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Washington DC Semi-Pro Soccer – Bilaterial laparoscopic surgery 5mm inguinal hernia?
I am a USL (semi-professional league) soccer player in my 30’s. I live in the Washington DC area when not traveling. During a game about four months ago I felt a dull pain in my lower left groin. Immediately after the game I was unable to put any substantial weight on my left leg and walking was difficult. Thinking it was a pulled muscle, I rested and managed the pain. I had three false starts returning to play after a month rest each time, where upon running the pain would immediately come back.
When taking ibuprofen, I was able to run with very little pain, but immediately after and the next few days I was again unable to walk normally.
I now have developed daily pain in my lower abdomen (even when resting). When attempting to use my core to do a sit-up type movement or leg adduction (e.g. squeezing a pillow in between your legs) I can feel pain.
After reading about “sports hernias”, I visited a hernia doctor in Washington, D.C. to see if this was a possibility. No lump/hernia was detectable with a physical exam, but with an ultrasound they found what they said is an actual 5mm inguinal hernia on my left side. The surgeon has recommended immediate bilateral laparoscopic surgery with mesh.
After conducting significant research, I am left with some key questions that don’t appear to have been fully answered here before?
1. I have read that hernias most often have no or limited abdominal pain. However, my doctor has informed me that my hernia is most likely the cause of my abdominal pain. This includes the current daily pain even if I am just resting because smaller hernias “tend to be more painful”. Is this accurate?
2. I was told by my surgeon that because he is doing laparoscopic surgery it is highly recommended that the surgery be bi-lateral with mesh placed on both sides (even though I currently have only a hernia on the left side) as this will be the one time that we will have this type of access to the right side and the right side could be effected? Is this accurate and is bilateral surgery recommended with a hernia only on one side?
3. I requested an MRI to confirm the inguinal hernia diagnosis (versus sports hernia or any other cause) but was denied by insurance indicating that the ultrasound is sufficient to confirm my issue is the inguinal hernia. Is this accurate?
4. I have read a lot about the mesh versus no mesh issue. I am thin and very active with the hope to return to professional soccer. Is mesh my best chance of retuning to playing as quickly as possible with limited chance of hernia complications while playing?
Appreciate your feedback. Obviously this is a potential life/career changing decision and want to make sure I do it with the most accurate input.
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7 Replies
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WashingtonDC, consider it a blessing that you have posted here. I WOULD STAY AWAY FROM MESH PERIOD DON’T DO IT. FIND A HIGHLY EXPERIENCED SURGEON WHO WILL DO A PURE TISSUE FIX AND INSIST ON IT, Some great options listed above. I am a runner who got mesh implanted 7 years ago. I am in the process of looking to get it removed now. Basically, what I notice it that I have chronic inflammation now after activities that has led to burning and dull aches pains in the hernia mesh areas on an ongoing basis now. It doesn’t start out like that, but it will get to that point if you are very active in my experience. I am also EXTREMELY concerned with how this chronic inflammation can lead to autoimmune conditions down the road as I have now been experiencing systematic symptoms 5-7 years in > chemical and food sensitivities, escalating allergies, off balance\dizziness feelings when the pain flares up in the hernia area like I’m slowly being poisoned…no previous history in family on any of this. POLYPROPYLENE DOES NOT BELONG IN THE HUMAN BODY. In addition to chronic inflammation, there is complications such as mesh erosion, infection, extrusion, migration, fragmentation, chronic pain potentially to contend with and there is no long term testing for these since they were grandfathered in with the FDA 501K process. Please do the research and you will realize there is no reason to do the mesh if you go to the right specialists. Also, please watch 60 minutes this weekend, it is related to mesh complications and polypropylene in the human body. I understand this will be an eye opener. Good luck, I hope you heal well.
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Sounds like you may have something else going on and they found a inguinal hernia you probably already had.
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I would avoid a surgeon who wants to “reinforce” the other side. A ultrasound is non invasive and it can be done standing up which is how its easiest to see a hernia. Its only a couple hundred bucks too. It will show more then a mri in most cases if you have a hernia. Id start there.
Im a active soccer player I used to play 3 times a week I played with a inguinal hernia for several years and never had a issue. To me it does not sound like you have a inguinal hernia or at least not one that is causing your pain. Perhaps you already had the inguinal hernia and have something else going on.
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Mainstream doctors have the whole – ‘lets immediately get you into surgery and do bi-lateral mesh implant’ ritual they push on everyone. They seduce people with talk of ‘gold standard treatments’ and ‘you will be like new’ – but often times that’s all pure bullshit when it comes to mesh. Mesh could possibly destroy your soccer career and even ability to exercise or do manual labor in any capacity.
If you find it’s a true hernia I would go to shouldice to have it fixed. It it’s a sports hernia I would do a minimal repair technique. Oftentimes with a sports hernia, the hip may be causing bio-mechanical stress on the lower abs that causes the rectus/adductor or floor of the inguinal canal to strain. The other posters on this thread have listed some excellent resources. -
This is the Dr. Brown I mentioned, and it’s also the type of story that does not exist for the common hernia, and a mesh repair. Sometimes I wonder if some of these players don’t actually have real hernias. Regardless, the pros only go to certain places. If you can’t afford the travel and expense they might at least be able to refer you to someone in your insurance network.
https://www.sportshernia.com/dr-will…r-adam-moffat/
Edit – just realized that the story was written by Dr. Brown, for his web site. Still, Adam Moffat is a pro.
Edit 2 – it gets more interesting. Apparently, his sports hernia was an inguinal hernia. If you have contacts, he might be a good source of information for you.
https://www.transfermarkt.co.uk/adam…/spieler/36764
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I’m a fellow patient, not a doctor, but….
quote :When attempting to use my core to do a sit-up type movement or leg adduction (e.g. squeezing a pillow in between your legs) I can feel pain.To me that is a giant flag that you may have an athletic specific injury. Pain with resisted sit-ups and adduction are often classic symptoms of athletic pubalgia or another core muscle injury.
Have you tried resting the injury for a few weeks / months, or is that not an option?
Did the 5mm inguinal hernia found on ultrasound say if it was direct or indirect? And what the herniating tissue was? Was it reducible?
Where specifically is your pain? Is it at the muscle attachment point on your pubic bone, or in the inguinal region, or adductor attachment, or testicle, or the lower abdominal muscles, or none or all of the above?
The good news is you’re located on the east coast, and Washington DC is just a two hour train ride from one of the premiere sports injury facilities in the world at Vincera Institute in Philadelphia. They routinely do work on professional athletes and have a great track record for diagnosing and resolving a wide variety of complex athletic problems of the pelvis, abdomen, hip, and groin, including athletic pubalgia, inguinal hernias, adductor issues, nerve entrapment, and much more.
Sports hernia / inguinal disruption / athletic pubalgia experts:
– Dr William Meyers, at Vincera Institute in Philadelphia PA 267-592-3200
– Dr Alexander Poor – Vincera Institute, Philadelphia PA 267-592-3200
– Dr Demetrius Litwin – UMass MA 508-334-0661
– Dr Brian Busconi – UMass MA
– Dr Andrew Boyarsky – NJ 732-360-3520
– Dr William Brown – Fremont CA 510-793-2404
– Dr Ulrike Muschaweck – Munich Germany / London UK
I believe most of the aforementioned surgeons perform no-mesh surgical repairs for athletes when possible, inquire with them directly to learn why they use that method.
Depending on your insurance and the clinic / doctor / practitioner / facility / etc you may need to pay some costs out of pocket.
Most of the aforementioned surgeons are quite reachable and communicative, and are more than happy to respond to inquiries and general questions. Whether it’s the 5mm inguinal hernia or a sports hernia or another issue entirely, they will almost certainly be able to diagnose it and give you more information along with treatment plans.
Anyway, best of luck. Keep us updated on your case, progress, and decision making.
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You might have seen some of my posts about my situation, if you’ve browsed the site. I was a very active soccer player myself, in the amateur leagues, in very good shape, probably of above average skill level, and bilateral implantation of mesh destroyed me for soccer. I was able to get back to the field very quickly, without losing much fitness but it was impossible to play at a high level AND have a life besides playing. I told my surgeon that if I was a farm animal and only needed to work and eat, that the surgery might have been appropriate for me. But life could not be enjoyed at anywhere near the level before I had the mesh implanted. The mesh was a constant irritation, causing swelling and discomfort, reducing my aerobic capacity, and eventually getting stiff and board-like. I was happier with the hernia. It was a slow three year downward spiral until I had the mesh removed. I knew I needed to have it out at two years, I was thinking about it at under one year. I wasted a lot of time trying to live with it.
If you look up Dr. Muschawek in Germany, and Dr. William Meyers of the Vincera Institute, and contact them, I am sure that they will tell you to avoid any mesh implantation, if you have any plans to have a professional career. Dr. William Brown is also known for working on athletes. They all work with athletes and they all see what mesh does to them. They all understand athletic pubalgia (sports hernia) also. They all have answered my email messages. Travel to someone who knows and has proven success with athletes. Do not try to work within your insurance system, or find somebody close, or try to save a few weeks or months, do whatever it takes to find an experienced hernia repair surgeon who repairs athletes. If they can’t look you in the eye and say that they have repaired a professional athletes hernia, one like yours, don’t let them fix yours. Your choice will affect more than your career, it will affect the rest of your life. Many surgeons do not really know what happens to their patients beyond the first few months after surgery.
And I can’t emphasize strongly enough how impossible it is to “work through” the effects of the mesh on your body. It’s not like an injury that will respond to a plan of physical therapy or nutrition or just working harder. The harder you work to get your body to accept the mesh the worse the response is. You can’t gut it out, or out-smart it, or take painkillers to cover it up. It’s like a living thing in your gut that you have to take care of.
My surgeon was top-notch, well-respected, and knew that I was a very active soccer player but he either didn’t know about how athletes have problems with mesh or he thought that his skill level would make a difference. There is a meme out there that the most important thing to look for in a hernia repair with mesh is the surgeon’s skill level. But there is also evidence that it is the material itself that causes the problem. So no matter how good your surgeon is, it won’t matter. I have looked far and wide for a success story about a professional athlete who was happy with a mesh implantation and have not found a single one.
Your story, except for the professional part, mirrors how my ordeal started. Having bilateral laparoscopic implantation of mesh was the worst decision of my life.
Good luck. Don’t convince yourself to “take the plunge” or “roll the dice”. The odds are stacked very much against a true athlete.
p.s. the hernia repair surgeons that use it really believe in it. That’s why you have to be extra careful. They just don’t know.
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