[DrBrown]

@sublogik
Some swelling and pain are common after hernia repair.
Elevate and compression will help the swelling.
Do not hesitate to contact your surgeon.
Regards.
Bill Brwon MD

[DrBrown]

A standing ultrasound with Valsalva maneuver is probably the best imaging test.
A careful examination for a femoral hernia in addition to inguinal hernia.
Regard.
Bill Brown MD

[DrBrown]

Most recent articles state the the chance for chronic pain is the same with or without mesh. But it is not stated how the non mesh repairs were done and if the non mesh repairs were done by an experienced surgeon.
If you try to find an article about chronic pain after hernia repair from the 1980’s (i.e. before mesh). There are no articles discussing pain.
Regards.
Bill Brown MD

[DrBrown]

The egg swelling is probably a hematoma or a seroma.
It should resolve with time, but return to see your surgeon.
The incision can be reopened to remove the blood. Sometimes aspiration will solve the problem.
Regards.
Bill Brown MD

[DrBrown]

Stefan.
The pain is probably not dangerous.
Hopefully the pandemic will resolve in the near future and you can return to see your surgeon.
Regards.
Bill Brown MD

[DrBrown]

@alephy
Coughing, constipation, and straining to urinate are the three problems that increase the intraabdominal pressure the most. Avoid these problems
Bill Brown MD

[DrBrown]

@good-intentions
Thank you for always finding interesting articles.
Your comments are spot on.
Bill Brown MD

[DrBrown]

The healing ridge will last about 6 weeks.
Be patient.
Regards.
Bill Brown MD

[DrBrown]

Dear Luke.
The cremasteric muscles will often pull the testicle up when something pops out of the hernia.
Everything should return to normal after the hernia is repaired.
Strongly consider a nonmesh repair.
Regards.
Bill Brown MD

[DrBrown]

@good-intentions
I agree that his funding sources limit his ability to fully endorse pure tissue repairs.
I disagree with the statement that the chance for chronic pain is the same with or without mesh. I almost never have any chronic pain problems after pure tissue repairs. If you review the literature before the 1980s there only a few articles about chronic pain after hernia repairs. It is also not mentioned in the surgical textbooks from the 1980s.
Thank you for helping us all stay up to date.
Regards.
Bill Brown MD

[DrBrown]

There is a chance that the pain will improve with time.
Your surgeon needs to examine the operative site. Often the etiology of the pain can be determined with a simple examination.
Also:
Ask your surgeon to order an ultrasound. That will help determine whether or not you have another hernia.
Ask your surgeon to block the ilioinguinal and the iliohypogastric nerves. That will help determine whether or not you have an entrapped nerve.
Ask your surgeon to perform a cord block, that will help determine if there is a problem with the spermatic cord.
Regards.
Bill Brown MD

[DrBrown]

@alephy
If the nerves are the source of significant pain before the operation, then a neurectomy may provide significant relief.
If you are having a mesh hernia repair, then some surgeons cut the nerve to prevent the nerve from being scarred to the mesh.
For pure tissue repair, there is usually no reason to cut the nerve.
Regards.
Bill Brown MD

[DrBrown]

Dear Luke.
You probably have an indirect hernia.
The hernia is probably small.
The retraction of the testicle is not dangerous to the testicle.
I advise you to have the hernia repaired when convenient for you.
Regards.
Bill Brown MD

[DrBrown]

@peterc
I am sorry that we did not get the good result that we both wished for.
It was my hope that removing the mesh and repairing the muscles would allow you to regain the strength that you needed.
Bill Brown MD

[DrBrown]

@holeinthewall
For inguinal hernias, recurrence is usually small.
It should not be repaired is you only have twinges.
Avoid smoking, coughing, constipation.
Regards.
Bill Brown Md

[DrBrown]

@alephy
The nerves are not routinely cut with pure tissue repair.
Regards.
Bill Brown MD

[DrBrown]

@holeinthewall
You are correct. It is possible to reduce an incarcerated hernia.
Since your hernia is giving you trouble, I would advise you to see your surgeon and had the hernia repaired in the near future.
Regards.
Bill Brown MD

[DrBrown]

Dear D.
the risk for incarceration is small, so if the hernia is asymptomatic then it certainly does not need to be repaired at this time. If you take 100 patients with an asymptomatic hernia, in 18 months about half of the patients will decide to have the hernia repair because of symptoms.
if you travel to 3rd world countries a lot, that would be a another reason to consider hernia repair at this time.
but watchful waiting is a very good decision.
Regards.
Bill Brown MD

[DrBrown]

Dear Angela.
Your situation is more complicated than usual. I would advise you to go to the University of Toronto and see a surgeon in the department surgery. I would also advise you to strongly consider a non-mesh repair if surgery is required.
Kind regards.
Bill Brown MD

[DrBrown]

Dear Luke.
The ultrasound should be done while you are standing with a Valsalva maneuver.
Both sides should be examined.
Most medical schools will have well-trained technicians and radiologists.
Regards.
Bill Brown MD