drtowfigh
Forum Replies Created
-
Nerve entrapment usually doesn’t occur after the first 6 months.
-
Excellent discussion about a very difficult problem.
Some comments:
If you have testicular pain since the mesh removal, you may wish to see how you do with spermatic cord blocks. Sometimes the mesh invades the little nerve plexus around the vas and removing the mesh leaves behind the damaged microscopic nerves. There is a treatment for it. It starts with a diagnostic cord block.
Any pain that radiates below the knee can be related to your spine. Get that worked up. You may have had an underlying disc or something to start with, and the positioning from the robot made it worse. That should also be treatable.
The cyst you are reporting over the testicle may be a fluid collection or hydrocele. I need more information to help you figure out that one.
-
It is rare for someone to have no reason for chronic pain.
Inguinal hernias can cause pain with sitting, especially leaning forward, such as behind a desk or at a dinner table.
If you indeed have an inguinal hernia as the cause of your pain, CT may be normal or perhaps it was misread. I often move on to an MRI if the history and examination are suggestive of an inguinal hernia, since CT can miss the small inguinal hernias.
-
Once the infected mesh is removed, the rest of your body will help rid the infection, with antibiotics, now that there is no foreign body. Deformities that are there may still remain. Depends on the reason for the deformity.
-
Your situation is a bit complicated and really requires a surgeon to carefully get a detailed history, review your images to confirm they weren’t misread, and examine you with a few things in mind:
1. How many tacks did you have put in? Are the areas of your pain related to the tacks? Too many tacks can either individually cause pain or can cause muscle spasm
2. Did you have a tight repair? In other words, is the mesh placed too tightly, not allowing you to stretch backwards? Mesh shrinks, so if it is already placed too tightly, then once it starts to shrink, it can be even tighter, hence the pain and/or hunching down.
3. Where is the mesh as compared to your bladder? Is it laying on the bladder, causing symptoms?Sorry that I don’t know anyone in Texas to help you. I just operated on 3 patients from Texas this month for mesh-related problems.
-
The #1 risk factor for hernias is genetic predisposition. Can’t do anything about that. Most patients that have multiple hernias have a genetic alteration in the collagen in the hernia-prone tissues. They are just naturally weaker there.
Risk factors that can be controlled for so that you don’t have recurrences from your hernias and/or reduces the risk of another hernia:
– control any straining, such as from constipation or enlarged prostate
– maintain normal weight
– no nicotine
– exercise and maintain muscle strength -
Nothing to worry about.
Sometimes, peritoneal fluid can eek into the canal. Also, the bulging may be a weakness rather than a hole, in which case it may expand or contract.
-
Just to give some perspective for you:
Many patients who underwent a plug type inguinal hernia repair have a palpable area of firmness, which is the mesh plug. That does not necessarily mean the mesh is causing the pain. In many patients, it is the mesh. In others, it may be something else.
If the mass is as small as the head of a pencil’s eraser, then likely that is not the plug itself. That said, the pain may still be from the plug, if you’ve had it since the operation.
My recommendation is to make sure you see at least two specialists. Mesh removal is not something you want to have done without doing your homework. You want to pick a surgeon who has the expertise to handle whatever is found during surgery. If it’s a suture, then perhaps removal may be able to address the problem. If it is the plug itself or a recurrence, then the surgeon you choose for the procedure should have the expertise to handle that situation as well.
I call these my box of chocolates. You often never know what you’re going to get once you’re in there. So as much data gathering as you can get before surgery is helpful.
-
The body may react to a hernia with slowing of the intestine. It is not a well studied concept but I see it at times.
-
Hi there. Any updates for us?
-
Unfortunately, time will tell how you will fare. Everyone has a different trajectory for recovery. As long as you are improving, ever so slightly, with time, then that is a good sign.
It is hard to diagnose your symptoms or provide exact diagnoses or causes for the symptoms you have without a careful examination. Your surgeon should be able to help you.
-
HI. What is the update on your status? Bladder irritation from hernia repair can occur but is rare.
-
how are you doing since your operation?
-
usually ok. i try not to place mesh in women seeking to get pregnantt.
-
not infection. just pain. due to mesh inflammationon or irritation of vas and its nerves.
-
the mesh patches the hole. for inguinal hernias, the hole is fairly small (vs abdominal wall/ventral hernias). as long as the mesh adequately patches the hole, the abdominal contents will not pierce the mesh.
the reason for pain is very complex and needs careful evaluation. -
A comment about the other side, with the older mesh repair. If you have new pain years after a hernia repair, it is due to a recurrence of the hernia, unless proven otherwise. If performed open, the recurrence should be considered to be repaired laparoscopically, and vice versa.
-
Sorry, no one that I know of in Arizona. Dr. Hibner only sees females with pelvic pain, not hernia-related.
-
There is such a thing as a chronic low grade infection of mesh. It does not present as obviously as acute infection. Tends to present with pain, swelling, low grade fevers, fatigue, joint pain, headaches, chronic fatigue.
Treatment can include longterm antibiotics and/or mesh removal.
-
Inguinal hernia can cause: bloating, urinary frequency. Rarely, pain can radiate up toward the mid-abdomen. Constipation must be controlled.
Please seek consultation by a hernia specialist. This is the type of patient where I would order a dynamic MRI pelvis with valsalva as part of the workup.