drtowfigh
Forum Replies Created
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Interesting questions, mst3K:
Several factors play into my decision to offer non-mesh repair and its suitability for the patient. For example, smaller hernias in patients with low risk for recurrence are best suited for suture repair. Their age is often not a primary factor. That said, if they are frail or have a direct hernia, the chances are that they are more likely than average to fail a tissue repair. Also, how long one has had their hernia is not a factor.
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Capricious is an excellent term. And everyone is different in how and when they get symptoms.
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Best of luck to you.
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Nausea is due to the pain. See it a lot. Does not necessarily imply you have intestinal involvement.
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Not sure what your diagnosis is. Spigelian hernias should be repaired if they are symptomatic.
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Ice packs! Learn to love them. They are best for hernia pain relief.
Anti inflammatory medications and supplements help too.
Best of luck!
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Yes absolutely. Chances are a hernia has been there well before you noticed it.
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This is the MRI protocol we use for detection of occult inguinal Hernias.
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Perfectly written. Kudos to your doctor.
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Jogging and weigh lifting are considered safe. In fact, most exercise is considered safe and encouraged.
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Please search this sight for hidden hernias. There is a ton of information for you here.
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A real sports hernia is a tear of the muscle. MRI is the best for this diagnosis.
Surgery is last on the the list of treatments. First it’s rest and anti-inflammatories. Next may be injections.
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There is no evidence that has insufflation necessary for laparoscopic surgery weakens the abdominal wall or makes a small hernia bigger or more symptomatic.
It is is true that if you repair one side, it is possible that once you are symptom free on one side you may then start feeling more symptoms on the other side. It’s called distracting pain. That is not guaranteed and it’s perfectly safe and feasible to delay repair of an asymptomatic side until you are symptomatic.
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The history of hernia recurrence has shown that if you repair an indirect hernia only, then you if you get a recurrence it will most likely be a direct hernia. The opposite has not yet been shown.
For laparoscopic mesh repair with mesh, the indirect, direct and femoral hernias are all covered.
For open inguinal hernia repair with mesh, the direct and indirect inguinal Hernia areas are covered.
For Shouldice and Bassini, both the direct and indirect spaces are involved.
For the Marcy, only the indirect space is repaired, which is why it’s mostly reserved for children and some women.
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I love reading all of this exchange. Im so impressed with the knowledge that is being shared.
I have little to add. WasInTN pretty mich said it all:
– synthetic mesh is permanent
– the intention of hernia repair is a permanent repair, however reality is that there is a certain hernia recurrence rate, somewhere between 0.25% and 5% for inguinal hernia repair with mesh. Most of us specialists have recurrence rates under 1%
– a recent paper showed that half the recurrences occur at 1 yr and 75% within the first 3 years.
– cause of recurrences are technical and related to patient’s own risk factors. -
For an average or above average sized male, Hernia’s on both sides, laparoscopic surgery with mesh is the best bet.
For a male with only one sided hernia, I would typically offer open with mesh if it were a huge scrotal hernia. I.e., extends down to the scrotum.
The most common situation I would offer non-mesh repair is in very thin males and small hernias or if there is a clear allergic potential.
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Also Dr Gina Adrales in Baltimore.
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With some exceptions, if a hernia is not affecting your daily life then it can be watched until it does get to that point.
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Happy to be of help. There are multiple reasons for pain after hernia repair. Mesh is only one of them.
Never too late to get better.
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Dr. Belyansky is the best person to answer those questions. Examination is key to helping you get the correct answer. Reoperative groins and the symptoms that come with them can be very very complicated. Whatever I tell you may lead you in the wrong direction.