drtowfigh
Forum Replies Created
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Possible Hernia, But With Odd Symptoms?
Inguinal/groin hernias sometimes do affect bladder issues, such as pain with a full bladder, bladder spasm, frequent urgent urination.
The size of the area of the pain related to hernias does not usually correlate with the actual size of the hernia.
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Sex toy
It is possible you have had hernias for a while and they are now symptomatic. Does not mean that any activities you performed necessarily made them become more symptomatic. It may just be coincidence.
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Neurectomy with 2nd surgery
If revisional surgery involves approaching the groin hernia in the same manner as the original surgery AND mesh needs to be removed, then risk of need for neurectomy is real. The reason is because nerve injury may occur as a result of peeling off the mesh, as the mesh is placed over the nerves. In normal state, if the nerves are not disturbed, most patients have no problems having mesh on the nerve, as the mesh and nerve on in their own planes, millimeters from each other but not eroded into each other. As part of the mesh removal process, a few millimeters of adjacent adherent tissue may be removed with the mesh and so that may (or may not) result in nerve injury, as the nerve or nerve part may be part of that tissue that is removed. Our eyes alone cannot detect any microscopic injury to the nerve. Thus, the safest position taken by some surgeons is the cut the sensory nerve that may be damaged as part of the mesh removal portion of the operation.
Hope it helps.
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Neurectomy with 2nd surgery
If revisional surgery involves approaching the groin hernia in the same manner as the original surgery AND mesh needs to be removed, then risk of need for neurectomy is real. The reason is because nerve injury may occur as a result of peeling off the mesh, as the mesh is placed over the nerves. In normal state, if the nerves are not disturbed, most patients have no problems having mesh on the nerve, as the mesh and nerve on in their own planes, millimeters from each other but not eroded into each other. As part of the mesh removal process, a few millimeters of adjacent adherent tissue may be removed with the mesh and so that may (or may not) result in nerve injury, as the nerve or nerve part may be part of that tissue that is removed. Our eyes alone cannot detect any microscopic injury to the nerve. Thus, the safest position taken by some surgeons is the cut the sensory nerve that may be damaged as part of the mesh removal portion of the operation.
Hope it helps.
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Possible Hernia, But With Odd Symptoms?
TomTomorrow:
Yes, that is correct.
A Urologist should be able to help you. -
Possible Hernia, But With Odd Symptoms?
“muscle-related” pain can be due to a hernia, since it is a muscle defect.
I strongly recommend consulting with a general surgeon.
Very few causes of groin pain/ASIS pain also radiate into the testicle. It’s often an inguinal hernia.
With regard to the ridge, perhaps that is the hernia bulge? It is hard to tell without examining you…
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6th Right Inguinal Hernia
Plenty of excellent laparoscopic surgeons on the East Coast. What you really need is a surgeon comfortable to go in laparoscopically or robotically for a second time.
I recommend Dr. Brian Jacob in NY.
Also, consider Dr. Eric Pauli in Hershey. -
Is this normal or should I see my doctor?
Most likely, no.
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surgeons with <1% recurrence & chronic pain rate?
As far as we know to date, absorbable mesh is not a good alternative for inguinal hernia repair. Also, as you probably know, it is not the standard of care.
The logic that your pain will dissipate once the mesh is gone assumes your risk for chronic pain is purely mesh-related. That is rarely the case. The more common situation is pain due to recurrence, erosion of the mesh, nerve entrapment or direct nerve injury. Also, often the chronic pain is related to the inflammatory reaction of the mesh, and most absorbable mesh, with the exception of some pure biologic mesh, also cause significant inflammation.
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Possible Hernia, But With Odd Symptoms?
Michaen:
I assume you meant 12 weeks of physical therapy…
What you describe may be an inguinal hernia. You would require an examination by a general surgeon, or better yet a surgeon who is a hernia specialist, to confirm the diagnosis.
Other causes, though less likely, may be hip-related or sacroiliac joint-related.Were you told specifically that you do NOT have an inguinal hernia? And if so, how did they come up with that diagnosis?
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Possible Hernia, But With Odd Symptoms?
TomTomorrow:
You may have a hernia. The question is, is the hernia the cause of your symptoms? That’s an important one to get answered, because hernias that are not causing symptoms can be watched and do not necessarily require surgery. It would be unfortunate if you had hernia surgery, it did not improve your symptoms, and you had a complication or pain from the hernia repair.
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inferior epigastric
Bladder being empty may be a figure of speech. It just means your bladder is not full and therefore you are. It hrinating because you need more fluids, not because your bladder is incapable of emptying and is full .
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Possible Hernia, But With Odd Symptoms?
Not sure if you happen to have A groin hernia, but it cannot be caused or become symptomatic from lying on your back and there is no relation between that and your sexual symptoms. I would seek consultation by a urologist first.
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Sex toy
Yes. I believe she that smaller hernias hurt more.
And yes, the pain does sometimes radiate as you explained -
inferior epigastric
Not sure about your questions BeenThere.
For laparoscopic repair many of us routinely empty the bladder, such as with a urinary catheter. It removes the bladder from our area of surgery.
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Modified Kugel open technique
The Kugel approach for hernia repair is well described. I’m. It sure what the modified Kugel implies.
It is basically an open anterior approach repair with mesh. The Kugel patch that is used is a two layer ringed mesh.
There are many surgeons who offer this repair and have good results.
In my opinion a) the Kugel mesh used is too thick and bulky for the groin and b) for primary repairs there is little benefit to this over a laparoscopic repair.
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Can I recover alone?
In general, most patients can recover alone after open or laparoscopic inguinal hernia repairs. So, no worries or stress about that.
Also in general, the recovery of each patient can vary. However, when performed by an expert, laparoscopic repair has the advantage of shorter recovery and lower acute and chronic pain risk. Longterm outcomes in terms of recurrence for one-side hernia repairs are typically about the same.
That said, there are differences among surgeons and their individual outcomes. An expert in open surgery will have better short term and longterm outcomes than an non-expert in laparoscopic repair, and vice versa. Thus, I always recommend that you follow your surgeon’s recommendation as to the type of repair, as that is usually the repair that will provide the best outcome in his/her hands.
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Pain with toy
I think it is worth your while to be ruled out for an occult inguinal hernia.
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Pain with toy
It would be rare for me to explore for a hernia if I have not already exhausted all non-invasive forms of doing so.
That said, to answer your question: yes, if no hernia, then just close up, so to speak.
I am not sure that you have a hernia from your actions. That said, you may have a simple occult inguinal hernia, and a workup to prove that may be helpful.
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Femoral or Inguinial Hernia under Lymph Node
It is not necessary to have IV gadolinium contrast with your MRI if the purpose is for hernias. So, therefore, it would be okay to nurse immediately if you are not given contrast.
Watchful waiting is appropriate for most “minimally symptomatic” or “asymptomatic” inguinal hernias, with one exception: femoral hernias should be repaired. The timing is based on your needs, but it should not just be watched, in general.