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Questions to Ask General Surgeon
My physician has ruled out an infected appendix, diverticulitis, ovarian cysts, and more as causes for my persistent pain, right side pelvic area, via ultrasound, CT scan and bloodwork. Based on a suggestion by his P.A., I began to wonder about hernia while my doctor instead scolded me for doing too much activity and suggests I strained an abdominal muscle. I am 58, generally quite fit and started experiencing this pain over a month ago. It began acutely and moderates with rest but does return and be quite debilitating.
Yesterday, my physician agreed to refer me to a general surgeon with experience with hernias. I’m not certain this physician’s experience extends to women’s hernia.
I would appreciate any and all advice for me on what to ask this surgeon so that we might verify or rule out hernia?
Thank you in advance.
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2 Replies
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Questions to Ask General Surgeon
I suggest you search this forum for discussions about women’s hernias. There is a lot more written than I can repeat on this thread.
You are correct that women’s hernias are often overlooked. This is because the presentation and findings of inguinal hernias are often different among women vs men.
Symptoms range from groin pain to pain radiating around the back, into the vagina, down the upper thigh or inner thigh. It is worse during periods. Nausea and bloating may be notable. It’s worse at the end of the day, best with lying flat.
If you have point tenderness at the internal ring when you are being examined, that is the most sensitive finding predictive of hernias among women. We reported in our study that 87% of women with chronic pelvic pain and this finding on exam ended up having an inguinal hernia, and surgery will cure their pain.
A dynamic ultrasound or MRI pelvis will help confirm this diagnosis prior to surgery.
In my experience, a skilled surgeon who will listen to your story as oppose to rely on typical exam findings seen among men, will suit you fine.
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Questions to Ask General Surgeon
ASk if you can have an MRI to look for other causes, such as musculoskeletal problems in the adductor tendon, psoas muscle, rectus muscle, hip or spine. They would need to ask the radiologist how to order the test to get the proper information, including hernia. These (with the exception of hernia) are not seen on ct scan. The other alternative, and you may end up with this anyway, is a diagnostic laparoscopy with or without hernia repair. Sometimes the fat in the preperitoneal space can cause groin pain in women, and there is about a 60-70% chance of improvement with lap hernia repair in this situation (provided the pain is groin/pelvic). An intraperitoneal diagnostic laparoscopy can also look at the appendix directly, along with the ovaries, as well as for endometriosis. If it comes to this, may want to also ask if the case could be combined with a gynecologist. Hope this helps!
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