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I recommend focusing on finding a gifted hernia surgeon specialist — and there are many in the UK – and seek guidance from them to tailor a plan of care based on your needs.

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Every surgeons’s practice is different. Eg, in some states in the USA, morbid obesity and smoking are highly prevalent. We know that that combination makes tissue-based hernia repairs a poor plan of care and laparoscopic surgery is usually a better choice. In my practice, my patients tend to be thinner and I see a lot of women. In such a population, I offer tissue repairs for inguinal hernias much more commonly than perhaps my colleagues who have a different practice.

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Symptomatic implies any symptom. It could be a mild twinge or debilitating pain. Minimally symptomatic implies your symptoms are mild and do not interfere in your daily activities.

It’s standard to have a discussion prior to surgery about the planned surgical technique.

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Please share the name of your Houston surgeon. We have had a lot of people asking for hernia experts in Texas. There aren’t that many.

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Thanks for joining the forum. We have many participants from India and surgeons who have provided their assistance.

Here is one post that directly addresses your need for a surgeon in India:

https://herniatalk.com/forums/topic/pain-after-inguinal-hernia-repair-using-phs/

Pain after inguinal hernia repair using PHS.

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So happy you’re doing well and the problem has been addressed. The important detail is your current pain is different than your prior pain and the prior pain is resolved!

Tissue repairs have a longer recovery than other options. Also, having both done at the same time can prolong the recovery.

Ice packs and NSAIDs (ibuprofen, naproxen) should help. Make sure you’re not constipated.

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Thanks for joining this forum. You can use the search function to find past discussions on sexual function.

Based on your post, I recommend that you seek consultation with a hernia surgery specialist and get all your questions and concerns addresses. The surgeon can also tailor a plan of care to your needs.

To answer your questions:
– stay away from the Kugel patch and repair
– open surgery with mesh has higher risk of nerve injury than all other procedures
– hernia surgery does not affect sexual FUNCTION. Those nerves and organs are completely separate. There can be complications that cause pain with intercourse, ejaculation, or orgasm, but function is not directly affected.

Note that my responses directly contradict some of your conceptions. This is why it’s so important to seek correct consultation to get correct information. Those of us who do this for a living can best digest the data out there for you as we have a global view. We can also therefore alleviate the anxiety from all the information you are reading on your own.

You can also watch the HerniaTalk session I had with Dr Paul Turek, who is a male sexual function specialist and urologist.

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Thanks to all who participated tonight. I tried to answer all your questions. As usual, there were way more questions than we had time.

Topics that we covered included prevention, safe exercises, pregnancy, testicular pain, nerve injuries, and much more. If you missed it, you can watch and share via YouTube: https://youtu.be/aGgdeI3_Km4.

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Actually a very good question and I get asked it regularly.

No, they cannot puncture the hernia. In few cases where you have a very large hernia and there is colon within the hernia, the hernia should be reduced prior to colonoscopy.

No, colonoscopy would not in any way affect the hernia.

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Thanks to everyone who participated. This was a HerniatTalk sesssion packed with so much information.

The first half of the hour was devoted to the treatment of groin injuries seen among professional athletes. This includes sports hernias and athletic pubalgia.

The second half of the hour was devoted to the treatment of small hernias, women’s hernias, and tissue-based inguinal hernias. Tailoring care is so important!

If you missed it, watch and share here: https://youtu.be/0hd6O9pZvBM

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There are multiple different ways to treat hernias. Mesh-based is one of them. And there are a multitude of mesh options and mesh repair options.

It is best to have your hernia repair tailored to your needs. A true hernia specialist should be able to offer you the risks and benefits of a range of repair options. Some hernias cannot be repaired without mesh.

There are risks with all operations. This includes complications due to mesh or complications after non-mesh repairs. We have many examples of both on this forum.

In general, most hernias should be repaired when they are symptomatic.

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That may be difficult to find. I don’t know of any surgeons who specialize in tissue-based repair. Perhaps seek a consultation with a hernia specialist first and then consider traveling outside Texas if you wish for a second opinion.

You can search this site for keyword, Texas, to see if any show up. Dr. Kent Van Sickle practices in San Antonio.

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In my experience, most neurosurgeons don’t handle peripheral nerve issues related to hernia surgery. And only some pain management specialists know what to do.

I encourage you to watch the HerniaTalk session I had with Dr Payam Vahedifar, Pain Management specialist who treats many of my patients. The link is here: https://youtu.be/Wxk3LWBrWBg

Basically, if you have neuralgia after a neurectomy, first best choice is repeat nerve block and maybe percutaneous ablation. That is performed by a Pain Management specialist who is experienced in doing so and understands what we do as surgeons. Another surgical neurectomy may also be necessary.

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Size is not a determinant of need for inguinal hernia surgery. If you have symptoms, the benefit to your quality of life favors hernia repair. If you have no symptoms, you can safely watch it with 0.18% per year risk of complication, such as incarceration. So, it’s low. I encourage watchful waiting for most of my patients.

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Great!
What did they find and what operation did you have done?

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Thanks to everyone who participated in this session of HerniaTalk LIVE. It was fun and quite educational. We discussed a wide range of sexual dysfunction problems that can arise from hernias or hernia repairs. Topics included pain with orgasm, erectile dysfunction, retraction of the testicle with orgasm or erection, painful intercourse, pelvic floor dysfunction.

You can watch the entire episode here: https://youtu.be/AFniMzbXI4w

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Happy to help if you want to send me your records to initiate a consultation. Drs Orenstein is also a good resource at OHSU.

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Happy to help. Sometimes an inguinal hernia can cause these symptoms. And it would show on imaging. Just because the report doesn’t say it doesn’t mean it’s not there.

I’d need more information. But inguinal hernia is certainly in the differential.

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What a cool HerniaTalk session we had! We discussed the details of a Silverback gorilla’s emergency hernia operation, in addition to human hernia-related problems, with Dr. Andrew Wright. Plus, a very heartwarming Special Christmas announcement.

If you missed it, you can watch the full hour on YouTube channel here: https://youtu.be/RCTD1nnimBo

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That’s dr Alexander of the Shouldice clinic.