Varicocelectomy + sports hernia + pain + mesh
05/04/2021 at 8:34 am #29025DomeParticipant
Hey guys. I’m here to share my story and potentially reaching out to other folks who can offer advice. I’ve watched some of the fitting talks of Dr. Towfigh which led me here and I wish I would have found this site earlier. I’m also a fresh medical school grad from Hungary so it was even more frustrating that I couldn’t come up with a proper diagnosis by myself before doing the surgery. Anyway, here it is.
So in 2014 after working out for nearly a year I developed mild left scrotal pain. The urologist found a varicocele, got my varicocelectomy but the pain remained. He tried nerve blocks and ABs without any success, then eventually the neurologist said it might have been neuropathy and offered amitriptyline which I didn’t take. Without physical activity it got better so I kind of forgot about it and skipped the gym. I was still doing cycling, running and skiing and all was ok.
Then roughly in 2017, during sex, my testicles got pulled so an immediate sharp pain up my genitofemoral nerve developed and remained for months. No torsion was seen, so another round of ABs, checkups and tests led to the fact that nobody could offer any help. Since that moment I had a pretty much ongoing, 1-4/10 fluctuating pain on the lateral part of my left testicle. Nothing else. It never got worse immediately if I did sports, usually appeared after a couple of weeks of doing physical activity, having a 7-8/10 strength then fading away. Sometimes it disappeared for weeks then it came back out of nowhere. It was this weird for like a good year and then it became more and more prominent with exercises involving high abdominal pressure or a strain around my inguinal/pubic/adductor region, so I started doing yoga and stretching. Sitting at work for a long time usually made it worse, and I skipped cycling too. After these adjustments it kind of went away, then some skiing made it significantly worse again. I could never really point out whether if it’s an abdominal wall issue or an adductor issue, given the fact that sometimes digging the ground or doing simple pullups would bring the issue to the surface again, sometimes without any major physical activity. I was getting more and more frustrated, since I’m quite outdoorsy and I had to leave those behind.
Then in 2019 somebody found a small (1,5cm) inguinal hernia on the ultrasound when I was applying high abdominal pressure, so we got happy that it might be that causing my issues, rubbing the genitofemoral nerve the wrong way, so I went for a TAPP repair with mesh. After the mesh the pain was slowly fading away, I ended up doing yoga, hiking, surfing without any issues for a year. I was only feeling a 1-2/10 pain when I was doing some core exercises to get some core strength but the pain disappeared quite quickly. At this point my only goal was to build my core and stabilize my pelvic structure with the mesh being my pal holding everything together.
I was doing well and I was happy that it’s past me. Then 5 weeks ago the pain appeared (I was also doing gardening, digging, side plank crunches, abdominal work, but really lightweight and at that point I was pain free for nearly a year), and I was waiting it to disappear but a couple of days later the whole mesh started to get more painful, with the transversal muscles flaring up too on that side & my inner left thigh, also down my left leg. Even getting up from bed was an issue and the mesh was palpable and painful (My BMI is like 18.5, so I can check the anatomy on my body pretty easily). The ultrasound showed nothing but a CT scan showed some mild inflammation and wrinklage of the mesh. So I stopped any physical activity and started some NSAID, B1, B6 medication and Dr. Brown’s herbal therapy which I found here. 5 weeks later my mesh is not painful anymore, but my old friend, the lateral side scrotal pain is back and stronger than ever, and I feel like there’s a definitive exacerbation when sitting/lying on my mesh side/using my abdominal muscles. It usually goes away at night and comes back during daytime activities, especially sitting/core activation.
So my overall idea is that – listening through the talks and checking out info – I might have had a weak abdominal anatomy to begin with and working out extensively developed my sports hernia, impacting my genitofemoral nerve and me trying to go back to the gym quickly, not focusing on core strength and having the varicocelectomy + pulling accident actually formed a tissue issue which got worse over time. Then before putting effort into proper physiotherapy I got the mesh which stabilized the area and worked for a year, but pulling it made me go back to square 1. At this point my plans are doing physio + searching for a nerve block possibility.
Is it possible that after a year a mesh would move, wrinkle and flare up just by doing some everyday physical activity? It seems so illogical that surfing and mountainbiking didn’t cause any issue, then months later digging the garden and doing some planking would?
I would be happy to go back to the state I was in months ago, skipping the gym but being active, but I’m kind of bummed I have a mesh and the old problem. Any advice would be greatly appreciated.
And I also started to spread the word here around the clinics about sports hernia which is not known at all. That’s the least I can do do raise awareness in our not so holistic medical system.
05/04/2021 at 9:59 am #29027mitchtom6Participant
Hey Dome, just read your story. It’s PG-13 but details are important in this field.
I, too, had a suspected mesh irritation about 5 years after my implant. I had been doing a lot of stair running prior to the onset of that pain.
In any case, it has been an on/off issue for me for about 2 years now. A cortisone shot brought great relief to me, and I would advise that you, at least, try that as a non-operative measure. Perhaps this will help settle things down in a semi-permanent fashion.
It sounds like you are still reasonably mobile and active despite the condition you are experiencing, I’m glad to hear.
As for me, I tried doing some “side planks” myself a few months ago, and surprisingly, they seemed to have really contributed to the pain and discomfort I had been feeling near my pubic bone. I reattempted a few times, and they continued to bother my area. So, I don’t do them anymore. In fact, any sort of “planking” seems to predispose me to irritation/pain, so I no longer do them, or pushups, since the posture is similar. I’m ok with letting go of those exercises.
Try eliminating those moves, and consider the steroid trigger point injection. In the meantime, don’t go crazy with the core stuff. A little bit is good enough.
Best of luck.
05/05/2021 at 8:26 am #29050DomeParticipant
Yeah, those stuff seems to worsen my pain too, so I was really cautious implementing them again to my workout. Did you quit running the stairs too? What kind of exercises can you do without the pain?
Currently I am on the hunt to get the shots so thanks for mentioning that it helped you too.
05/05/2021 at 1:02 pm #29059mitchtom6Participant
I have been doing a decent amount of rowing over the past year. I was on a rowing team in high school, so it kind of takes me back. Plus, its a smooth, predictable motion that doesn’t involve side-to-side motion or anything abrupt or jarring. As long as your settings are right, it’s not too taxing on the joints. I keep the damper at 5 or below. The first few months, I really eased into it, gradually. I try to ice my groin after doing it, too, which helps.
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