse the number of implantations they’ve done with expertise in understanding how to minimize your risk of chronic pain. If your surgeon can only talk about how many operations they’ve performed but not about the long-term success rate of those procedures find a different surgeon. All surgeons should know how their work lasts, over many years. Lack of knowledge does not mean success. Mesh repair is easy and simple for the surgeon but the consequences can be huge and difficult for you. Experience in mesh implantation is not the same as hernia repair expertise.
Good luck.
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