Problems after hernia repair

Hernia Discussion Forums Hernia Discussion Problems after hernia repair

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    • #32128
      David
      Participant

      I have had an inguinal hernia repair previously, about 20 years ago on the left side.
      I injured myself after exercising a year ago. My scrotum started pulling my testicles up painfully high randomly throughout the day. It looked like swelling, but I now think it may have been the bulge of the left testical under skin.
      A few months ago a doctor felt a cough impulse on the left where the previous hernia was repaired. An ultrasound scan confirmed the mesh had come away at the corner and fatty tissue had breached the mesh.
      I had it repaired by robotic key hole surgery about 5 weeks ago, but ever since, I’ve still been having the problem with my testicles rising up very high and it’s even more painful than before the operation even though I’m on 20mg amitriptyline, up from 10mg before the operation.
      I don’t understand what has happened. The hospital think the repair feels solid and pain is due to bruising from the operation. I stupidly didn’t tell them that my testicles are rising up so high. I need to get back to them, but any insight into what may have happened could be helpful, thanks.

    • #32129
      Good intentions
      Participant

      Sounds like the nerve that controls the cremasteric reflex is being impinged. I actually just posted an article about it in Watchful’s Shouldice discussion. I will link it below. It’s old but it describes several case studies, similar to your problem.

      You didn’t say what type of mesh implantation you had 20 years ago, open or laparoscopic. Also not clear if any mesh was removed when the recurrence was repaired. Dr. Towfigh says that new mesh is never laid over old mesh but you can find several reports of this being done around the various internet sources. It sounds like you had another piece of mesh placed to fix the recurrence but the old mesh was left in place. I would guess that you’ll need more work done to fix the testicle retraction problem.

      This paper will be informative, I think. Good luck.

      https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1979762/pdf/brmedj03205-0028.pdf

    • #32135
      David
      Participant

      Hi Good intentions,
      Thank you for your quick reply.
      What you said does make sense and it is very helpful.
      The first was an open repair. The operation a few weeks ago was laparoscopic.
      I can only describe it as an uncontrollable tightness like a muscle spasm which comes on randomly during activity or just before a bowel movement. The only thing that seems to really relieve it is a warm bath.
      I am going to the doctor’s this morning to ask about pain management and what to do next.

    • #32138
      William Bryant
      Participant

      Maybe David has given us another reason here for Shouldice to cut/resect the cremaster.

      It would tie in with what I read about some surgeons cutting cremaster to avoid testicke retraction into inguinal canal causing a failure of the tissue repair.

      In the circumstances maybe cutting cremaster is lesser of the risks if dangling testicle isn’t paunful and retracted is.

      Good luck to David in resolving it anyway as I have spent a weekends with rsi computing pain and pain definitely gets you down.

    • #32266
      David
      Participant

      Hi,
      Sorry to resurrect this thread, but I am still waiting to go for my hospital appointment.
      If it is a nerve that is being impinged as Good Intentions says, would that cause the testical to be pulled up unnaturally high?

    • #32267
      William Bryant
      Participant

      I think it’s more likely to be the muscle? The cremaster.

      It may a coincidence and not hernia related although that seems too much of one maybe.

      https://www.findatopdoc.com/Questions/retracting-testicle-in-adult

      Apart from that link there is a condition where men haveban overactive cremaster reflex a d the testicles go into body during sex or exeertion… I used to have to push one of mine down sometimes before I had hernia.

    • #32268
      David
      Participant

      Thanks William, It definitely feels like muscle spasms.
      Before a bowel movement or whenever I have some wind or if I’m cold, I get pain and tightness in the left inguinal region and my testicles will be pulled up unnaturally high. It’s extremely uncomfortable and can last a long time.
      The one thing that I know will relax it is to sit in a warm bath. Lying down also helps.
      When it’s happening, I have pain and sensitivity where the hernia was, it hurts to bend and sit for long and when it is relaxed I don’t have any pain and it feels normal.i can’t physically control it though.
      The problem is it’s having a big impact on my life and it’s making me feel low.

    • #32269
      William Bryant
      Participant

      That’s ok David. If the repair was recent it may be because the testicle is going into the space where the hernia was, thats what one of the links says, and it sometimes rectifies and eases after time,that’s the good news. Hopefully that will happen with you too. And perhaps it’s just a matter of time until it’s ok again.

      Know exactly what you mean about getting you down. My hernia is doing that to me… Not sure who or where I should have surgery and worried about after operation too!

    • #32272
      drtowfigh
      Keymaster

      @dm249, there are multiple reasons for this.

      When the testicle was moving up, this was the first sign that your inguinal hernia repair had recurred. Once it was repaired, then the question is:
      – is the testicle retracting because it’s used to being higher in the canal, and the spermatic cord is foreshortened, so now that there is a mesh holding part of the spermatic cord in place, the testicle doesn’t reach lower? There is a treatment for this. It can include dissecting the mesh off the spermatic cord or performing an orchiopexy.

    • #32273
      David
      Participant

      Thanks again William and thank you @drtowfigh
      When you say ‘When the testicle was moving up, this was the first sign that your inguinal hernia repair had recurred’. Do you mean it was the first sign that the hernia had reccurred?
      If so, that does make sense to me.

    • #32276
      Good intentions
      Participant

      You should get a copy of your surgery notes to see what exactly was done. There is no single method for laparoscopic surgery, there is a multitude of methods and materials. There might be something in the notes that is a clue.

      Also, write your questions down before your visit and make sure to refer to them when talking to your doctor. Most doctors do not want to hear about problems after they have worked on you. Their first impulse will be to tell you to wait it out, “it’s normal”. Once you’re in that setting you will have trouble guiding the discussion. You might only see the surgeon for a few minutes.

      Send a note if you can with the specific problems described to the doctor’s office so that they will be documented. As you can see from the many posts on this forum, pain from hernia repair is often discounted as not significant and/or temporary. Your specific problem might just be grouped in to the larger group of “normal” post-surgery pain. You might have to be very adamant that your problem is not normal and not acceptable.

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