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Post Hernia Repair Nerve Pain
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[USER=”3024″]andrew1982[/USER] notify
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quote andrew1982:-hernioplasty (minimal repair technique)
Are you sure that you did not have a mesh repair? The word “minimal” is a word that really is only meaningful relative to certain other procedures. Some open techniques are considered “minimal” even though they use mesh. “Minimal” is a popular word, misused, literally, often. The details of what exactly was done during the hernioplasty might help you understand the source of your problem.
And “hernioplasty” is a word generally used to describe a mesh repair. So, by your description, and the definition of the word, mesh was used for the repair.
Some of the open mesh techniques, like the Onstep procedure, involve pushing the mesh all the way down to the pubic bone.
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Hi all. To update you all, the pain remains pretty constant – no huge improvements. I’ve had some sessions with an osteopath to resolve the adductor problem and also work on the scar tissue and this has provided some relief but the main issue below the incision trough to the base of penis (numb but also painful/stabbing/electric type pain) and allodynia in the groin crease remains.
I’ve had an MRI and ultrasound and both have come back fine.
My consultant is suggesting we wait until the 3 month mark, at which point he is hoping things will have improved but if they don’t we’ll move to pain killing injections to start with. He feels it is too early to do anything other than low level drugs and wait until we reach the 3 month mark. I’ve swapped the Lyrica (pregabalin) out for Elavil (amitriptyline) but have only been taking this for 3 days so it’s too early to give any comment on how it’s working.
Mentally, it’s a struggle. To go from fully functioning/no pain to being in constant pain with no guarantee of resolution is very difficult to accept.
If anyone has anything to suggest it would be much appreciated.
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quote Good intentions:Hello andrew1982. I just created a new topic including an article about post-surgery pain, and your topic drew my attention as a result. It is really surprising to see that your surgeon performed neurolysis as a prophylactic measure, in other words, to prevent a future problem, that did not exist at the time of surgery. It has been expressed by the professionals on the site that this is not “standard of care” for a hernia repair.
Since the damage is done, all you can reasonably do, I think, is try to let things heal completely then try to work back to your desired level of fitness and activity.
Beware the pain management programs, they most likely do not have specific regimens for people who have had their nerves cut already. Neurolysis is supposed to be a last resort, not a prophylactic measure. So you are not a typical pain management patient.
Here is a link to the paper I just posted about. It might have something useful in it. Good luck.
very difficult to enter as a layman in such a debate, furthermore, my English with translator has limits in the exposition of the concepts I express … In the intervention suffered by andrew1982 … I believe that our doctors have already diagnosed the damage and also suggested the way to fix it. The question of prophylactic neurolysis, as you well remember, has been debated and discouraged by site doctors here … I confirm that I am aware of excellent surgeons who, perhaps in a different form, they practice it, and pain doctors who claim that neurectomy is to be avoided (perfectly in line with the doctors on this site) while neurolysis can be an option of necessity (when nerve positions require it). Ultimately it would be useful to understand if the diagnosis made by dr Brown is shared by the dr Twight refers to the neurolysis of the ileoinguinale or rather to the neurectomy of the genital branch
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I let the issues run their course. I did take some Naproxen on the bad days.
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Hi Feurmann. I didn’t have mesh – mine was tissue repair. Did you have any treatment for the pain or did you just let it run its course?
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Hi Feurmann. I didn’t have mesh – mine was tissue repair. Did you have any treatment for the pain or did you just let it run its course
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Hello Andrew. I believe my procedure was similar to yours – open with mesh. There was no neurectomy on the GFN but the operative report did say that the IN was injected with some kind of anesthetic. My recovery was very slow. I experienced a wide variety of different sensations in the groin (burning, tingling, itching, aches) on and off on a daily basis for about 18 months. These gradually diminished with time, but progress was not always linear. My bad days were never severe enough to interfere with daily living – at most, the sensations I experienced made daily activities more uncomfortable. I am now two and a half years post-surgery and can say that most of these sensations are either gone or small and infrequent enough not to be bothersome.
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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 resected.
Hello andrew1982. I just created a new topic including an article about post-surgery pain, and your topic drew my attention as a result. It is really surprising to see that your surgeon performed neurolysis as a prophylactic measure, in other words, to prevent a future problem, that did not exist at the time of surgery. It has been expressed by the professionals on the site that this is not “standard of care” for a hernia repair.
Since the damage is done, all you can reasonably do, I think, is try to let things heal completely then try to work back to your desired level of fitness and activity.
Beware the pain management programs, they most likely do not have specific regimens for people who have had their nerves cut already. Neurolysis is supposed to be a last resort, not a prophylactic measure. So you are not a typical pain management patient.
Here is a link to the paper I just posted about. It might have something useful in it. Good luck.
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Done thanks
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[USER=”935″]drtowfigh[/USER] can you pls publish my latest reply which has been marked as spam. Thanks.
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Hi everyone,
I thought it would be good to update you all on my progress, as, from a personal point of view, I’ve found it very helpful reading other peoples stories online.
Things have changed for me but I can’t say they’ve really improved.
Whilst the burning/nerve type pain is now less prominent but I now have increased actual pain (mainly dull/tender/nagging, occasionally sharp) in my groin (area from just above incision the base of penis) across almost all of the right side; right groin canal is very sore, bottom right quadrant of groin feels swollen/firmer than left side (especially as the day goes on or after moving around); right testicle now aches.
All in all, I am very worried that it is now 7 weeks post-surgery and my day to day activity is restricted and I am in constant pain.
I’ve sought a second opinion from a very well regarded specialist who was not impressed at all with the fact that the GFN was divided and the prognosis hasn’t left me full of hope that this will ever be resolved.
More than anything, the whole situation is hugely upsetting – I have a young daughter and 8 weeks ago we were chasing each other around the park and I was picking her up/swinging her round, etc . . . with absolutely no pain or restrictions caused by the hernia – I was probably in the shape of my life.
My new consultant is sending me for an ultrasound and MRI.
If anyone has anything to suggest/add that would be much appreciated.
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your information on the intervention is quite detailed and the deductions would seem to give reason to Dr. Brown who claims that it is better not to touch the nerves in any way. In your case the neurolysis does not seem to have worked. I understand that you feel like a guinea pig because many of us expect to know what you will do and with what improvements
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Dear Dill. Please tell me where you did your operation.thanks.
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Andrew, from the timestamps on your post, it appears you had your surgery about 1 month ago. That is pretty recent. I would encourage you to give it more time. It will take several months for things to settle down.
My repair (bilateral, mesh, TEP), while different, took a few months to settle down. Occasionally I would get flare ups, and even random sharp, burning pains for up to 6 months, sometimes if I moved funny, or sometimes when I would urinate. With time, they decreased in frequency. After 6 months, I was relatively pain free until about 5 years later when I felt something tear. Now I am contemplating mesh removal.
Point being, you are too early in your recovery to become despondent. Don’t assume worst-case. Give it time and things may settle down. We’re pulling for you. Be glad they were able to do it without mesh.
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[USER=”3024″]andrew1982[/USER]
Adductor longus injury will often improve with a steroid injection into the origin of the tendon and the surrounding periosteum.
This can be done easily in the office without imaging.
I would encourage you also to have a nerve block. This can also be very beneficial.
Regards.
Bill Brown MD -
Hi. I’d rather not say who my surgeon was for now. Happy to let everyone know once I’ve got some clarity as to what exactly is happening with my repair. I have a follow up with the surgeon a few days time.
The severity of the burning pain reduced spontaneously by about 30-40% overnight at week 3 but no further changes since then. This was about a week after starting pregabalin – not sure if the 2 are related.
My abductor is also very tight on the side of the repair and when I run my nails over the abductor I can feel sensation in my groin – all very strange. I’m stretching it and also using a theragun on it but it tightens up again fairly quickly.
Pain seems to be worse in the evening – it’s almost as if there is increased swelling below the surgical site but not that you can see on the surface of the skin.
I still have a lot of numbness around surgical site.
I’m already taking high dose vitamin c and also CBD oil to try and help as well as a load of other supplements that I have read might help.
I’ll keep you all updated.
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[USER=”3024″]andrew1982[/USER] do you mind sharing what surgeon performed a non-mesh repair for you?
You can message me privately if you’d rather not share it publicly here. I am trying to maintain a list of non-mesh hernia surgeons, so any additional doctors to add to the list would be welcome
You last posted about a week ago, have you noticed any change in your symptoms since?
There is some evidence that 500mg Vitamin C daily can gradually improve nerve pain over time. Don’t expect immediate results.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3389328/
If you are located in a region that allows medical marijuana, some patients report positive experiences with reduced nerve pain over time with that as well.
Best of luck, keep us updated on your case and how you’re doing.
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Dear Andrew.
I have not had much success with Lyrica.
A nerve block with steroids will have a much better chance to help you.
Nerve pain is slow to resolve. 6 months is a more likely duration.
Regards.
Bill Brown MD -
[USER=”3024″]andrew1982[/USER]
I have not had very good results with Lyrica.
Nerve blocks with local anesthetic and a steroid can be very beneficial and provide longterm relief.
There is a good chance that the pain will resolve with time, but it will take longer than 4 weeks.
4 to 6 months is a better estimate.
Regards.
Bill Brown MD
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