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Possible occult hernia or not?
[USER=”935″]drtowfigh[/USER] I’ve been dealing with unexplainable groin pain in my upper left groin area for about a little over a month, starting right at the top of where the “v-line” begins going down the line. It’s not sharp or sudden, but constant, dull and achey. I have no pain on the right at all, no testicular pain or nothing, the pain is just in that exact area. I’ll attach a photo of the area circling where it is exactly. Reason I post this here on this forum is because I know Dr. Towfigh is an expert when it comes to multiple reasons for groin pain and also because I know occult hernias can sometimes be a possibly for groin pain when no bulge is present.
The pain is really felt when I am sitting down or rested up with my legs straight on the bed. Also sometimes when I’m laying down depending on the position I’m in. When I am walking or standing, the pain somewhat goes away. The pain is mostly a 4-5 on my pain scale, daily. I don’t feel the pain when I cough or sneeze, but I do feel the pain when I expand my stomach or raise my voice. It almost feels like it’s pushing up against a vein or something like that because there is a chord like structure in the area (not sure what it’s called, not expert on anatomy) of the pain and when I press down on it, it creates the pain. But I’m not sure if that it’s the source of the pain or if it’s just creating the pain because I’m pressing down on whatever it is that I’m feeling. Sometimes I’ll also get a tingling sensation throughout my leg when I walk, but not painful.
As far as how it started, I’m not quite sure. I used to work in a produce department so I did a lot of heavy lifting and hard labor. When I first noticed this pain, it was when I got home from work about a little over a month ago and it was really bad that night. After that shift, I had to take off about 4 weeks for something else, but the pain had gone away pretty much during that time. I went back last Friday, and it’s back again right now. It started about three days ago. I’m not sure if I pulled a muscle perhaps, maybe pinched a nerve, or if this could even be symptoms of an occult hernia. I’ve read a lot about people having groin pain with no bulge and later realizing they’ve had a hidden hernia. I also should note that during the time off from work, I did a loooot of sitting down. I don’t know if that can cause a pinched nerve or not.
Any information would be appreciated!
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11 Replies
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[USER=”2042″]Jnomesh[/USER] Thanks for the information. How did the hernia specialist finally concluded that you had a hernia?
The pain today had actually subsided a good amount. I did some stretches last night and have been massaging the area and that seems to be helping a lot. I had been waking up with the pain straight out of bed but this morning I didn’t. But it’s only one day so I don’t know. I have an appointment tomorrow with my primary so hopefully he can give an idea at least on what it could be.
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I (not a doctor) agree with good intentions that mesh issues can have a effect on other areas especially since they can be quite large with different fixating devices to boot. That being said the specific area that you outlined could also be the beginnings of a indirect hernia or a occult/hidden inguinal hernia. My right indirect hernia was kind of a classic hernia a bulge where you’d expect to see it and everything that went along with it.
However my left indirect hernia was nothing status quo-there was no bulge, lots of burning especially when sitting and was higher up in the area you have outlined m. It wasn’t picked up on physical exam, MRI or Catscsn (not maybe it would of been if I had seen a hernia specialist who knows how to read the scans themselves.
it took almost a year and a half before a hernia specialists diagnosed me with a hernia .
Of course one problem solved led to another as mesh repair ruined my life for many years until it was finally removed. -
The acronyms can be undefined. Most of them refer to placement of the mesh. IPOM is, apparently, still an “intra-abdominal” laparoscopy method, as opposed to TEP which stays between the peritoneum and fascia, never entering the abdominal cavity. The work is done inside the abdomen.
So, adhesions are one possibility for pain. That’s the main reason for the coating on the mesh. Also see where the sutures are placed. We just had a short discussion about tension in another topic. If he mesh shrinks the sutures on the corners get pulled, along with the tacks. That seems like potential for discomfort.
This video seems informative. I assume that there are variations, of course.
https://www.youtube.com/watch?v=I_kSyqdpROE
[USER=”2871″]Runner123[/USER]
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[USER=”2029″]Good intentions[/USER] I have the operation report. It was 5×5 inches of circular mesh with a coated barrier. And the placement wasn’t TAPP or TEP, it was IPOM so it was placed intraperitoneal up against the peritoneum, if that’s what you mean. So no dissection of the peritoneum was made except for the trocar sites. But yeah I see what you mean. I’ve actually read a few times where that happened and the patient didn’t even know all along and wasn’t even informed. I find it to be shocking to say the least.
[USER=”935″]drtowfigh[/USER] Hopefully Dr. Towfigh can give me insight on if she’s ever seen this before.
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Actually, without the report you don’t know how big the piece of mesh was.or where exactly it was placed.
The entry point does not determine placement with TAPP or TEP. And the initial reason for the surgery does not determine the final result. If your surgeon saw an inguinal hernia he/she might have “fixed” it without your knowledge. He/she might have dissected the peritoneum back the point where you’re feeling pain to make room for the umbilical mesh.
I would not assume anything. Get as much information as you can and let the facts determine what’s happening.
Good luck.
[USER=”2871″]Runner123[/USER]
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[USER=”2029″]Good intentions[/USER] It was repaired laparoscopically with mesh, the technique was IPOM. Although I don’t believe that the first surgery has to do something with the pain I’m dealing with since the location of the mesh isn’t in contact with anything. But who knows. If it would have something to do with the first surgery, I could only think of the placement of the trocar site maybe? One trocar was placed in my lower left abdomen. But I would assume that if it was because of that then I would have felt the pain right after surgery. But again, what do I know.
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[USER=”2871″]Runner123[/USER] notifying, forgot.
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quote Runner123:[USER=”2029″] I just had an umbilical repaired a couple of months back that I’m having minor problems with.
That is an important disclosure. Do you know how the umbilical hernia was repaired? It is often repaired with mesh. Mesh is rapidly becoming the “do-all” repair method for all sorts of abdominal problems. Since the mesh and tissue contacting it contract, a mesh repair can often cause new problems.
Get the details of your first repair to see what was done. It will also play a part in the repair of your new hernia if you have one. It will affect the types of repair that are possible.
I’m sorry that you are in this situation. You’ll want to become very educated in what was done to you and what might be happening.
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[USER=”2029″]Good intentions[/USER] Thank you for the reply. I’m really hoping it isn’t a hernia. I just had an umbilical repaired a couple of months back that I’m having minor problems with.
I have an appointment with my primary on Tuesday so hopefully he can give me an idea of what it could be. Usually during physical activity it doesn’t bother me but it doesn’t bother me either the next day after it. It kind of just lingers everyday. And I am in Texas.
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[USER=”2871″]Runner123[/USER] notifying
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Hello Runner. Have you had a physical examination by a doctor? I can almost guarantee that that will be suggested. It could be the start of a “normal” hernia, impacting a nerve. If you have insurance and/or can afford it you should start with your doctor, or maybe go directly to a hernia specialist.
Your screen name choice implies that you might be athletic. Does the pain get better or worse with physical activity? If it gets worse that’s a sign of athletic pubalgia, AKA sports hernia. If it gets better but hurts the next day, that might be a normal hernia starting.
The details will help but you might have to get imaging to be sure.
Post your general location and people might have a recommendation for a doctor close to you. Choosing the right doctor is important.
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