chrpainman
Forum Replies Created
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Dr. Towfigh,
I went to a urologist a couple of months ago. He thinks it’s prostatitis related and gave me another 10-day round of Cipro. My symptoms once again went away on the Cipro, but then came back a few days after finishing the cipro, just like before. My only trigger has remained ejaculation, but the pain has really gotten better the past couple of weeks. The duration and intensity of pain has slowly decreased after each ejaculation. However, I sneezed yesterday while sitting down (something I normally try to avoid), and since then the pain has come back. If this is small hernia recurrence, I suppose there is no point in waiting for it to get better before seeing a hernia surgeon? I think I already know the answer but figured I’d ask you anyway.
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quote drtowfigh:ejaculation pain after surgery
I respectfully disagree with the 6-weeks. There is no evidence to support inactivity, including sex, until 6 weeks postop for inguinal hernia repairs. Especially primary non recurrent ones and laparoscopic.
I don’t restrict my patients on any activity. This is also supported practice by the European Hernia Society consensus statement.
Pain with ejaculation and orgasm may be related to mesh:vas deferens interface. It should resolve with time. If it doesn’t, see a specialist. Rarely, the mesh may need to be lifts off the spermatic cord.
Otherwise there is no correlation.
I had a similar experience to the OP. I had my inguinal repair with mesh 12 years ago, and I had pain during and after ejaculation for months after surgery. It took up to a full year before I stopped experiencing this. The episodes gradually decreased in duration and intensity over time. Recently however, about three months ago, I’ve started to have this post ejaculation pain again. Feels the same as it did back then. Dr. Towfigh, what exactly causes this? And what type of specialist would evaluate this? I know of a good general hernia surgeon.
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quote drtowfigh:1. Yes. Imaging may show a recurrence even if there is no examination finding.
2. Testicular pain may be related to inguinal hernia. Also, antibiotic has anti-inflammatory effect. So if pain is improved on antibiotic, it may have been a bacterial infection or a mesh-related inflammatory problem. If pain is cured with the antibiotic, then most likely that’s infectious.
So, you’re saying it could have been a testicular bacterial infection ’caused’ by a recurrent hernia? And would the ejaculation trigger be hernia related? Somehow the hernia causing inflamation the vas deferens? Similar to vas deferens pain post hernia repair?
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quote drtowfigh:Hernia-repair pain or urological?
new hernia
Dr. Towfigh,
Would a recurrent hernia account for pain after ejaculation, or for the fact that the left testicle pain went away after a few days on the Cipro? This has me very confused.
A lot of this reminds me of the hernia pain I felt my first year post-op. But I’ve never had the strong left testicle pain (which went away), or the the general pain/cramping across my pelvis which comes and goes, and is sometimes accompanied by an urge to urinate more. -
quote Chaunce1234:chrpainman, I am not a doctor just a fellow patient, but:
Personally I would try requesting a dynamic ultrasound with valsava on the side you are experiencing groin pain on.
As Dr Towfigh suggested, an MRI with valsava can be even better but sometimes it is harder to get insurance or a doctor to sign off on, and some clinics do not know how to perform the proper test, you may want to present some research to help your case with that. Here is Dr Towfighs research on that particular matter https://www.ncbi.nlm.nih.gov/pubmed/25141884
Start noting if any particular activities worsen the pain, improve the pain, or change the nature of the pain. That can be helpful for a doctor to troubleshoot as well.
Perhaps seek out a hernia expert or groin pain expert in your region, they could help rule in/out a hernia recurrence or other possible issues. There are experts scattered around the country and the world, but you may have to travel to get to one depending on your location.
Thanks, I’ll bring that up to whomever I see.
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Hernia-repair pain or urological?
My primary doctor did a hernia evaluation on me when all this started and didn’t feel anything. Does further testing often find a recurrence that a typical evaluation would not?
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Hernia-repair pain or urological?
My last urologist visit was nearly ten years ago. I recently consulted with an online urologist and he thinks it’s more likely to be related to either my ongoing prostatitis or a hydocele. I have an appointment set up with a urologist locally in a few weeks, I’ll probably start there.
When you say a small recurrence of my hernia repair, you mean a flare up of pain from scar tissue / past nerve entrapment or a new hernia?
Thanks