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Reversing and Reconnecting nerves after neurectomy
Is there anyway to reconnect the nerve branches once a lap genital neurectomy and open iliohypogastric and ilioinguinal neurectomy have been performed …was having zero nerve pain and not any pain at all and still My surgeon cut my nerves and now my groin back hip and pelvic floor have weakened so much and Its causing me to not have any sexual function at all ..pelvic floor is so messed up …just beyond horrible and I need help … pelvic floor PT isnt doing anything .pretty sure my pelvic floor has collapsed ..also have a lap placed progrip mesh..not sure how much that is contributing to my situation @drtowfigh
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15 Replies
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Dr Towfigh
Mine is an awful story of multiple problems post op- mostly centered around significant continuing groin and testicle pain. I had mesh removed after two previous surgeries for mesh placement and groin exploration and all three nerves were cut. The last surgery – the mesh removal – was horribly invasive and destructive and has left me functionally impaired and in constant pain. The surgeon abruptly discharged me and now will not speak with me. I don’t know why. I’m made to feel as if I did something wrong. I did not. I have seen multiple urologists regarding the testicle pain and no one does the procedure you mention. The prevailing theory is that cutting the GFN has exacerbated a previous issue with epididymitis- and now I may need the epididymis removed. I tried to contact Dr Turek but he would not do a video visit with me unless I committed to coming to LA. I live on the East coast and this is not feasible. I guess my point is for anyone who is reading this and considering mesh removal- think long and hard about it. I am permanently impaired and forever maimed as a result and I went to one of the top removal surgeons in the country. I’d give anything to go back to how I was – instead I’m cursed with this horrible outcome.
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This is true. Some times genital branch neurectomy can cause hanging of the testicle. It’s not 100%. It may be closer to 1-2%, as the original Shouldice technique and others routinely cut that nerve.
The treatment of the hanging testicle, however, is not orchiectomy. It’s a cremasteric pull-up procedure, where the muscle is pulled up and sutured to the pubic tubercle. I would question any plan for orchiectomy.
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Dr Towfigh
I’m sorry. I respectfully must disagree with you. I too had a triple neurectomy and with the transection of the GFN nerve I lost the cremasteric reflex and the scrotal muscles. My testicle now just hangs and is a constant source of pain and discomfort. I never knew, until now, that the GFN had a motor component. Would have been prudent to explain this to me. Now I’m told only an orchiectomy will solve my problem. I’ve seen multiple urologists.
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@julian
Any way you can be evaluated by Dr. Towfigh? If anyone can help you, she can (speaking from experience!). -
Depends on the level of the neurectomies. Most neurectomies for groin pain do not result in functional deficits. If there is pain or neuroma or a hernia-related problem, usually those can be treated, though for sure it is a challenging problem.
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As for reconnection: the answer is no.
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@julian your situation needs careful evaluation. Sounds like you’ve had multiple operations plus neurectomies. Imaging and a careful history can help figure out what the underlying cause of your symptoms may be.
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@julian
Dear Julian.
After neurectomy you will slowly regain some of your strength, but it is a very slow process. Try to be patient. Exercise the pelvic floor with Kegel exercises.
Follow up with your surgeon frequently to get additional help.
Regards.
Bill Brown MD -
Julian, so sorry to hear of your continued suffering. I hope you find answers. Don’t give up! #ItsNotJustAHernia it’s our lives! I pray that you find strength as you continue searching for answers.
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I’ve given up….i need my nerves back…no DR can help with that
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So how am I supposed to gain my function back after neurectomies are done because I have only gotten worse…death seems like my only escape at this point …. Chen never even gave me a chance to heal..just took my nerves..took part of me away and now I’ll never be the same
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I’ve seen all Drs I can think of…nobody can give me any real answers as too why I’m like this…seems like my only option is too remove this mesh and see if things improve…and that would be my 2nd removal in the same area I already had removal which many have said is not a good idea but I really dont know what else to do
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So do these nerves have important motor function cause I was told it’s all sensory which seems to not be the case and unfortunately my first mesh messed me up so bad that this neurectomy done was just too much for me..going into my removal surgery with neurectomies I was already super weak and fatigued in those muscles and now I sit here 1 year later and I’m the worse I have ever been….little to no function or feeling in genitals…hips groin and pelvic floor are super weak..legs are weak..my pelvic floor function and strengh is just beyond gone …I went for removal to save my pelvic floor and sexual function and the neurectomies with this new meshhave made things so much worse…how am I suppose to lift my scrotum and testicle and groin up and to the side without my nerves ? I need answers … been doing pelvic floor therapy and still not really doing much at all…constant pelvic floor spasms..severe pressure in my groin …. how am I supposed to live my life like this..no groin strength..back has given out….I dont know how things have gotten this bad but they have and I need help…but no Dr has answers for me
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I’m trying…its just hard when no one really has answers for you..especially since my nerves are gone and more mesh has been placed inside …I just wish my nerves were saved instead of being cut cause I needed that function desperately but now I will never have that function…. no quality of life..cant even enjoy a simple walk anymore
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