drtowfigh
Forum Replies Created
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Serious pain, femoral hernia maybe?
Yes
Typical of hernia.By the way, I just saw Dr Ramaswamy this weekend at a hernia conference. She has not yet heard from you. Let me know if there are any problems getting in to see her or Dr Pierce.
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Triple Neurectomies
Nerves grow back at a very slow rate. The purpose of neurectomy is not to have nerves grow back and so a segment of nerve is actually cut out so that they don’t regrow. The proximal cut end is buried into muscle to reduce neuroma formation because muscle is a nice vascular bed free from the scar tissue of the operation. If it’s. It buried, the risk of scar tissue growing into the cut end of the nerve is higher (think tree roots growing into cracks), thus neuroma and pain.
We have learned a lot since we started performing laparoscopic neurectomy. It seemed that the ILIOINGUINAL and iliohypogastric nerves also may have motor nerves. That branch off in the retroperitoneal space, before they inner are the groin.
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Alternatives to mesh
Linda,
Though the only path toward a hernia cure is a surgical procedure, there are activities you can do to reduce your symptoms. Keep thin and athletic. Perform exercises which focus on core strengthening. Don’t smoke nicotine. Prevent constipation. -
First post – post vasectomy pain person – had relief with one reversal but still burning pain high up in cord/inguinal area
Neuroma usually occurs many many months postoperatively, so it is certainly a possibility.
Allow me to ask my urology colleagues.
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6th Right Inguinal Hernia
Okay, well this makes a bit more sense.
I agree with Dr. Goodyear’s plan. He is truly a wonderful surgeon.
Did he remove some of your plug before patching the recurrence? I am just curious.
Anyway, give it some time. You could have pulled something, but that will heal.
If you need yet another operation, I would consider a laparoscopic or robotic-asssited repair with mesh. -
Has anyone here had a Neurectomy triple neurectomy adn what were the results (Good/Bad/Ugly)
I’ll ask some of my patients to respond to your post. I think it is an excellent one.
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Possible hernia in Los Angeles
All the laparoscopic surgeons in Los Angeles that I know accept insurance.
Which part of town do you live in?
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Had surgery!
First, not all diastasis causes pain (in fact almost all do not cause pain) and not all hernias repaired within a diastasis recur (in fact most do not recur).
Also, all abdominal wall diastases show up on CT and MRI. If it wasn’t reported, it does not mean that there is no diastasis.
Lastly, you mention diastasis as well as pelvic floor prolapse. Diastasis is in the middle of the abdomen, between the two rectus muscles (your six pack). Pelvic floor prolapse is related to the bladder, vagina, and/or rectum with prolapsing into the perineal region. Do you have both problems?
It is possible that you had the umbilical hernia repair, but since it is within the diastasis, you still feel an instability of your abdominal core muscles. A tummy tuck will cure that problem, as it fixes the diastasis. This is typically performed by plastic surgeons. I offer a robotic-assisted diastasis closure (or tummy tuck) to those who are candidates for it. If that is indeed your problem, then the diastasis closure may help and it will also support your umbilical hernia repair.
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Post vasectomy complications
I ran your situation by a renowned specialist in vasectomy/reversal/testicular pain as well as by my favorite pain management specialist.
First, I don’t understand anatomically how you can get a pelvic hematoma from a scrotal procedure. But, if you did get a pelvic retroperitoneal hematoma of significance, that can irritate all the nerves in that space, including the pudendal nerve, etc. I agree with Dr. Earle’s assessment.
That said, your symptoms are persistent, progressing, and are no longer localized. Have you considered the chance of CRPS (complex regional pain syndrome)? If that is indeed what you have, no local procedure may improve it and in fact further surgery may exacerbate it.
Do you have a good pain management specialist who can or who has treated you for this?
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spegelian questions
You are very correct in the lineage of your questions. If you feel a bulge, then it should be visible on CT scan, even without a bear down or valsalva. If the report is “negative,” then you need it to be re-read by a specialist.
Flank hernias are either traumatic (e.g., bad car accident) or due to surgery, as Dr. Goldstein stated. But you are mentioning bulging at the groin crease and the hip, with symptoms that are more suggestive of an inguinal hernia.
I recommend you see a specialist in hernias that can review your imaging, take your history into consideration, and perform a careful examination.
Where do you live? We can refer you to someone local who we know and respect.
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Neurectomy
Not necessarily. Open neurectomy usually causes less risk for atrophy than laparoscopic neurectomy, which is done more proximally and therefore has a higher risk of cutting nerves that are more than just skin nerves.
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Dr. Towfigh – Neurectomy
Try Dr Brian Jacob
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6th Right Inguinal Hernia
I’m interested to know how many and what types of hernias you had performed and with what techniques. 5 operations is a lot!
And I agree with my esteemed colleagues, Drs. Earle and Goldstein:
Let it heal. You probably just pulled something. It is not going to be late to diagnose a recurrence. If the pain persists after several weeks of rest, local and topical treatment, then you can consider an MRI pelvis. But give your body some rest! Sounds like you’ve been through a lot. -
Medium inguinal Hernia – Traditional Tension Repair
it’s hard to find a surgeon that has a lot of experience in tissue repair alone. they tend to be older surgeons (in general). also, northern california has great surgeons but not too many hernia specialists.
Try
– Hobart Harris
– Marc Zare
– Jeff Gutman -
Post vasectomy complications
Wow. This is truly complex.
I do not see, from an anatomic standpoint, how the vasectomy itself could cause lateral femorcutaneous nerve damage. Those two areas are very far apart. Is it possible that you had genital branch of genitofemoral nerve damage at the time of vasectomy? Where on your body was it performed: the scrotal base or near the groin crease?
It is possible that if the vasectomy procedure was performed at the groin crease and you had a lot of bleeding, that the pelvic nerves were irritated by the bleeding. That may take weeks to months to recover, but again, there should be no permanent damage to nerves due to the blood. Your body takes care of dissolving the clots on its own. The most you would have would be fibrous scar tissue in the area, and that scar is remodeled and softened with time, too.
Your symptoms may either be completely unrelated or a result of too much treatment too early in your course.
So I am stumped. Let me run this by my colleagues who specialize in some of these problems and get back to you on that.
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Serious pain, femoral hernia maybe?
Also try Dr Bradley Pierce.
http://www.fairview.org/Providers/Bio/D_120548 -
Serious pain, femoral hernia maybe?
Try Dr Archana Ramaswamy.
She is a hernia specialist and skilled laparoscopic specialist.
She is at the University of Minnesota. -
Hidden hernia, undiagnosed, very frustrated
If you feel a popping out and that is reducible then for sure any such hernia can be seen on CT scan, ultrasound, or MRI.
Hernias can occur either at the scar from your prior surgery or in the midline between your belly button and your chest bone. Sometimes, these are falciform ligament hernias. Someone has to very carefully look at your films.
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Hernia or Psoas?
If you are undergoing laparoscopic surgery, it is not so important to differentiate between inguinal and femoral hernias
What is important is the timing. Most of us agree that most inguinal hernias can be safely watched. Femoral hernias cannot. They should be repaired, especially if symptomatic.
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Serious pain, femoral hernia maybe?
Groin hernias among women can be small, without bulge, yet highly symptomatic. The pain can go down the leg or around the back. It can be worse during the period. Laparoscopy needs to be done with extraperitoneal exploration. Routine laparoscopy misses most of these hernias.
Meralgia paresthetica is different. It is pain (burning) only at the side of the thigh, not in the front. it is worse with standing. There is no groin pain or pain above the groin crease.
Your story sounds like a hernia. Small ones can hurt.