Triple neurectomy

[groundfaller]

Triple neurectomy

Well frankly, I haven’t even seen a pain specialist yet so I haven’t discussed any kind of neuropathy. Last week I saw my surgeon and her feedback was “this might be the new you” which was very difficult to hear. It has been 9 months since the surgery and the pain I experience now is worse than before the operation and it is getting more frequent and more painful and more disruptive.

If I lie down when I’m in pain or in the morning after a night lying in bed the pain is usually seriously reduced. Some mornings I feel pretty good actually. My job requires a reasonable amount of heavy lifting which can bring on a sharp pain directly at the hernia site. Walking for 20-30 min will also induce pain but the onset is more gradual and it occurs lower in the groin and there is swelling associated with it. In fact, just to left of the top of the scrotum and then extending to the thigh, I will develop a thick ropey feeling that can be felt to the touch. I think it is important to note that it took weeks after the surgery to move without significant pain. I hear accounts of people walking well within the first week. That wasn’t me.

There were two events in the last 3 months that brought on worse pain. One was a business trip in the end of Sept and it took several weeks to improve. The second was over Thanksgiving where, after a slow increase in time riding my bicycle through Nov, I did some mountain biking. Both of these events left me nearly immobile for several days with sharp shooting pains that would radiate from my low groin to my hip bone protrusion. The later occurrence over Thanksgiving has never seen a great reduction in pain.

According to the original surgical report obtained from the doctor’s office I had a “large direct inguinal hernia” which was repaired with an “extra-large mesh plug” and a “mesh overlay cut to size.” There is no mention of the type of mesh used but a site sponsored by Davol has her listed as a hernia surgeon if that means anything. In several places in the report there is mention of 2-0 Prolene sutures as well as the mention of a 2-0 vicryl suture (among a lot of other medical jargon).

I am currently seeking a new doctor for another opinion since it seemed liked the surgeon who performed the operation does not want much else to do with me given her response. She did arrange for physical therapy at my request which I started this week.

[WisconsinHerniaDoc]

Triple neurectomy

Triple neurectomy refers to removal of the three nerves that supply sensation to the groin and can be injured during hernia repair. Unfortunately, groin pain after hernia repair is not often as simple as just removing these three nerves. It has a lot to do with the technique that was employed during the initial operation (open or laparoscopic), the mesh that was used, surgeon experience, mesh fixation, patient factors and a variety of other key issues.

If you have neuropathic pain (meaning pain that is caused by inflammation or injury to those nerves), then triple neurectomy may be beneficial. However, other causes of pain will not necessarily be alleviated by this procedure. It is a procedure that is not done by most surgeons and you certainly would want to see someone with experience with this problem.

What sort of pain are you having?

[groundfaller]

Triple neurectomy

I’m hoping since this was originally posted, someone might now have some feedback to this question. It seems like this is often cited as a possible treatment for chronic pain but I find very little anecdotal confirmation of its success and the literature that I have previewed is not very convincing either.