Very painful hernia

[SomeGreyBIoke]

Thank you for your message drtowfigh. Left testicle was removed as I had tumours which luckily were not cancerous, ever since then had pain in the pubic area, and after ultrasound it was discovered that I have got a small hernia on the right side.

Since I never had pains pre-operation, part of me thinks I am still healing, pain will settle and so I don’t want to do anything hasty. Yes I think my nerve was cut as I feel numbness and weird sensations.

Problem is that any literature I read, it always says that it takes approximately 6 weeks to heal, I am nearly 4 months past and pain still persist 🙁

[drtowfigh]

Some thoughts:

[USER=”2505″]newagehernia[/USER] – your questions are very unique to your concerns. There are a lot of repair options for inguinal hernias. Best, as you said, to see a Hernia specialist that can tailor the available options and their ports and cons to your needs.

If it helps you, since you travel, I do offer online consultation for those who cannot initially come to see me in person. That often helps answer questions and give direction. Can contact my office for more information. [email protected]

[USER=”2491″]SomeGreyBIoke[/USER] – the orchiectomy and how it was done may be related to your symptoms. Was it done for undescended testicle? If so, the inguinal canal may have had a hernia that was not addressed at the orchiectomy. Was it done for cancer? If so, the genital nerve branch is at risk for injury.

Those are two different diagnoses that have different treatment plans. Need to see an expert that understands these to help you best.

Ice and anti inflammatories work best. The narcotics don’t help and the associated Constipation may make it worse.

[SomeGreyBIoke]

quote Chaunce1234:

Was the other operation done laparoscopically? Have you tried to do anything to treat the primary symptom (pain) like a nerve block?

Does laying down flat on your back help the pain? Or does anything else make it better or notably worse?

Hi Chaunce, no, it was an open surgery, they’ve hacked into my inguinal canal. I am taking very small doses of antidepressants and they seem to be working for nerve pains, which seem to be changing regularly. First it was just a solid pain, then feeling as if I were burned, now unpleasant feeling and numbness. Yes I feel virtually pain free first thing in the morning, it starts hurting if I wear tighter clothes and after a day of walking.

If it came to it and I needed hernia repair, what are your opinions on disovable meshes?

[SomeGreyBIoke]

quote Good intentions:

Did they do any exploratory surgery at the time? Was the right side examined?

Maybe the scarring on the left side is pulling on the right, causing pain. January is not that long ago. Have you tried any methods of reducing the material in the canal? I don’t know if it was a real physical effect, but I seemed to get some relief from my direct hernia by elevating my pelvis above the upper half of my body. It takes the pressure off of the area. It’s actually what they do during laparoscopy to create a space in the abdomen, tilting the body, letting the intestines slide downward. Of course, there’s no CO2 to help but it might offer temporary respite.

Good luck.

Hello Good Intentions, thank you for your response. No, haven’t had exploratory surgery, just ultrasound. There is a bit of scarring, it was an open surgery, they have cut into my inguinal canal. I am still a bit numb on the left, looks like my nerve was cut in the process. I am fine first thing in the morning after decent sleep, was also prescribed small doses of antidepressants to take the edge off nerve pains, seems to be working. That is interesting what you said about scarring pulling on the right side. If this is the case, I wonder if scar will stretch eventually and pain will go away. Will read more about it. Have a nice weekend.

[Chaunce1234]

quote SomeGreyBIoke:

Hi Good intentions,

Thank you so much for your message. I’m in a bad place as my pains started after another operation back in January, part of me thinks that pain is still to do with that op and not hernia, and probably hang on and don’t do anything drastic at this stage.

Was the other operation done laparoscopically? Have you tried to do anything to treat the primary symptom (pain) like a nerve block?

Does laying down flat on your back help the pain? Or does anything else make it better or notably worse?

[Chaunce1234]

quote newagehernia:

Hi, I saw your post.

I have a right Inguinal hernia . Started 1 year ago. Pain developed quickly and have been suffering in very high pain , discomfort, groin weakness and heaviness since. I force myself to walk 5km to 7km a day though it’s not fun. Strangely walking is less painful than sitting, standing , or walking slowly (like a museum) . Very up and down. Mostly down. When irritated, can be painful for a few days above normal background pain.

I do not want plastic mesh. And I have some (irrational?) fears and anxiety of both current access methods of repair.

My research has found the following assuming it is an indirect hernia down the canal like mine is (from a coughing accident due to a bad cold )

1. Lcepc, pediatric laparoscopic extracorporeal non mesh repair. I have seen a Japanese study online and a USA doctor in Ohio doing it on adults. How simple ! Ultra minimally invasive. Don’t know if it works but why not? This kind of hernia is not always from a broken Inguinal floor.

2. Tigr matrix , a mesh dissolves in 2 phases ultra long term. The founder ( see novus scientific website) says he has to educate surgeons that long term dissolvable mesh 100 percent works for indirect hernia . Can be used tep lap or open.

3. Ovitex , a mesh of sheep and dissolvable plastic. It is almost better then number 2 as it’s biological mixed with a dissolvable support of plastic making it easier to insert. Very new not yet available in europe. There is some doubt of biomesh degrading too soon but studies I read say 90 percent of these indirecr hernia can be fixed this way but at higher cost and maybe higher recurrence. Is there added risk (plastic mesh or no mesh has risk too)

4. As a last resort , there is convincing evidence that pvdf (dynamesh) has low inflammation and elasticity superior to polypropylene. It’s not ultra light but apparently material matters more then weight. As a second choice in this category maybe a dual absorption mesh like ultrapro, seramesh pa, or maybe timesh?

Problem. Who to find to do these new and non standard fixes that soon will be standard for this specific subgroup? Or to have a customized approach and choose best option for you ?

Most centers do the nuclear option , they don’t care what specific hernia type or location you have.

a surgeon who is open minded and sees the advantages of above would be great.

I’m also travelling making it hard to find a surgeon since they are everywhere and don’t know if it’s worth the cost and bother to find out. Most don’t answer email so If you pick a traditionalist you’ve just wasted a big consulting fee and travel expenses.

What to do ? So far I’m struggling along but no doubt a surgery is necessary, current methods or better methods not withstanding. Part of me thinks it would be a pity to have a repair I hate because I don’t have time to use a newer method or technology that is already having many studies but not enough data . Sometimes you can’t have data for everything in time sadly.

Ps, whatever method is used with foreign object make sure they use glue and are a specialist hernia expert.

You might want to post this to a new question thread for best response results.

Where are you located? Perhaps a regional expert can be recommended that would suit what you’re looking for, or help you make a decision.

[Good intentions]

quote SomeGreyBIoke:

Hi Good intentions,

Thank you so much for your message. I’m in a bad place as my pains started after another operation back in January, part of me thinks that pain is still to do with that op and not hernia, and probably hang on and don’t do anything drastic at this stage.

Did they do any exploratory surgery at the time? Was the right side examined?

Maybe the scarring on the left side is pulling on the right, causing pain. January is not that long ago. Have you tried any methods of reducing the material in the canal? I don’t know if it was a real physical effect, but I seemed to get some relief from my direct hernia by elevating my pelvis above the upper half of my body. It takes the pressure off of the area. It’s actually what they do during laparoscopy to create a space in the abdomen, tilting the body, letting the intestines slide downward. Of course, there’s no CO2 to help but it might offer temporary respite.

Good luck.

[newagehernia]

Hi, I saw your post.

I have a right Inguinal hernia . Started 1 year ago. Pain developed quickly and have been suffering in very high pain , discomfort, groin weakness and heaviness since. I force myself to walk 5km to 7km a day though it’s not fun. Strangely walking is less painful than sitting, standing , or walking slowly (like a museum) . Very up and down. Mostly down. When irritated, can be painful for a few days above normal background pain.

I do not want plastic mesh. And I have some (irrational?) fears and anxiety of both current access methods of repair.

My research has found the following assuming it is an indirect hernia down the canal like mine is (from a coughing accident due to a bad cold )

1. Lcepc, pediatric laparoscopic extracorporeal non mesh repair. I have seen a Japanese study online and a USA doctor in Ohio doing it on adults. How simple ! Ultra minimally invasive. Don’t know if it works but why not? This kind of hernia is not always from a broken Inguinal floor.

2. Tigr matrix , a mesh dissolves in 2 phases ultra long term. The founder ( see novus scientific website) says he has to educate surgeons that long term dissolvable mesh 100 percent works for indirect hernia . Can be used tep lap or open.

3. Ovitex , a mesh of sheep and dissolvable plastic. It is almost better then number 2 as it’s biological mixed with a dissolvable support of plastic making it easier to insert. Very new not yet available in europe. There is some doubt of biomesh degrading too soon but studies I read say 90 percent of these indirecr hernia can be fixed this way but at higher cost and maybe higher recurrence. Is there added risk (plastic mesh or no mesh has risk too)

4. As a last resort , there is convincing evidence that pvdf (dynamesh) has low inflammation and elasticity superior to polypropylene. It’s not ultra light but apparently material matters more then weight. As a second choice in this category maybe a dual absorption mesh like ultrapro, seramesh pa, or maybe timesh?

Problem. Who to find to do these new and non standard fixes that soon will be standard for this specific subgroup? Or to have a customized approach and choose best option for you ?

Most centers do the nuclear option , they don’t care what specific hernia type or location you have.

a surgeon who is open minded and sees the advantages of above would be great.

I’m also travelling making it hard to find a surgeon since they are everywhere and don’t know if it’s worth the cost and bother to find out. Most don’t answer email so If you pick a traditionalist you’ve just wasted a big consulting fee and travel expenses.

What to do ? So far I’m struggling along but no doubt a surgery is necessary, current methods or better methods not withstanding. Part of me thinks it would be a pity to have a repair I hate because I don’t have time to use a newer method or technology that is already having many studies but not enough data . Sometimes you can’t have data for everything in time sadly.

Ps, whatever method is used with foreign object make sure they use glue and are a specialist hernia expert.

[SomeGreyBIoke]

Hi Good intentions,

Thank you so much for your message. I’m in a bad place as my pains started after another operation back in January, part of me thinks that pain is still to do with that op and not hernia, and probably hang on and don’t do anything drastic at this stage.

[Good intentions]

I’m not sure that size of the hernia is the issue for pain, it would be what tissues are being strained. Location, more than size. It sounds like you’re describing an indirect hernia, which would be an expansion of the inner ring of the inguinal canal. It’s not supposed to expand at all, it’s supposed to be just big enough for the spermatic cord.

If you read more threads you’ll find several on “hidden” or “occult” hernias. I think that these are areas that are starting to stretch and grow in to visible hernias, but haven’t created enough deformation yet to be visible. The tissue is being strained and creating pain, but there’s nothing to see. Read some of those and it might give you another point of reference.

On the other hand, some people have very large hernias, that are not very painful at all. My hernia was a direct hernia and the pain would go away after a week or two of no activity. I only had surgery to try to get my potential for activity back.

I’ve wondered sometimes if the words used to describe size of a hernia are describing the amount of material pushed through the defect, or the size of the defect itself. Even the size of the defect can be vague, since there are three dimensions to consider, along with shape. Round versus long and narrow, for example.