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PLEASE HELP- 3 Weeks Post op inguinal laparoscopic hernia repair w/ mesh- 29 y/o male
[USER=”2580″]DrBrown[/USER] [USER=”935″]drtowfigh[/USER] I recently had bilateral laparoscopic inguinal hernia repair with mesh on 6/21/19 and have been having quite a bit of difficulty with the recovery. I have been getting a jolting/sharp nerve pain with leg movements (putting socks on, getting into and out of car, sitting transitions) only on my right side – no problems on the left side whatsoever. I am currently a little over 3 weeks post op and also have a consistent dull burning type pain on the inside of my groin (only on my R side) that will also radiate into my R testicle most of the day. When I get into and out of the car, in and out of bed, or lift my leg up to get my socks on – i get a sharp jolting pain on my upper and outer thigh that stops me dead in my tracks. Walking and laying flat will alleviate the pain and feel much better, but sitting and scrunching forward will cause that burning and occasional sharp nerve irritation/entrapment type feeling.
I believe that the nerves being affected are the lateral femoral cutaneous nerve of thigh and genitofemoral nerve? I am 6′ 185 pounds white male age 29 who considers himself a very active/fit guy. Has anyone else dealt with something similar? Could the mesh have folded or balled up causing the nerve irritation?
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10 Replies
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[USER=”2922″]kipthor[/USER]
Dear Kipthor.
I am glad that you have gotten better.
Most athletes with pain related to the mesh improve with time.
Best wishes.
Bill Brown MD -
Hi everyone – just wanted to give an update on my previous symptoms. I am now roughly 3 months post op and feel so much better. I will get a nerve twinge randomly, but it is very infrequent. I am about 95% better and I am guessing that I will continue to see improvement in subsequent weeks and months. There are many days where I don’t even think about my surgery, which is a big change from before where I literally couldn’t get it off my mind.
For those struggling initially post op – just realize that it does take some time for things to settle down and to fully heal. It was hard to be patient, especially for someone that is young and very active. Stay positive and LET YOURSELF HEAL and RELAX. Hope this gives some of you out there with some much needed encouragement and positivity – hang in there!
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Hi [USER=”2922″]kipthor[/USER] , I am planning to have the same procedure in a month. Can you please post on your status?
Thanks
Ram -
Based on your symptoms, I think it would be worthwhile to have imaging to check the mesh placement and see if it has folded or balled up. I usually order MRI pelvis.
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Dear Kiptor.
Pain that goes to the scrotum, inside of the thigh, and the pubic hair region is usually the ilioinguinal nerve.
Pain that goes to the testicle itself is usually the genital nerve.
The lateral femoral cutaneous nerve usually goes to the outside of the thigh.
Nerve blocks can be performed to help determine which nerve is giving you trouble.
For example if the ilioinguinal nerve is anesthetized with a local anesthestic and you feel better for a few hours that would be strong evidence that that nerve is the source of your trouble. Then a steroid injection may provide long term relief.
Nerve pain will often improve with time. So I would not advise any major procedures at this time.
Baby powder after your shower may help. Compression shorts may help. Capsaicin Cream may help.
Let me know if there is anything else that I can do for you.
Regards
Bill Brown MD
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I understand your trepidation with the medication.
i was just offering some things that helped me to function although minimally as I was unable to work or function with my pain and symptoms .
As I mentioned I had a multitude of issues but yes regarding the burning pain there was none when standing and sometimes lying down. Walking and standing the burning pain was not present .
I would imagine there is a higher probability of mesh folding or crumpling with self fixating meshes not that it can’t happen with fixation too.
Ly mesh was not fixated with sutures tacs or staples either. -
quote Jnomesh:I had a burning pain in outside groin crease and lateral front thigh and it was brought about by sitting. This happened about 5 years post laparoscopic implantation. I had other symptoms and issues too but the burning whole sitting was unbearably painful.
it turned out my mesh had folded. But I’ve read that the Lateral femoral cutaneous nerve I heard can also be damaged if a tac or staple used to fixate the mean punctures it.When I did all of my research I rarely came across any literature about this nerve causing issues when sitting even though I was almost positive this LFCN WAS one of the issues casing me my burning excruciating pain.
interestingly about a year and a half after removal I found a article of a woman who had LFCN issues and the diagram and pictures of where her pain was was exactly as mine. Finally a article that showed the burning pain not only on the thigh but also in a little patch of the outside crease of the groin.
Of you went to PM me I can send you the link or see if I can pair it here.
Some possible helpful tidbits that helped me lessen the the pain symptoms whole you figure out what to do
1) you can get a LFCN nerve block-it is used for diagnostic purposes. It was difficult for me to feel how much it helped jc I was having other painful issues as well.
2) Gabapentin helped me a good among although the side effects for some can be bad. For me it made me kind of feel Like a zombie but it helped me manage the pain.
3) unzipping pants and even using my finger to lift the waistband helped when driving
4) a tens machine I put the electrodes on my lower back helped immensely and I used it a lot while I was driving which I had to do a lot for work.
5) unfortinately most of these suggestions are merely a bandaid and it definitely sounds like your mesh surgery has caused this pain. Seek a top notch hernia specialist even if it means traveling and paying out of pocket. There are a few good ones mentioned on these forms. I used dr. Igor Belyankski, there is Sherwom Towfigh, dr. Billings and dr. Jacobs. These surgeons specialize in laparoscopic surgery the same as yours.
of mesh has to come out or exploratory surgery has to performed them you want to tackle it the same way mesh was inserted. Stay away from the surgeons who only specialize in open repairs.
Get your operative report and find out your type of mesh-mine was the bard 3D maxx and some of had issues with it folding. Find out what was used to fixate your mesh. Review all the notes.
This may be hard to hear but you probably will want to stay away from your implanting surgeon and go straight to someone who has experience design with these issues and removal. The advice you might get form your implanting surgeon is to give it time or go off to pain management.
its amazing how a lot of implanting surgeons either don’t believe your pain, don’t believe the magnitude or don’t know what to do.
id explore pain management to help reduce pain and explore what it might be but if also simultaneously reach out to one of the top specialistsThe mesh was parietex pro grip self fixating mesh. Was used on both sides when he repaired both L and R inguinal hernia. Weird thing is that I have absolutely zero difficulty with the left side – only the R.
As far as medications go – i have zero ambition to take anything for the pain that carries some side effects. I actually work in healthcare and need to be able to concentrate and not feel lethargic most of the day.
Was your pain pretty much gone/much improved when you stood up and walked around?
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quote Good intentions:Can you give more detail on the surgery? “Laparoscopic with mesh” covers many different combinations of material and method. Which side was the original hernia on? Did the surgeon find another and repair it while he/she was there?
The answer to both of your questions is yes. People have had your problem, and mesh does fold. Read through the many topics on the site, there is a recent one with a similar problem. I think that any direct contact of a nerve with the mesh can cause pain.
Get your surgery notes and there might be some clues there. The advice that you will receive is to wait and see what happens, because it’s only been three weeks. Good luck.
Original hernia was on the R side – indirect hernia. He did find a hernia on the other side when he went to check. Both sides used a parietex progrip self fixating mesh. It’s werid that my L side has no pain at all, which makes me wonder if the mesh has folded over causing this discomfort.
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I had a burning pain in outside groin crease and lateral front thigh and it was brought about by sitting. This happened about 5 years post laparoscopic implantation. I had other symptoms and issues too but the burning whole sitting was unbearably painful.
it turned out my mesh had folded. But I’ve read that the Lateral femoral cutaneous nerve I heard can also be damaged if a tac or staple used to fixate the mean punctures it.When I did all of my research I rarely came across any literature about this nerve causing issues when sitting even though I was almost positive this LFCN WAS one of the issues casing me my burning excruciating pain.
interestingly about a year and a half after removal I found a article of a woman who had LFCN issues and the diagram and pictures of where her pain was was exactly as mine. Finally a article that showed the burning pain not only on the thigh but also in a little patch of the outside crease of the groin.
Of you went to PM me I can send you the link or see if I can pair it here.
Some possible helpful tidbits that helped me lessen the the pain symptoms whole you figure out what to do
1) you can get a LFCN nerve block-it is used for diagnostic purposes. It was difficult for me to feel how much it helped jc I was having other painful issues as well.
2) Gabapentin helped me a good among although the side effects for some can be bad. For me it made me kind of feel Like a zombie but it helped me manage the pain.
3) unzipping pants and even using my finger to lift the waistband helped when driving
4) a tens machine I put the electrodes on my lower back helped immensely and I used it a lot while I was driving which I had to do a lot for work.
5) unfortinately most of these suggestions are merely a bandaid and it definitely sounds like your mesh surgery has caused this pain. Seek a top notch hernia specialist even if it means traveling and paying out of pocket. There are a few good ones mentioned on these forms. I used dr. Igor Belyankski, there is Sherwom Towfigh, dr. Billings and dr. Jacobs. These surgeons specialize in laparoscopic surgery the same as yours.
of mesh has to come out or exploratory surgery has to performed them you want to tackle it the same way mesh was inserted. Stay away from the surgeons who only specialize in open repairs.
Get your operative report and find out your type of mesh-mine was the bard 3D maxx and some of had issues with it folding. Find out what was used to fixate your mesh. Review all the notes.
This may be hard to hear but you probably will want to stay away from your implanting surgeon and go straight to someone who has experience design with these issues and removal. The advice you might get form your implanting surgeon is to give it time or go off to pain management.
its amazing how a lot of implanting surgeons either don’t believe your pain, don’t believe the magnitude or don’t know what to do.
id explore pain management to help reduce pain and explore what it might be but if also simultaneously reach out to one of the top specialists -
Can you give more detail on the surgery? “Laparoscopic with mesh” covers many different combinations of material and method. Which side was the original hernia on? Did the surgeon find another and repair it while he/she was there?
The answer to both of your questions is yes. People have had your problem, and mesh does fold. Read through the many topics on the site, there is a recent one with a similar problem. I think that any direct contact of a nerve with the mesh can cause pain.
Get your surgery notes and there might be some clues there. The advice that you will receive is to wait and see what happens, because it’s only been three weeks. Good luck.
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