drtowfigh
Forum Replies Created
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Dr. Towfigh – Neurectomy
I recommend you consult in person with Dr Paul Turek. He can help make sure you have had everything done. Also, he has great Pain Psychiatrists who have had excellent results with pain treatment using non-surgical methods.
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Muscle atrophy
For the groin I do recommend MRI, but you also need to have the physician with expertise to interpret the MRI.
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Posting never appeared
We have published on this topic of how it is best to evaluate a hernia. You can read it here:
http://www.ncbi.nlm.nih.gov/m/pubmed/25141884/And here:
http://www.springer.com/us/book/9783319215860If the examination is not obvious for a hernia, imaging is necessary. Ultrasound and MRI are most useful. CT scan less so. Regardless of the study, if it’s not correctly interpreted then it’s not useful. In our study ¾ of all studies misdiagnosed or under-diagnosed hernias.
And yes, almost all inguinal hernias can be performed without general anesthesia and some even without sedation and using local anesthesia alone.
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New to the forum need some advice.
Twinges, dull aches, pulling sensations maybe related to the hernia repair and almost alsoays resolve with time. Sometimes it may take over a year. As long as the pain is not debilitating, your body should help take care of the symptoms as it is constantly remodeling scar tissue.
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Do I have a hernia?
If you are debilitated by the pain, it’s worth seeking another opinion and have your studies re-reviewed. Spigelian hernias, Abdominal cutaneous nerve entrapment syndrome, incisional hernias, endometriomas, and inguinal hernias can all cause similar pain. The key is the history and review of the tests you’ve already had.
Which area do you live? Perhaps we can help make a referral for you.
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Why might a groin hernia cause testicle pain and/or spermatic cord pain?
We don’t have any objective test to determine if the fat in the inguinal canal is the cause of testicular pain. It is mostly the skill of the surgeon in asking the right questions and having the knowledge base to rule out other causes of testicular pain. In some cases, hernia repair is done and the testicular pain is not cured because there was a different reason for the testicular pain.
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Need abdominal wall reconstruction surgery – recommendation
Try Dr Archana Ramaswamy at University of Minnesota.
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hernia rpair
Hiatal hernias occur around the esophagus/stomach region. The repair is not typically termed “tension free.” That is a term used for abdominal wall and groin muscle hernias. Also, it is an internal hernia, so there should not be any red lump exteriorly.
You are in best hands if taken care of by a gastroenterologist and a surgeon skilled in foregut surgery b
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No mesh tissue repair surgeons in Washington or Oregon?
hernia repair using tissue only is becoming a most skill. There are benefits and risks as with any repair. In my practice, I recommend tissue repair for inguinal hernias to the very thin, to your non-obese women, and to any who have fibromyalgia, lupus, other inflammatory disorders or sensitivities. It is generally not a good idea to undergo tissue repair in the obese, the elderly, or for recurrent hernias.
In Washington/Oregon try Dr Robert Martindale. I am not sure if he does them but he may. He is at OHSU. Perhaps Dr Orenstein can confirm.
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What ?s should surgeons be asking their patients?
Thank you all for sharing your insight. This is exactly the reason why HerniaTalk exists.
For sure the term “hernia expert” has been thrown around and most are by general surgeons who perform hernias, without expertise in handling complications from these hernias. Hence the importance of such a forum to seek the right information for your needs.
We try diligently to refer you to colleagues in your neighborhood who are true hernia experts. If you do have excellent experiences with surgeons of your own, please share openly on this forum. Others will learn from you and you can help thousands.
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Thank you Dr Goldstein and Dr Towfigh/hernia ??
No specialists in North Dakota. I know because I’ve treated patients from that state and have had a hard time even getting followup care for them there.
Minnesota: consider Dr Archana Ramaswamy. She’s very smart.
I provide online consultations where I can review all your scans for you. I am concerned they may be misread. You can find this opportunity on my website http://www.beverlyhillsherniacenter.com
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Severe pain 14 months after TEP-repair
Interesting story.
If pain is due to mesh related inflammation, I typically start with local injections which includes steroids. The injection is at the level of the mesh:muscle interface. I use ultrasound guidance. This helps treat pain and buys time until the inflammation dissipates. Injections need to be repeated.
I have not seen much inflammation-related pain with the Parietex polyester mesh.
If pain is due to too tight a repair, one option is neurotoxin injection. A few Pain specialists perform this. I do it under ultrasound guidance. It really helps.
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Post Surgery discomfort
Symptoms suggestive of hernia-related or mesh-related pain:
– discomfort at the site
– pelvic floor spasm
– testicular painThese symptoms are all potentially curable after evaluation by a hernia specialist skilled in evaluating hernia repair-related pain.
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Recurrent Inguinal Hernia vs. Malgaigne’s Bulge vs. Preperitoneal Lipoma regrowth
In some patients, the mesh plug may be palpable. That alone is not an indication for mesh removal. That decision should be based upon symptoms, such as pain or hernia recurrence.
If pain is due to meshoma, mesh balling up, or the mesh plug, surgery is the only option.
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My INTENSE / DEBILITATING Right Groin Pain resolves with rest then comes back 8 weeks later
Can a hernia pain come and go? like can the pain last 10 days and then subside for three months or for one month after extensive horizontal rest and decreasing all activity?
– Yes, it is possible.Pain at the upper inner thigh, radiating from the groin in the front, can be from an inguinal/groin hernia.
Evaluation by your hernia surgeon is valuable regardless of its timing with your symptoms.
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Postpartum Umbilical hernia?
If a hernia is the cause of your pain, make sure it is evaluated for incarceration of content.
Otherwise, prevent straining, such as with constipation. Work on losing weight if that is an issue, as that will also help reduce abdominal pressure. Use ice for comfort.
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Possible hernia in Los Angeles
Based on your symptoms, I would recommend that you be evaluated by a laparoscopic specialist in abdominal surgery and have your MRI/CT scan reviewed by that surgeon. Either the imaging was misread or it did not catch the internal hernia, as it is may be an intermittent internal herniation.
Most internal hernias are treated surgically based on history. Imaging is only helpful if it shows the internal hernia. A negative imaging study does not rule our an internal hernia.
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Why might a groin hernia cause testicle pain and/or spermatic cord pain?
Why is that some groin hernias might cause pain in the testicle and/or cord pain?
– We don’t know exactly, and we cannot predict which hernias in which patients will cause pain. There is a very broad range]Does the hernia itself sometimes internally compress against the ilioinguinal or genitofemoral groin nerves? [/i]
– YesOr is it inflammation from the hernia that irritates the nerves indirectly?
– I think it is the direct pressure. The inflammation is also due to the incarceration or pressure.Is a surgeon typically able to actually visualize the cause of pain during a surgical procedure?
– Depending on the type of pain, the surgeon can surmise why there was pain. -
Mesh Removal?
Brooke,
Dr. Earle just recently moved his practice to Haywood Hospital. -
Serious pain, femoral hernia maybe?
Jane Brody article in New York Times
About hidden herniashttp://mobile.nytimes.com/2011/05/17/health/17brody.html?referer=&_r=0