[Chaunce1234]

I’m sorry you’re going through this.

[USER=”1991″]LeviProcter[/USER] makes a strong point that a re-do surgery is a big deal. Thus if you even are to consider it, be sure you seek out an expert in that particular specialty, including mesh removal, who has done it many times before. Unfortunately that may involve traveling.

Two names in the northwest that have been recommended on these forums before are the heads of the hernia departments at UW and OHSU:

– Dr Andrew Wright at UW Washington

– Dr Robert Martindale at OHSU Oregon

I have also seen Dr Peter Billings recommended here and on other forums.

I am not sure what experience these doctors have with mesh removal specifically, but it wouldn’t hurt to ask them, and presumably they could be helpful resources.

And if you happen to be interested in visiting Los Angeles, California, then Dr Shirin Towfigh who runs these forums has notable experience with this topic and would be a great resource.

Anyway, good luck, stay positive, and keep us updated on your progress and decision making.

[Chaunce1234]

I am not a doctor but my 2 cents is that if you can manage or resolve a problem without another surgery, then you might want to try that first. A pain shot might help and it could also be diagnostic and informative, if a numbing shot in one particular nerve pathway completely resolves the pain, then that may help a doctor to help narrow down the cause. But discuss this all with a knowledgable doctor, maybe even get a second opinion, let them help you come up with a plan. Some doctors also may prescribe a 30-45 day course of powerful NSAID (meloxicam, naproxen, etc) assuming it is compatible with you.

Does anything in particular help the pain go away, or make it notably worse? Does heat or ice help or hurt? Does applied pressure make it better or worse? Is the pain generalized, or focused in a specific area? If you are able to take NSAIDs, does ibuprofen or aleve help, or make no difference at all?

This following list may or not be helpful to you, it’s various doctors in the eastern half of the USA which have a specific interest in hernias and/or groin pain.

– Dr Brian Jacobs in New York, NY

– Dr William Meyers in Philadelphia, PA

– Dr Alexander Poor in Philadelphia, PA

– Dr Jarrod P Kaufman MD in Brick, NJ

– Dr Igor Belyansky in Annapolis, MD

– Dr David Grischkan in Cleveland, Ohio

– Dr Paul Szotek in Indianapolis, IN

– Dr Bruce Ramshaw in Knoxville, TN

– Dr Jonathan Yunis in Sarasota, FL

Obviously there are going to be many other great docs out there too, so by no means is this thorough or inclusive. If you are inquiring yourself with doctors, you might want to ask if they have experience with the particular issue you are dealing with, and if they have been able to treat it successfully, and how. As others here have echoed, re-do surgeries are complex and if you ever go that route then you would definitely want someone with notable experience in that regard, particular with laparoscopic experience since your initial surgery was laparosopic. Dr Towfigh and the other helpful physicians on this forum undoubtedly have some recommendations as well.

Good luck, stay positive, and keep us updated on your progress.

[Chaunce1234]

quote jlhunter:

[USER=”2042″]Jnomesh[/USER], yes osteitis pubis is just a fancy name for inflammation of the pubic symphysis that can be caused by several things so the fact that I have inflammation doesnt help in figuring out what is causing it.

[USER=”1916″]Chaunce1234[/USER] yes I am athletic, 30 years old, there was no traumatic event that caused my symptoms….the only life changing event was that I had a career change going from being a teacher and standing all day to a desk job where i sit most of the day. But my activity/exercise has always been pretty heavy and consistent. Thank you for the extra information, and I will certainly look up Dr. William Meyers in Philly……I did go back to my PCP today who wants me to get an abdominal/pelvic CT but I dont trust this doctor as he took 2 months just to get back to me on bloodwork. Im hoping your suggestion of an MRI/CT above means you agree that might be a good next step.

I really jsut do not know where to start because I have both groin and pelvic pain and I dont know if they are related or two separate conditions. Hence why I went to a PCP trying to think big picture but not sure I can trust a doctors office that is neglectful in their care!

Can you describe your pain? Is it confined to a specific area, or is it diffused along a particular nerve pathway? Does taking ibuprofen or anything help? Does ice or heat help or make it worse? Do you have tenderness to touch or pressure?

I can very much relate to your approach of going to a PCP and imagining having them be the center of the treatment plan. But with that said, and having myself been through this as a fellow patient, a PCP tends to be a generalist and they often have little to no experience with groin and pelvic pain, nor the myriad potential causes. Groin/pelvic/hip pain is often a symptom driven specialty in and of itself, which sometimes encompasses multiple different specialities, which is why patients dealing with this type of pain often get bounced around between PCP, urology or ob/gyn, surgeons, orthopedics, gastroenterologists, pain management, radiologists, neurologists, you name it and a good number of patients on this forum have probably seen them trying to get answers. Sometimes the answer is shockingly simple or obvious. Sometimes the answer is complex, sometimes it’s multiple things. And sometimes there is no answer. The workup can become ridiculous, tiresome, expensive, and confusing.

Ultimately you need to be your own advocate. As [USER=”1176″]Momof4[/USER] story says above, sometimes things are overlooked. This is why the specialist can be so valuable for the ambiguous cases. My personal opinion is if you have unclear groin/pelvic/hip pain and are near an expert or have the capability of traveling to consult with one, then do it. Dr William Meyers is near you, and there are multiple other experts on the east coast as well.

Anyway, good luck and keep us updated on your progress and decision making.

[Chaunce1234]

How are you doing now, any relief, progress, or difference in symptoms?

If you are concerned about having a groin hernia and the traditional “cough test” has failed to be definitive, you might want to request a dynamic ultrasound with valsava on the effected groin region. It can be a helpful diagnostic tool to rule in/out a groin hernia. There can be many other other causes of groin pain too however.

If you are you in a specific part of the country and want recommendations for hernia doctors perhaps share your state or city.

Best of luck, keep us updated on your case.

[Chaunce1234]

Was your hernia symptomatic or painful prior to surgery? And if so, is that pain or discomfort relieved since?

It sounds like you had a great experience as far as surgeries go, so congratulations to you and I wish you the best. I have been interested in the comments left by Dr Kang as he seems to be an innovator, and it’s always helpful to hear from patient success stories. I wonder if the procedure Dr Kang offers is unique then perhaps he could publish a paper on the specifics or post videos to YouTube of the full procedure for other surgeons to learn from, just a thought. Innovation that improves patient outcome is always a good thing.

As an American, it is inconceivable to imagine a hernia surgery or even a simple medical procedure for $500 given our current state of affairs with costs running wild. $5,000 and up is often the cost of an insurance deductible alone over here!

Best of luck and keep us updated on your progress.

[Chaunce1234]

I’m sorry you’re going through this, chronic pain is very unpleasant. Have you been checked for a hernia recurrence? Did Dr Chen elaborate on the relationship between symptoms and your weight? Are you underweight or overweight? Do any particular activities or behaviors make your symptoms better or worse?

A general comment if you, Jnomesh, or others have difficulty with eating, digestion, and nausea would be to try drinking a strong ginger tea or real ginger ale (the types where ginger particles are floating in the bottle, it is strong) before a meal and see if that helps.

My opinion as a fellow patient, if you are already in the Los Angeles area you might want to make an appointment to see Dr Shirin Towfigh, who also happens to run these helpful forums and wrote the comment above, and get her to review your case. She is very knowledgable, I believe her number is (310) 358-5020

Best of luck, and keep us updated on your case and progress.

[Chaunce1234]

quote kevin-pa:

I’m in Eastern Pennsylvania. 2 hours from NYC or Philadelphia. Considering regular open surgery. Only symptoms I have is a dull groin ache if I am on my feet all day long. Or if I go for a long hike, or something. Otherwise, I’d never even know I had it besides the small bulge. I have tried to look up photos online to see how my bulge compares to others. Somedays it’s barely there and almost flat. Other’s it might feel like it’s the size of an egg cut in half.

I am seeing the surgeon tomorrow, actually. As I mentioned, I had (have?) a scheduled surgery date for Nov. 30.

How did the appointment go?

It sounds like the hernia doesn’t bother you much which is great. Also a chief of surgery would presumably have a good number of hernia procedures under their belt with a lot of experience, but you can always ask the surgeon how many hernias they have fixed too if you might find that helpful.

If you want a second opinion for whatever reason, the following is a list of eastern USA surgeons that either have a particular interest/specialty in hernias and/or possibly offer non-mesh repair if appropriate to the patient. Obviously there are going to be many great docs that are not on this list too.

– Dr Brian Jacobs in New York, NY

– Dr Samer Sbayi in Long Island, NY (trained at Shouldice clinic in Toronto)

– Dr William Meyers in Philadelphia, PA (special focus on athletes, sports hernia, and core injuries)

– Dr Alexander Poor in Philadelphia, PA

– Dr Jarrod P Kaufman MD in Brick, NJ

– Dr. Andrew Boyarsky in New Brunswick, NJ

– Dr Igor Belyansky in Annapolis, MD

– Dr David Grischkan in Cleveland, Ohio

– Dr Paul Szotek in Indianapolis, IN

– Dr Bruce Ramshaw in Knoxville, TN

– Dr Jonathan Yunis in Sarasota, FL

– Dr Robert Tomas in Fort Meyers, FL

Good luck and keep us updated on your decisions and progress.

[Chaunce1234]

Just to chime in here as a fellow patient, I have read a working theory that, at least with regard to thin/athletic/fit patients, a “hidden hernia” is often basically the early stages of a regular hernia that hasn’t fully formed the traditional bulge yet, but can either be a small amount of intrabdominal fat lodged into the inguinal or femoral canal which compresses a nerve, or even a tear or disruption in the groin muscle from an injury that compresses on a nerve or indirectly pulls on a nerve by yanking on surrounding muscle fibers. The latter is sometimes referred to as “inguinal disruption” or “sports hernia” and is known to be a painful condition.

Anyway, this is clearly a complex topic.

As for patients who desire a non-mesh repair in the USA, it has to be sought out rather specifically because it is not a common procedure despite there being a clear market demand for it. I have posted a list in some other forum threads before with surgeons in the USA who are known to perform non-mesh repair for anyone interested, for most people they will need to travel, often to another state or region of the country.

[Chaunce1234]

jlhunter,

Are you athletic or an athlete? Age? Can you describe your pain? Was there a particular onset or event?

Dr William Meyers at Vincera Institute in Philadelphia, PA is well known and runs an entire clinic devoted to groin, pelvis, hip, abdominal, core, orthopedic, et al pathology, and are very skilled at diagnostics as well. They do a lot of work with pro-athletes and are well regarded, at the least it may be worth a consultation given the near proximity to you.

Osteitis pubis is certainly a diagnosis and it’s not to be ignored or discounted. An extended course of anti-inflammatory may help but like everything else you should speak with a doctor knowledgable about the particular problem.

As for groin and pelvic hernias, a relatively common and cheap test that can be diagnostic is a dynamic ultrasound with valsava on the impacted region. An MRI of pelvis and CT might also show other pathology, or a hernia, but hernia is commonly overlooked and can be notoriously difficult to spot especially when radiology interpretation is outsourced to some off-site location without sufficient patient profile, which is perhaps why some doctors read the scans directly themselves even if it is difficult.

Best of luck, keep us updated on your case and progress.

[Chaunce1234]

Personally, if I had a small hernia that was not bothering me at all, and that a surgeon told me was low risk and thus suitable for watchful waiting, then I would likely wait. But if your hernia is painful or bothering you, or if a surgeon says it is risky, then of course consider surgery.

Aim to be comfortable with both your surgeon (or their expertise) and the procedure itself.

What symptoms do you currently experience? What procedure are you considering?

Where are you located? Perhaps someone can provide you with the name(s) of some regional hernia experts near you. It can be beneficial to get a second opinion.

Good luck, keep us updated on your decisions and progress.

[Chaunce1234]

I do not know of anyone in Montana, ID, WY, ND practicing non-mesh repair, but you may have some success in contacting local surgeon offices and asking directly.

The following is a list of surgeon names on the western USA that have appeared on these forums and on other websites associating with non-mesh hernia repair but it could be on a case-by-case basis, you would likely want to contact them directly and inquire if they perform the non-mesh repair for your type of hernia, and if you are a suitable patient for the procedure.

– Dr Peter Billing in Seattle, WA

– Dr Allison Perrin in Seattle, WA

– Dr Rebecca Petersen in Seattle, WA

– Dr Andrew Wright in Seattle, WA

– Dr Paul Dally in Vancouver, WA

– Dr Robert Martindale in Portland, OR

– Dr Michael Mastrangelo in Bend, OR

– Dr William Brown in Fremont, CA

– Dr Shirin Towfigh in Los Angeles, CA

– Dr David Chen in Los Angeles, CA

– Dr Edward Phillips in Los Angeles, CA

– Dr Robert Burns in Newport Beach, CA

– Dr Kevin Petersen in Las Vegas, NV

– Dr Zafar Parvez in Gallup, NM

Shouldice Clinic in Toronto Canada is perhaps the most famous globally for non-mesh repair of hernia, and if you are traveling anyway it may be worth a consideration.

A handful of others found elsewhere in the eastern USA are:

– Dr Brian Jacobs in New York, NY

– Dr Samer Sbayi in Long Island, NY

– Dr William Meyers in Philadelphia, PA

– Dr David Grischkan in Cleveland, Ohio

– Dr Paul Szotek in Indianapolis, IN

– Dr Bruce Ramshaw in Knoxville, TN

– Dr Jonathan Yunis in Sarasota, FL

– Dr Robert Tomas in Fort Meyers, FL

Hopefully this list is a helpful starting point for you.

Good luck. Keep us updated on your decisions and progress.

[Chaunce1234]

jeanvic,

Is the pain in a specific location or diffuse? Where do you ice to then gain relief?

Perhaps one of the best initial tests to have to check for a groin hernia is to a dynamic ultrasound with valsalva maneuver (bearing down as if you are attempting to pass gas or defecate) on the region with pain or symptoms, performed by a skilled radiologist or technician.

MRI with valsalva of pelvis/abdomen can be even better but finding hernias, but is a somewhat less common scan for that purpose and may have some confusion when you request it. Referring to studies may be helpful in such a case.

For NYC, you might try talking with Dr Brian Jacobs or on Long Island there is Dr Samer Sbayi, both names have appeared on forums discussing hernias and could be a good starting point.

Good luck and keep us updated.

[Chaunce1234]

What about an absorbable temporary lattice that is sprayed or soaked in the patients own stem cells, to try and encourage native tissue growth? Is that just nonsensical?

What about a temporary mesh that was soaked in platelet rich plasma? Any theoretical benefit?

Are there any recent updates or ongoing research with the completely absorbable meshes?

Is there any longterm data/evidence supporting the Desarda repair yet?

quote :

– New less invasive techniques. I’ve been performing robotic-assisted non mesh (tissue) repairs with good success.

Can you give any more details about this? What’s the recovery like compared to other repairs? Has it been effective or tried on a patient with pre-op pain?

[Chaunce1234]

I hope you can convince more surgeons and new medical students to learn the technique, it is still clearly applicable in the modern era for a fair number of cases anyway. Maybe you can teach it? Do you still teach med students?

[Chaunce1234]

rbh05, you’re very welcome I hope some of the information shared here is useful. Do you mind sharing a little more about your case? Age? General health? Onset of symptoms? Was anything noted in your pelvic/ab imaging scans? Did you get any imaging with valsalva?

Please keep us updated on your case, symptoms, progress, and decision making. Best of luck!

[Chaunce1234]

I am sorry you are going through this. Groin pain is very unpleasant as any sufferer knows.

How are you doing now? Any update on your case? I assume you are located in UK if you had a Gilmore procedure?

[Chaunce1234]

Any update on you case? What area are you located?

Good general advice is see a doctor who has experience working with patients like yourself (very physically fit, very physically active), and preferably a hernia specialist / expert with a notable amount of experience. There are multiple ways to fix a hernia, be sure to discuss and understand each of them so you know what is recommended for you and why. Learn the risks and benefits of each, etc. Good luck, keep us updated.

[Chaunce1234]

Any update? How are you doing? Have you seen a doctor about your recurrence?

What was your original repair type that failed? You might want to seek out a specialist who has experience in recurrences.

I am not sure of what surgery types performed you would need to inquire directly and ask if they have experience with recurrences as well, but a few names of west coast hernia specialists that have come up in these forums and elsewhere are:

– Dr Andrew Wright at UW Seattle

– Dr Rebecca Petersen in Seattle

– Dr Robert Wright in Washington

– Dr Paul Dally in Washington

– Dr Robert Martindale at OHSU

– Dr Sean Orenstein at OHSU

– Dr William Brown in Palo Alto

– Dr Shirin Towfigh in Los Angeles

– Dr David Chen at UCLA

– Dr Bob Burns in Newport Beach

There are likely others as well. Good luck and keep us updated on your case.

[Chaunce1234]

quote mela414:

Having sutures removed Tuesday. Fingers crossed. Hope he gets them all. Not sure what this means hernia wise. I never even knew I had a hernia there. They only found it when fixing my femoral hernia. I never had pain there either. Now I have pain all the time. I will be happy once the sutures are gone and hopefully the pain goes away
mel

Did you have your follow up procedure? How are you doing? Any update?

[Chaunce1234]

rbh05, I’m sorry to hear you’re going through this.

Perhaps reach out to one of the following doctors (or all) that are somewhat regionally close to you, these are doctor names that come up frequently on these forums:

– Dr Paul Szotek in Indiana, his website is https://www.indianahernia.com/ and phone number is 317-660-5362 or 765-655-2538, he sometimes answers questions on these forums and knows Dr Towfigh so is presumably familiar with some of her diagnostic protocols.

– Dr David Grishkan in Ohio is also a midwest hernia expert, phone number is 216-591-1422

– The east coast has other noted groin/pelvic/hernia docs, in NYC is Dr Brian Jacobs, in Philadelphia is Dr William Meyers at Vincera Institute

Here are a few generic ideas, this is just advice from a fellow patient and I am not a doctor:

– Request a dynamic ultrasound with valsava of the painful area in the groin, searching specifically for hernias, this is fairly cheap and most insurers should approve it

– You may want to request a dynamic MRI with valsava, Dr Towfigh has research that backs this up as another detection mechanism for hernias. A dynamic valsava imaging may show something a standard MRI/CT won’t. Also be sure whoever the radiologist is checks for other issues with hip, pubis, core muscles (sports hernia), etc

– When did the injury / pain first occur, and was there a related event?

– Where is the pain distribution?

– What makes the pain worse?

– What makes the pain better? Anything?

– Have you tried anti-inflammatory course? Nerve blocks?

– Gather detail about what you have tried for treatment so far

– Gather as much detail you can about the pain, where it is, what makes it worse / better, what caused it (if anything)

Also be sure to rule out things like core muscle injury / sports hernia, hip issues, bacterial issues, etc.

Good luck, keep us updated on your case.