DrBrown
Forum Replies Created
-
Dear Jnomesh.
I have asked Dog if he he will let me post the photos from his operation.
It will clarify many of your questions.
Regards
Bill Brown MD -
Dear Jnomesh.
If I had a hernia, I would love to repair it myself. Unfortunately, I am not as flexible was I used to be.
Your best bet to find a local surgeon is find a surgeon who was trained before mesh was available. So he/she would have to be in their late fifties or sixties. Write out your list of questions so that you do not forgot anything. Take someone with you, under the stress of the office visit you will forget half of what the surgeon tells you. Do not hesitate to record your visit.
Everyone is welcome to come to Calfornia. I have operated on patient’s from every state except Minnesota and Iowa. So they will get a discount.
Best wishes.
Bill Brown MD -
Dear Chaunce.
I agree with you, especially since many hernias are repaired that are asymptomatic. It is wrong to take a patient with minimal symptoms and turn him/her into a patient with chronic pain.
Regards
Bill Brown MD is -
Dear Pinto.
I would let symptoms be your guide.
If you are not having any trouble, then wait.
Also consider money. If you have met your deductible for the year then you might save money by having it fixed now instead of later.
Regards.
Bill Brown MD -
Dear Kis007.
I agree with Dr Towfigh that you should first be evaluated for a hernia.
If that is negative, the consider seeing a urologist.
The test can ride high from either tightness of the cremasteric or tightness of the scrotum itself.
I have used Botox several times, but it is expensive and often needs to be repeated.
Regards.
Bill Brown MD -
Dear Kevin P
The scrotal fullness could be blood, Swelling of the spermatic cord, or scar. All these usually improve with time. An ultrasound is simple test that should be diagnostic.
If you were not having nerve pain before surgery, then I am not sure why the nerve was cut. Also simple cautery of the nerve can lead to neuroma. If the nerve has to be cut, then the nerve should be ligated with a fine surgery and buried into a local muscles.
I agree that if you had a direct hernia, you would not have required any dissection of the spermatic cord.
I you would like to post your operative report, I would be please to review it with you.
Regards.
Bill Brown MD -
I agree with Dr Towfigh that lateral thigh pain is probably the lateral femoral cutaneous nerve.
I pray that it improves with time. The nerve can be injected as it passes under the inguinal ligation. An injection sometimes provides relief.
Regards.
Bill Brown MD
-
Dear Chauce1234.
The ilioinguinal, iliohypogastric, and genital usually provided sensation to very specific areas. So from physical examination the doctor can usually determine which nerve has been injured. Then the patient can treated with nerve blocks, ablation, TENS, Neurontin, or neurectomy. Unfortunately the nerves often cross connect. What I mean from that say the patient has pain from the ilioinguinal nerve. But because there are often connections between nerves, even if the ilioinguinal nerve is cut pain can often still get back to the brain from the iliohypogastric nerve.
Regards.
Bill Brown MD -
Dear Good Intentions.
Your comments and information in this forum are a start, but I agree it would be very helpful if the FDA would acknowledge the problem. Many surgeons that use mesh do not realize that their patients have serious problems with mesh, because the patient goes to another surgeon to have the mesh removed (i.e. Myself and Dr Towfigh)
I appreciate your effort to keep attention focused on Mesh.
Regards
Bill Brown MD -
Dear Kevin B.
Do not hesitate to ask your surgeon any questions or concerns that you have.
Your recovery will be better if you know what is going on and what to expect.
Sitting at home and worrying is not helpful. Get the information you need
Regards
Bill Brown MD -
Dear Kevin b.
Many of the symptoms your describe are related to neuretomy. In most cases this will improve with time.
Dry the skin after your shower and apply baby powder. Occasionally lidocaine or capsaicin cream will help (available OTC) A nerve block can help.
The testicle should improve with time.
Work with your surgeon, he/she should also be able to give advice.
Regards
Bill Brown MD -
Fortunately, I have many women who run my life.
Bill Brown MD -
Dear Vegas.
From your description, your pain is probably related to the ilioinguinal nerve. You can try capsaicin or lidocaine cream. The creams can sometimes help. A nerve block is often helpful. Neurotonin is occasionally helpful, but most people do not like the side effects. If you have mesh, then the mesh can be injected with local anesthetic.
An Ultrasound can check for a recurrent hernia.
Regards.
Bill Brown MD -
Dear Pinto.
I do not know the cost of Ovitex. But if they spent a $2m on the robot and they think the mesh is to expensive it must cost a lot.
You have to have general Anesthesia for the Robot. An open repair can be done with sedation.
Your external oblique is probably fine for a Desarda.
I would still advise a non mesh repair.
Regards.
Bill Brown MD -
Dear Bmul100.
I agree that standing will not increase your risk for a hernia.
Bill Brown MD -
Dear Pinto.
If fear about the hernia means that you can not play the sports that you enjoy, then I would advise you to have the hernia repaired.
Regards.
Bill Brown MD -
Dear Alliej.
It is unlikely that a hernia would cause your symptoms.
I would advise you to see a gastroenterologist.
Regards.
Billl Brown MD -
Dear Pinto.
With a small opening in the abdominal wall, intestines are more likely to become incarcerated, but the risk is small.
Also with a small opening there tends to be more pain when the intestines pop out.
With a larger opening, the intestines will pop out more often, but there tends to be less pain.
Unless you travel to countries where medical care is poor, I would advise you to have the hernia repaired when you start to have symptoms.
You can help by getting your weight down if you are overweight, and to stop smoking if you smoke.
I would advise a non mesh repair.
Regards.
Bill Brown Md -
Dear Kevin b
I am glad that you are on the road to recovery. I am especially glad that your nerve pain is better. That can be very difficult to treat.
Regards.
Bill Brown MD -
Dear Bobcoco.
If you have a strangulated hernia then you usually quickly get worse (more pain, Swelling, Fevers). Since you are getting better, then it is doubtful the hernia is strangulated. If you are concerned, call you primary doctor. He/she can refer you to a surgeon or the ER for an evaluation.
regards.
Bill Brown MD