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Question about recurrent repairs – hoping for Surgeon input as well
Hi Everyone,
I was hoping to get some information on a recurrent hernia I may potentially have. I underwent primary laparoscopic right inguinal repair in 2017, and most recently (December 2022) have started having anterior groin, leg, hip, and testicle pain on the same side. Prior to that I was healthy and had zero issues. I’m very thin and have a 24-25 BMI. I originally thought this could be muscle and/or hip related, but still trying to get a proper diagnosis and figure out what kind of doctor to see.
Anyway, I got an ultrasound for a recurrent hernia in December 2022 when this started (as prescribed by my PCP), and they didn’t find a recurrent hernia. I’ve still been paranoid that I have one and that I didn’t “bear down” enough during the ultrasound, as the same side where I have pain seems to not look the same as the left side when staring at my groin (slightly raised on the surgery side). I think there may be a tendon or spermatic chord that’s inflamed or something, but I’m not not sure.
I’m going to see the original surgeon who fixed my primary hernia next week to have him take a look and discuss what may be going on. I could also be having scar tissue or nerve pain, but really scared it’s a recurrence.
Question for the surgeons and/or folks that have experience with a recurrence:
Are there any surgeons in the US that perform a secondary laparoscopic/robotic repair on a recurrent hernia that was fixed laparoscopically the first time? I know open anterior repairs have more complications than lapro, and if I can I would prefer to get the recurrence repaired laparoscopically (pending I even have one). The surgeon who repaired mine has done over 5,000 now, so I’m hoping that there’s no recurrence and I’m just over paranoid.
Thanks for the help!
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3 Replies
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Thanks @markt I’m hoping I don’t need to get an MRI because it’s expensive, and the surgeon can tell me what he’d recommend. Everything I’ve read said ultrasounds with standing Valsalva is the best way to see if there’s a recurrence, but really hoping the surgeons can chime in here and give me some good advice.
@drtowfigh – really admire you and hoping you can share some insight into my questions as you have time and what you’d recommend as my next steps. I will post once I meet with my surgeon as well.
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Any chance you might have strained your groin?
If you have no visible bulge, and an examination doesn’t reveal a palpable hernia or some other problem, then you might inquire about MRI (ideally, dynamic MRI) as it is superior to ultrasound and CT in detecting hidden/occult hernias. Even if it isn’t a recurrence, MRI may be useful in helping to diagnose the problem if an examination yields no good info.
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Perhaps Dr. Towfigh can chime in, as she was part of a group who have published papers on imaging and their work suggested that MRI was far superior to CT or US at diagnosing *hidden/occult* hernias (i.e. those with no bulge and that are not palpable upon physical examination).
AFAIK, she still recommends dynamic MRI in such cases, but perhaps dynamic US is adequate? I think their published studies looked at standard MRI and US (not dynamic) but I’m not 100% sure, so perhaps she will comment further.
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