drtowfigh
Forum Replies Created
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Possible hernia in Los Angeles
Internal hernias are unrelated to abdominal abs use.
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My INTENSE / DEBILITATING Right Groin Pain resolves with rest then comes back 8 weeks later
Thanks for your post.
Buttock cheek pain is never inguinal hernia-related.
But other symptoms may be suggestive.
In addition to working up the lumbar spine and groin, check for
– hip problem
– obturator hernia -
Recurrent Inguinal Hernia vs. Malgaigne’s Bulge vs. Preperitoneal Lipoma regrowth
Here are my thoughts:
– preperitoneal fat through the inguinal canal is a hernia.
РMalgaign̩ refers to a bulging without defect or protrusion of contents
– inguinal hernias are best repaired if symptomatic of increasing in size.
– MRI pelvis may be misread or under diagnosed by the radiologist for a hernia recurrence, especially given the ultrasound finding.
– laparoscopic surgery would be my recommendation if recurrent hernia requires surgery. -
Serious pain, femoral hernia maybe?
Anti-inflammatories work the best.
Advil is great. Aleve is a little more potent.
Other anti-inflammatories that you can add include
– ice packs
– Arnica Montana 30C
– Bromelain
– Turmeric
– Ginger -
Mesh Removal?
Try David Earle in Springfield.
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Postpartum Umbilical hernia?
Excellent post and thanks for initiating this discussion about pregnancy and umbilical hernias!
Belly button (umbilical) hernias are common during pregnancy. You may see a popping out of the belly button region, and it usually occurs toward the third trimester. Most of these go back to normal shortly after your delivery.
The risk of a hernia persisting after pregnancy is related to many factors. These include genetic predisposition, number of pregnancies (see it after the second pregnancy), and size of the baby/belly relative to the mother (especially twins).
In my practice, I don’t recommend umbilical hernia repair unless it is painful or is growing in size. Also, I do not recommend repair during pregnancy or while you are breastfeeding.
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Abdominal incisional hernia
Thanks so much for posting. I hope you will find this forum helpful.
Some questions:
1. What operation was your incisional hernia from? Where exactly was the hernia? And how big?
2. How was the hernia repaired? Open or laparoscopic? Since Sepramesh was used, shall we assume the mesh was placed inside your abdomen as opposed to on top of the muscle?Yes, mesh can distort the view flyby an ultrasound. But not completely.
Once mesh is in, my feeling is that ultrasound is no longer the choice imaging.
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Dr. Towfigh – Neurectomy
JG,
In the case of isolated genitofemoral neuralgia after hernia repair, laparoscopic neurectomy is my choice of technique. For sure open would be more difficult and higher risk for additional morbidities and injury. In general, we wish to transected nerves proximal to the injury (i.e. Between the site of injury and it’s communication back to the spinal cord) -
Dr. Towfigh – Neurectomy
Otzi,
Your symptoms are highly suggestive of an inguinal hernia. The ILIOINGUINAL or genital branch of the genitofemoral nerve may be irritated by the hernia. Hence your symptoms. There is no nerve damage and also no risk for permanent injury. -
Is hernia mesh as scary as the internet makes it sound?
Excellent question and point.
Here is my opinion about the large amount of information on the web against mesh implantation:
1. About a million patients undergo hernia repair annually in the US, almost all with mesh. ¾ of these are inguinal hernias. That’s a huge denominator.
2. For inguinal hernias, there are reports of 20% or more with some sort of twinge, discomfort 3 or months after hernia surgery, and 3% with chronic disabling pain. 3% of 750,000 is a very large number. Presumably, most of these patients have pain directly or indirectly related to the mesh implant.
3. If you look at the old studies before mesh, tissue repair also had its fair share of chronic pain. This is presumably due to the tension in the repair and risk for nerves jury as well.Personally, I don’t recommend mesh in patients who are super thin, small or average build women, or anyone with known fibromyalgia, chronic fatigue syndrome, autoimmune or inflammatory disorder. The risk of mesh-related pain I find to be higher in this group. This, I perform a Shouldice, or Bassini tissue repair for them. And I explain the risks and benefits of this choice. In others, I may choose to place a lightweight mesh, with less total foreign body , inflammation, and therefore pain. There are also hybrid mesh products which have yet to prove themselves as alternatives to lure synthetic mesh products.
I believe we don’t have enough evidence to prove that all mesh should be banned. For sure at this time there are hundreds of thousands of patients annually that do just fine and really need the mesh. However, what we lack is evidence-based decision-making as to who indicidually would benefit from which type of repair, mesh, etc. it’s a complex problem and add Bruce Ramshaw is leading the way to tackle this problem.
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Dr. Towfigh – Neurectomy
Otzi:
Thanks for your great posts.
A quick comment that may be relevant to you:
Groin pain is usually not from nerve damage unless there was a direct trauma or an operation that could potentially cause nerve damage.
Isolated testicular pain has a lot of potential causes, but once again, nerve damage is not the primary cause unless the nerve has actually been damaged.
My point is this: most patients with groin pain, especially radiating to the testicle, have a hernia.
The Puhr clinic in Florida is an excellence source for treatment of testicular pain due to an injury or prior surgery. However, in my experience, since they are urologists only, they may miss patients that have occult hernias.
In my experience, radiating pain is an occult inguinal hernia unless proven otherwise and I strongly recommend against fiddling with any nerves. -
Muscle atrophy
The Annapolis group is very skilled.
HerniaTalk is the forum I use to answer questions which will be able to help others who read these posts as well.
If you wish to have a consultation, I am happy to see you in my office or alternatively you can sign up for an online consultation at http://www.beverlyhillsherniacenter.com
I wish you well.
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Post vasectomy complications
For sure lap neurectomy is more likely to cause atrophy than open.
The FDA just approved a nerve stimulator best used for those with groin pain. Dr Tim Davis was among the Pain specialists involved in evaluating this. He’s in Santa Monica, CA. I’ll ask him for his input.
I agree neurectomy probably not in your best interest right now.
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Possible hernia in Los Angeles
I’m happy to see you. Also Dr David Chen. You just need a doctor who listens. Most laparoscopically trained surgeons can handle this.
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Had surgery!
You can try physical therapy to help realign your diastasis. The results are not good but at least it’s non surgical. The PT needs to focus on transversus abdominis muscle training and educate you on what you can do to reduce the risk of tearing. Sit-ups and getting out of bed without rolling to your side are both no-no’s, for example. Pinterest has great pics on how to do these exercises yourself. Search for transversus abdominis and diastasis exercises.
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Muscle atrophy
Inflammation of the SI joint, such as with ankylosis get spondylitis or sacroiliitis can cause groin pain.
If you have groin pain and lower back pain, sometimes that is due to an inguinal hernia. I guess muscle atrophy of the lower abdomen can do the same, since they are both part of your core..
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Serious pain, femoral hernia maybe?
Don’t lose focus
Your symptoms are most suggestive of a hernia.
Not to say you don’t have a prolapse, but don’t get derailed. -
Knee problems…
That can be fixed
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Hernia specialist in DC area
Try Dr SHARON Bachman in Virginia.
Also, hernia repair is based on pain and symptoms, not necessarily if you have a bulge.
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Medium inguinal Hernia – Traditional Tension Repair
Both should be covered by insurance.