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Hernia or Psoas?

Great! So happy that this forum led to your correct diagnosis. It is the main goal of why we do this.

As to your questions:
– can you explain why small hernias are often more painful than large ones? I BELIEVE THAT SMALLER HERNIAS ARE MORE LIKELY TO HAVE THEIR CONTENT PINCHED, THUS THE GREATER PAIN.
– are small hernias any easier to repair? Is there a greater chance that a mesh would not be required (I am thin and so am wary of the mesh). YES. PERHAPS.
– are painful hernias trickier to repair because nerves are involved? NO.
– does the fact that the hernia is ‘occult’ mean that it is literally deeper in the groin and therefore more difficult (riskier) to repair? NO
– if left untreated, what is the likelihood of it getting bigger? 100%. BUT UNCLEAR OVER WHAT PERIOD OF TIME.
– is there an advantage to getting it repaired sooner (while I am still relatively young at 55) rather than later? ONLY IF YOUR ARE SYMPTOMATIC.

As long as your surgeon is skilled in the hernia repair procedure planned for you, and he/she confirms you have a hernia, then the experience with women’s hernia is not as necessary. Really, diagnosis is much more difficult in women than the operation itself.

We have had posts here about the Shouldice Clinic not accepting patients with hernias who do not have an obvious hernia on examination. I have personally reached out to the Shouldice Clinic Chief Surgeon to discuss this. They have strong historical data that in their experience, if they cannot feel for a hernia on examination, the patients are less likely to have as good an outcome. Not sure why that is. I do not have the same experience.

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Inguinal hernia recurrence

Great news!

If you are happy with your outcome after surgery, please share your surgeon’s name and location so others nearby can have similar success.

Please also share HerniaTalk with your surgeon and invite him to join us.

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Fascia Tightening ??

Try Dr. Sam Ahn in Los Angeles. He is very good at thinking outside the box and trying innovative things.
Also, can try Dr. Hugh Gelabert.
Both are vascular surgeons.

Good luck!

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Dr. Towfigh – Neurectomy

Please do or just send email via Contact Us section. Mention HerniaTalk forum.

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Dr. Towfigh – Neurectomy

I’d have to confirm there is no hernia.

I would also submit you to repeat injections. If you had short term relief with injections, that is a good thing. In my practice, I would inject every two weeks until your pain is decreased.

If you fail that, then you may benefit from a surgical neurectomy. That can be done laparoscopically.

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Dr. Towfigh – Neurectomy

Based on your description, you may have a genitofemoral and/or ilioinguinal nerve injury.

Did you get local anesthetic injection by your pain doctor? This should help. It’s a bit difficult to do for that nerve in particular. If your pain doc can’t do it, seek one who can.

You may also have an occult inguinal hernia. Dynamic ultrasound or MRI pelvis should help discuss this.

I can help you if you wish to drive up a couple of hours. Dr Chen is also an excellent resource, also in Los Angeles.

I don’t recommend re operation unless you have no long term improvement in your symptoms or if you have an inguinal hernia as the cause of your symptoms.

Btw, did your original preoperatice pain ever get better?

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Is this a Hernia? In desperate need of help!

Any update?

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Inguinal hernia recurrence

Would love to hear an update.

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Chronic pain that will not go away

Based on your description, you may have a genitofemoral and/or ilioinguinal nerve injury.

Did you get local anesthetic injection by your pain doctor? This should help. It’s a bit difficult to do for that nerve in particular. If your pain doc can’t do it, seek one who can.

You may also have an occult inguinal hernia. Dynamic ultrasound or MRI pelvis should help discuss this.

I can help you if you wish to drive up a couple of hours. Dr Chen is also an excellent resource, also in Los Angeles.

I don’t recommend re operation unless you have no long term improvement in your symptoms or if you have an inguinal hernia as the cause of your symptoms.

Btw, did your original preoperatice pain ever get better?

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Fascia Tightening ??

I am so sorry about your situation.

There is a hand transplant surgeon I reviewed this with as well as another vascular surgeon and two hand surgeons.

All felt that there is nothing to do in terms of fascial tightening. All agreed that you should evaluate for proximal venous obstruction at the neck and upper extremity.

Note that after fascial release, the compartment will eventually scar down. And re-tightening the fascia will only re-exacerbate your issue.

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Inguial Hernia? Next Step? Bay Area? Dr. Towfigh?

Thanks so much for your post.

It’s so amazing the number of women I see with hernias that have undergone hysterectomy or oophorectomy when their pain was due to the groin hernia.

Your symptoms are am certainly suggestive of a hernia. You need to be seen by a surgeon with interest in hernias who is able to listen to you, evaluate you with an open mind, examine you carefully. That surgeon specialist needs to review your films to make sure the interpretation is correct.

In the Bay Area, there are several great surgeons. Go to the America Hernia Society website and plug in CA as your state and you can see all who are interested in hernia. Try Dr Hobart Harris. At Kaiser, try Dr Rock Liu.

Unfortunately, there aren’t that many who particularly specialize in hernias or even women’s hernias.

If it doesn’t work out for you up North, I am happy to see you in consultation. Sheila is my office manager and she can help you with accommodations. Most patients can fly or drive back home the next day after surgery.

I invite others on this forum who have had surgery out of their local area to report their experience.

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Training in Radiology

This is a timely article relevant to this discussion.

Based on my research, the results are even worse for radiologic evaluation of inguinal groin hernias.

http://archsurg.jamanetwork.com/Mobile/article.aspx?articleID=2442536&utm_source=Silverchair+Information+Systems&utm_medium=email&utm_campaign=ArchivesofSurgery%3AOnlineFirst09%2F23%2F2015

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How hernia surgeon could miss hernia?

Your right side does seem slightly more swollen than the left.

Any updates on how you’re doing?

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Pain in LLQ started about 2 months ago

Great. Looking forward to hearing about the results.

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Dr. Towfigh – Neurectomy

Thanks for posting.

Some questions and thoughts:

– what do you mean by “stripping”? Was it a varicocelectomy? Microscopic denervation? Epididymectomy? Hydrocelectomy?
– what problem was your urologist trying to address? Be specific.
– did you undergo vasectomy?
– where is the incision for this procedure? Groin (above the groin crease)? Scrotum on top part? Scrotum on bottom part?

Where exactly do you have pain? At the groin above the crease or below the crease within the scrotum? Is the skin hypersensitive at your upper inner thigh? At the lateral edge of your scrotal skin? Does the testicle itself hurt? Any pain with activities?

Have you seen your urologist? What does he/she say?

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Swollen Groin after Mesh Removal

Ok, well let us know what the ultrasound shows.

The genitofemoral nerve is at risk for irritation or injury with removal of laparoscopically placed mesh. That causes symptoms to the upper inner thigh and/or upper anterior thigh below the groin crease.

Did you have a hernia repair on the other side?

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Groin Pain – 4+ years of pain and frustration

I am familiar with the PUR Clinic and Dr Parekattil’s work. They do a lot of good work for Patients with vas deferens and spermatic cord problems.

If you do not have pain radiating to the testicle, then what was the purpose of the spermatic cord denervation?

I wonder if your problem is at the level of the open tissue repair. Dr Ramshaw can help with that. He is now in Knoxville, TN.

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Possible femoral hernia

Good luck!

Let us know what your consultation results in.

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Persistent Pain in Upper Right Abdomen – Hernia in Abdominal Wall?

Interesting that it was worse during your pregnancies. Although this would be a very atypical presentation, you may want to consider your gallbladder as a cause. It does “act up” during pregnancy. And ultrasound may show no gallstones but a HIDA scan may show dysfunction of the gallbladder, in which case removal may cure your pain. The sphincter of Oddi may also be dysfunctional or in spasm.

Just a wild thought. Possibly too wild.

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Inguinal / Femoral hernia?

Congratulations!

Lightweight mesh is suitable for many thin Patients.

Please let your surgeon know about our forum!