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Post Hernia Repair Nerve Pain
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Get those nerves blocked! No need to delay that aspect.
I agree with the Elavil. I also agree with the Lidoderm patches.
If you’re in a state that allows for marijuana, CBD cream can help too.
[USER=”3024″]andrew1982[/USER] Most importantly: there is a cure. Don’t lose hope. Whatever the problem, it can be fixed. Continue to be your own biggest advocate.
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2nd try – Unapproved
quote andrew1982:Hi Everyone,i am a 37 year old male in good physical condition. I was suffering from a reflectively small right side inguinal hernia for approx 1 year that caused no pain but needed to be pushed back in regularly so I decided to have it repaired.
I had open surgery (non-mesh) 2 weeks ago, details of which are as follows:
-neurolysis of the illionguinal nerve
-neurolysis and neurectomy of the genital branch of the Genitofemoral nerve
-hernioplasty (minimal repair technique)
-pre-peritoneal lipoma resectedThe days immediately following surgery were relatively pain free but from around day 6 I have been suffering from hypersensitivity/burning sensation that is very painful. The areas affected are from around 1cm below the incision to the base of my penis, the top portion of scrotal skin on right, the crease of my thigh/groin, the inside of my thigh and the top of the thigh to the right of the incision. The pain has not subsided since it began and is not hugely helped with pain killers (paracetemol/ibuprofen/tramadol). I’m pretty sure it’s the area served by the illionguinal nerve.
I have spoken with with my surgeon who is adamant that the pain will pass in a few weeks. I also asked why the nerve had to be removed when I had no pre-operative pain and was told that the hernia sack compressed the nerve and the nerve was adherent to the sack so had to be removed to prevent chronic pain. i was also told that the Iloinguinal nerve was protected but had to be mobilised carefully to avoid entrapment.
I am very anxious that the pain will not subside. Any advice would be much appreciated.
Hello andrew1982. andrew1982 Here is your post #1. Post #18 is just a comment about your post being Unapproved, nothing useful there. I couldn’t find anything about imaging.
The doctors who reply here are offering free advice and time. Anything that you can do to get them the information that they ask for will help you. I don’t think that they have the time to go back and look through old posts. No offense, I’m just suggesting that if you can collect and summarize what you know that you’ll get better advice. I suggest that you re-write your whole story, very concisely and to the point.
You’ve had quite a bit of cutting done on your nerves. It has been noted in past comments by the doctors that the cut or damaged nerves can result in a neuroma. The fact that it seems close to your skin surface is probably significant.
There is probably a solution for you but you’ll probably have to go through the standard process for nerve pain, whatever that is. Good luck.
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quote andrew1982:Hi Everyone,
i am a 37 year old male in good physical condition. I was suffering from a reflectively small right side inguinal hernia for approx 1 year that caused no pain but needed to be pushed back in regularly so I decided to have it repaired.
I had open surgery (non-mesh) 2 weeks ago, details of which are as follows:
-neurolysis of the illionguinal nerve
-neurolysis and neurectomy of the genital branch of the Genitofemoral nerve
-hernioplasty (minimal repair technique)
-pre-peritoneal lipoma resectedThe days immediately following surgery were relatively pain free but from around day 6 I have been suffering from hypersensitivity/burning sensation that is very painful. The areas affected are from around 1cm below the incision to the base of my penis, the top portion of scrotal skin on right, the crease of my thigh/groin, the inside of my thigh and the top of the thigh to the right of the incision. The pain has not subsided since it began and is not hugely helped with pain killers (paracetemol/ibuprofen/tramadol). I’m pretty sure it’s the area served by the illionguinal nerve.
I have spoken with with my surgeon who is adamant that the pain will pass in a few weeks. I also asked why the nerve had to be removed when I had no pre-operative pain and was told that the hernia sack compressed the nerve and the nerve was adherent to the sack so had to be removed to prevent chronic pain. i was also told that the Iloinguinal nerve was protected but had to be mobilised carefully to avoid entrapment.
I am very anxious that the pain will not subside. Any advice would be much appreciated.
Hello andrew1982. andrew1982 Here is your post #1. Post #18 is just a comment about your post being Unapproved, nothing useful there. I couldn’t find anything about imaging.
The doctors who reply here are offering free advice and time. Anything that you can do to get them the information that they ask for will help you. I don’t think that they have the time to go back and look through old posts. No offense, I’m just suggesting that if you can collect and summarize what you know that you’ll get better advice. I suggest that you re-write your whole story, very concisely and to the point.
You’ve had quite a bit of cutting done on your nerves. It has been noted in past comments by the doctors that the cut or damaged nerves can result in a neuroma. The fact that it seems close to your skin surface is probably significant.
There is probably a solution for you but you’ll probably have to go through the standard process for nerve pain, whatever that is. Good luck.
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quote andrew1982:Hi Everyone,
i am a 37 year old male in good physical condition. I was suffering from a reflectively small right side inguinal hernia for approx 1 year that caused no pain but needed to be pushed back in regularly so I decided to have it repaired.
I had open surgery (non-mesh) 2 weeks ago, details of which are as follows:
-neurolysis of the illionguinal nerve
-neurolysis and neurectomy of the genital branch of the Genitofemoral nerve
-hernioplasty (minimal repair technique)
-pre-peritoneal lipoma resectedThe days immediately following surgery were relatively pain free but from around day 6 I have been suffering from hypersensitivity/burning sensation that is very painful. The areas affected are from around 1cm below the incision to the base of my penis, the top portion of scrotal skin on right, the crease of my thigh/groin, the inside of my thigh and the top of the thigh to the right of the incision. The pain has not subsided since it began and is not hugely helped with pain killers (paracetemol/ibuprofen/tramadol). I’m pretty sure it’s the area served by the illionguinal nerve.
I have spoken with with my surgeon who is adamant that the pain will pass in a few weeks. I also asked why the nerve had to be removed when I had no pre-operative pain and was told that the hernia sack compressed the nerve and the nerve was adherent to the sack so had to be removed to prevent chronic pain. i was also told that the Iloinguinal nerve was protected but had to be mobilised carefully to avoid entrapment.
I am very anxious that the pain will not subside. Any advice would be much appreciated.
Hello andrew1982. [USER=”3024″]andrew1982[/USER] Here is your post #1. Post #18 is just a comment about your post being Unapproved, nothing useful there. I couldn’t find anything about imaging.
The doctors who reply here are offering free advice and time. Anything that you can do to get them the information that they ask for will help you. I don’t think that they have the time to go back and look through old posts. No offense, I’m just suggesting that if you can collect and summarize what you know that you’ll get better advice. I suggest that you re-write your whole story, very concisely and to the point.
You’ve had quite a bit of cutting done on your nerves. It has been noted in past comments by the doctors that the cut or damaged nerves can result in a neuroma. The fact that it seems close to your skin surface is probably significant.
There is probably a solution for you but you’ll probably have to go through the standard process for nerve pain, whatever that is. Good luck.
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Hi [USER=”2580″]DrBrown[/USER]
All I have is what I reported in post 1 (surgical) and post 18 (imaging).
It’s such a raw, awful, gnawing/burning/stabbing pain. Lying down and opening hips helps almost completely relieve the pain as does not wearing any clothes. Sitting and any sort of elastic waistband makes things worse.
With hindsight, I think the pain was there from the moment I came our of surgery but I couldnt tell as there was so much dressing over the entire area – I remember it felt strange through the dressing and that is similar to what it feels like now if I am wearing layers of clothes.
I’m hoping to get an injection in 5 days to see if that clams things.
Does anyone have any stories of people who had this sort of pain that resolved? My biggest fear is that nothing can be done – I certainly cannot live like this.
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[USER=”3024″]andrew1982[/USER]
I am sorry that you are having so much trouble.
Please post a copy of your operative report. That might yield some clues.
Regards.
Bill Brown MD -
[USER=”3024″]andrew1982[/USER] This is due to four factors that combine to almost create a perfect storm, the first is the fact the nerves that are cut are still firing so the impulse from the cut nerve is returning a lot quicker back to the spinal cord as the nerves shorter, which in turn forms a back up or overload at the branch connection to the spinal cord which causes pain, for this it’s wise to seek a PT who can work on opening the gaps in the vertebra and has a tens machine which they can work around the l2 and l3 sections of your back.
The next problems is that the branches of the nerves which are higher up than the division also become overloaded so you may now have an increased or hypersensitive of the bowel, bladder or genitalia.
This problem is also linked to the third problem of the actual end of the cut nerve, due to the trauma of the cut nerve our bodies reaction is to supply the area with sodium which is highly conductive thus making the pain worse, the added sodium in the area means that areas of the body which rely on sodium such as the bowel and bladder to keep a healthy ph balance now suffer causing bladder like infections and a stomach which is all over the place.
There is away you can combat both of these problems, the first being lidocaine patches 5mg which work at dispersion the sodium build up and making the cut nerves less conductive, the seconds a home remedy of adding half a teaspoon of Bicorbonate of soda to a glass of water for a week to reset the ph levels in your stomach and bladder as they will have become acidic.
And finally the 4th problem is the actual trauma of the surgery and scar tissue, which will be significant and only time and help from a PT who has an ultrasound machine will help, if the scaring is chronic and serve a direct steroid injection into this will speed the process up.
Hope this helps.
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Thanks Goodintentions
[USER=”2580″]DrBrown[/USER] [USER=”935″]drtowfigh[/USER] I would really appreciate if you could share any success stories of people who got better past 3 months with similar condition to me. Yesterday marked 12 weeks and I am still feeling awful. My life has been turned upside down and I am showing signs of depression. I have a young daughter and doing anything with her is such a struggle because of this constant pain in my groin. I can honestly say I don’t think I have felt anywhere near as low in my entire life.
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[USER=”2580″]DrBrown[/USER] Dr. Brown, andrew1982 says that his surgery was a non-mesh procedure. I asked about it in Post #26.
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[USER=”3024″]andrew1982[/USER]
If you have not had a nerve block, then that is the next treatment.
The mesh itself can also be injected with sometimes good results.
Removing the mesh is a major operation with a prolonged recovery. It should only be done as the last resort.
Since the pain sometimes resolves on its own, try to wait at least six months before removing the mesh.
You need to see a surgeon that is experienced with mesh removal.
Regards.
Bill Brown MD -
Does anyone have anything to add?
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[USER=”2580″]DrBrown[/USER] [USER=”935″]drtowfigh[/USER]
the burning pain/allodynia is now slightly worse, broadly across illioinguinal distribution. The pain is set off by touch mainly but moving is also uncomfortable. I did a lot of walking yesterday and wonder if this has anything to do with it. I’ll be at 11 weeks post operative tomorrow and there really hasnt been much improvement. I’m really worried about the pain becoming centralised or never improving and am struggling to cope mentally. If anybody has a suggestion/view/example of someone who had similar issues and recovered that would be much appreciated. I still can’t believe I’ve gone from being in the best shape of my life to this :(:(:(
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My Ultrasound report just came through:
Diagnostic ultrasound examination of the right inguinal region demonstrated maturing oedematous hypoechoic scar tissue in the subcutaneous tissues extending down to the lateral surface of the spermatic fascia at the internal inguinal ring. The maturing scar tissue contacts the genitofemoral nerve with the ilioinguinal nerve coursing directly into the region of the oedematous scar tissue.
[USER=”2580″]DrBrown[/USER] [USER=”935″]drtowfigh[/USER] have either of you ever seen patients who have nerve pain as a result of the nerve being trapped in scar tissue rather than because of damage to the nerve itself? Do you have any take on this report?
Thanks
Andrew
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Check out: https://www.dellon.com/
Lee Dellon is a peripheral nerve specialist – maybe the best in the world. Chief of neurosurgery at John Hopkins Baltimore – he also does surgery out of Vegas but only at selective times. Lots of testimonials on his website if you click around. Good luck.
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I have no faith in neurologists when it comes to these matters. They don’t see enough hernia patients to understand what we do and what can be done. Also, there are very few peripheral nerve specialists, and those that are deal with diabetic neuropathy and such. Ie, medical peripheral neuropathy not surgical.
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This not uncommon with tissue repairs. It’s why we moved to less tension mesh repairs. Patients used to have hospitalized for a week with these repairs.
I don’t disagree with your surgeon. Symptoms should subside by 3 months. But in the meantime, medications (amitriptylline) and local injections should help temper the symptoms.
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Hi everyone,
to update you all, I’m still not doing great.
I’ve had some sessions with an osteopath who resolved the adducter issues and has also been working on breaking the scar tissue up which has been useful to some extent – it seems some of the sensitivity around the incision is beginning to subside as a result of this. However, the “numb” area below the incision down to the top of the penis remains very uncomfortable – tapping it causes electric shock type stabbing pain, it remains swollen/firmer than the opposite side. This remains (and has always been) the biggest problem – it’s a combination of a strange feeling, nerve type pain and a feeling of swelling/fullness that is not at all pleasant to deal with. I would say it borders the area served by the ilioinguinal and genital branch of GF (which was divided in surgery) I have also noticed that the superficial inguinal ring is also tender to touch – this doesn’t feel like nerve pain, more like injury/tissue pain.
It will be 10 weeks on Friday and the knock on effect of not being able to exercise/keep my core strong/remain flexible and has resulted in old back problems recurring and which is causing me even more anguish.
My consultant doesn’t want to do anything until we reach the 3 month mark other than continue with the 10mg amitriptyline which we swapped in in place of the Lyrica. Next steps will be pain killing injections locally but my next appointment isn’t until mid-Jan because holidays are in the way.
[USER=”2580″]DrBrown[/USER] [USER=”935″]drtowfigh[/USER] what do you think of the approach? I know you mentioned blocks but my consultant is adamant that less is more and we should wait another month. My consultant is very highly regarded so I do trust them. On the other hand, the surgeon that carried out the op is also very highly regarded but isn’t being particularly helpful when I am trying to resolve the pain I now have. Concerns remain that this might never resolve/could get worse. It is really affecting my day-to-day well being both physically and mentally. I have been thinking about trying to get a neurologist who specialises in peripheral nerve problems involved as well – I’m not sure if anyone has a view on this? Any help would be much appreciated.
Andrew
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Hi – my understanding is it was similar to shouldice without touching the cremaster muscle. Thanks – I feel like I need all the luck I can get right now!
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Hello [USER=”3024″]andrew1982[/USER] I was not planning to make a case against mesh. I was just trying to understand what was done for your repair. Your details are very unclear. There are many types of non-mesh repairs. The Shouldice method, Desarda, Kang, and many others. “Minimal” usually refers to the size of the incision, the visible part. Not the actual area “invaded”.
Just trying to help. Good luck.
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100% not mesh repair
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