drtowfigh
Forum Replies Created
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Thanks everyone. These are all excellent points. I really appreciate your input. Let’s hope this is a successful small step forward.
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The type of pain you describe is seen with hernia repairs that may be too tightly repaired or if you have too many tacks (they can cause muscle spasm). The absorbable tacks take at least 6-8 months to dissolve. Most take longer. If the mesh is tightly placed, and that is the problem, then sometimes your body will accommodate, but at times it won’t.
For some of my patients, I inject local anesthetic between the mesh and the abdominal wall. In more severe cases, I inject Botox, to relax the muscle as it accommodates for the repair.
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With open mesh: adhesions to bowel of peritoneum is not an issue. Mesh migration is also not an issue except for the Plug mesh technique. Shrinkage is an issue with every mesh, but not a risk if the mesh is implanted with that knowledge in mind (i.e., not tightly sewn in).
A recurrence from an open repair is best repaired laparoscopically. It doesn’t usually matter if it’s a Shouldice or a mesh repair unless for whatever reason you cannot undergo a laparoscopic repair. -
In VA/MD: See Dr. Levi Procter, Sharon Bachman, Igor Belyansky.
The brand name is not necessary to help treat you, but can be found in the operating room nurse’s notes/implant log of your medical records.
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[USER=”2402″]Frogdog[/USER] Hope your operation went well. Sounds like you had a large defect. Would love to hear what was done for you. Also, if you recommend a surgeon in KC, that would be great for this forum.
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[USER=”2400″]HerniaStud[/USER] : incisional hernias are a different animal than inguinal hernias. You are reading a lot of hernia-related issues with inguinal hernias. Incisional hernias do not share that problem as much. It is much less of an issue. Perhaps because there are less nerves there, or more muscle–we don’t know. Incisional hernias should be repaired with mesh. The recurrence rate otherwise is minimum 50-60%. That’s a very high number.
Seek a surgeon you can trust and take their advice. The size of the hernia, location, and your body habitus and lifestyle will dictate what is the best repair for you.
Dr. Meyers is well known for his expertise in treating inguinal disruption injuries in athletes. Seems that is not your problem.
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The valsalva (beardown) portion of the MRI may be uncomfortable for patients with hernias. No damage is done. Contrast is not necessary. All are done lying down, unless you are in a standing MRI, which by definition you are standing.
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Sounds like a pretty classic inguinal hernia.
Barbell lifting, etc., has not been shown to increase abdominal pressure, and so is considered safe for those with hernias.
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Nerve pain after non-mesh hernia repair remains a problem. It is a bit easier to address than if mesh were involved.
My concern is that you have had pain for 6+ years. The results with nerve pain are not as good the longer you wait.
You still have a lot of options. Nerve block is first step. The timing, quality, frequency, and location of the pain will determine what may be causing it (e.g., suture entrapment vs scar tissue vs recurrence) and thus what the best treatment plan may be for you.
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Clitoral pain is often due to pudendal nerve issues. This can be from muscle spasm in the pelvis or direct injury to the nerve. It’s a difficult problem to treat. Seek consultation by Dr. Michael Hibner or other gynecologists who specialize in vulvodynia or pudendal neuralgia.
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If mesh is involved, MRI is the best study, as it shows the mesh and other details best.
If no mesh, than a well-performed hernia ultrasound with valsalva and maneuvers is adequate.
In my practice, I determine the radiologic study necessary after examining the patient, IF they never had surgery before. If they did have a repair, then I rely on MRI pelvis. That said, I read my own images, as the majority of the reports are misread for hernias. We have published about this problem (https://www.ncbi.nlm.nih.gov/pubmed/25141884) and recently updated our data, hopefully to be published this year.
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Non-mesh tissue repair typically has a longer recovery time than mesh repair. If symptoms are severe after 2 weeks, this should be evaluated to make sure it is as expected by your surgeon. I also recommend a re-evaluation at 6 weeks and 3 months if symptoms persist.
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Fatigue is generally not associated with hernias, but everyone is different.
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A good hernia specialist can help narrow down the causes of pain after hernia repair. Almost every single cause can be treated, so there is no reason to suffer.
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Not sure why your post was flagged. Fixed now. Thanks,
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Congratulations on the pregnancy.
Hernias can occur during pregnancy. We only operate if there is debilitating pain requiring narcotics (usually ice and naproxen/ibuprofen is adequate), or if there are signs of ischemia (i.e., blood flow being blocked to the area).
Constipation must be treated aggressively. There are a lot of safe over the counter options. Constipation with straining will make hernia symptoms worse.
In pregnancy, bulging in the area can also be due to a varices (bulging veins) or canal of Nuck cyst (fluid collection), so an ultrasound of the hernia is necessary for this.
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Sorry, no names of specialists I can provide in Utah.
CT scans are often misread, especially if the report says no hernia. They are wrong the majority of the time. We reported this back in 2014 (https://www.ncbi.nlm.nih.gov/pubmed/25141884) and have a followup paper coming out this year on the same issue.
Examination by an expert, correlating your symptoms with their knowledge of hernias, is what you need. Nausea can be a symptom of hernias. Ear symptoms are not related.
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Pain after hernia surgery is often inflammatory. Anti-inflammatories work best: i.e., ice and either naproxen/ibuprofen.
The chest pain after laparoscopy is from the CO2 gas. It goes away after a day or so. Most pain from laparoscopy is related to where there is a cut (e.g., the belly button) and where there was a lot of dissection, e.g., groin if the hernia was large. Lastly, testicular pain can occur. It is related to dissection of the hernia off the spermatic cord and placing an inflammatory mesh over the spermatic cord. Once the inflammation reduces, the pain should resolve.
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[USER=”2384″]jerseattlewa[/USER] : In Washington state, my colleagues who may be willing to remove mesh include: Andrew Wright, Peter Billings, Rebecca Petersen.
Why are you on Cipro? Are they treating a real infection? Epididymitis (if you are male)?
Dr. Raz is a urologist specializing in female surgery. The mesh issues and techniques to evaluate the vaginal wall (e.g., ultrasound) are different than inguinal hernia-related mesh issues and techniques for evaluation.
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[USER=”2345″]DianeW[/USER] : Some surgeon colleagues of mine in Australia that may be helpful to you. Not sure if they remove mesh: Keith Towsey, George Petrou, Rod Jacobs, Phil Lockie, Peter Bovey, David Wardill, Darrin Goodadll-Wilson, Mohammed Ballal.