[Watchful]

Bills44,

The lack of long-term data is a concern, but it doesn’t mean that the technique doesn’t work. It just means that we can’t tell yet.

[Watchful]

Thanks for posting here, KC. Would you be able to explain why your modified Marcy works in adult males and in large hernias, while the original doesn’t?

[Watchful]

@wirsz

Sorry to hear about this recurrence. You may want to consult with one of the top tissue repair surgeons in Germany (Conze, Lorenz, etc.) to see if it makes sense at all to try to fix it with a revisional tissue repair. I’m guessing it wouldn’t be the best option, but I’m certainly no expert on that.

They used to repair Shouldice recurrences with another Shouldice at the Shouldice Hospital. They probably still do that, but I’m not sure. For what it’s worth, when I asked my surgeon over there what I should do in case of recurrence, he said that most likely laparoscopic mesh would be the best choice. They actually do open posterior mesh operations there in some rare cases for primary hernias with bad tissue quality. However, that wasn’t the technique he was suggesting if I recur. I wouldn’t necessarily draw any firm conclusions from that. Just wanted to share what I was told there.

[Watchful]

Since Dr. Kang does an ultrasound, I would imagine that he will agree to operate if it shows a hernia. You can ask his assistant by e-mail. At the Shouldice Hospital, I believe they operate only on hernias which can be detected by physical exam. The more important question is: do you feel that you really need surgery for this hernia at this time?

[Watchful]

Sensei,

Any idea how a small invisible inguinal hernia can cause testicular pain? Pressure on the genital nerve branch? Has anyone ever explained that? I had a very large indirect hernia, and didn’t have testicular pain, so I’m wondering how all that works.

[Watchful]

It’s a tradeoff. I think most people didn’t recur even with the less rigorous repairs. If you you were of normal weight, your chances were probably quite good.

Recurrence is a big issue though when it happens, so there was a good reason to focus on it.

[Watchful]

McVay, corrupted Bassini, Marcy, whatever they felt like and was easy for them… My dad had such a surgery in the 90s. Small scar, little post-op pain, very fast recovery, no chronic pain. It did recur eventually. Same happened to that hernia surgeon Felix. He didn’t even know what tissue repairs he had, and they recurred years later.

I think recurrence was a significant issue back then.

[Watchful]

It was like a somewhat censored rerun. Not quite as fun as the original episode!

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We’re seeing it. Einstein said E=mc2, and HerniaTalk says J=C.

[Watchful]

I think what motivated the term is the belief that someone new here is actually someone else who has been with us for a while… Let’s leave it as an exercise to the reader.

[Watchful]

You can find the definition on Wikipedia under “Sock puppet account”, although I’m not sure why this particular term was raised here.

[Watchful]

@sensei305

What type of mesh surgeries did you have originally?

Are recurrence and scar tissue the only possible causes? Could it be nerve damage, or is that not consistent with the symptoms?

I’m curious about how scar tissue can be removed surgically without creating more scar tissue…

You’ve been going through a nightmare. I hope this 4th surgery improves your condition, and doesn’t cause other problems. Best of luck!

[Watchful]

I wonder if anyone does a dynamic ultrasound for hernia in the US. There are a few who do it in Germany, and I think Dr. Kang does it in Korea, but I never heard of anyone doing it in the US. According to Dr. Conze, it requires specific training and skills, which are not found in the US. Dr. Lorenz mentioned that if you know the groin anatomy very well, you can be good at this ultrasound. That knowledge seems rare…

[Watchful]

I have the same exact sensation that you describe while sitting. My surgery was a Shouldice repair, not mesh removal.

When I mentioned it to my surgeon, his theory was that scar tissue is causing this. I haven’t done any imaging, and I guess it is possible that it’s a recurrence. I have no idea what the best imaging is for this, or who can best diagnose it. Also, I don’t know if this could potentially be caused by nerve damage. I do have such damage, but I’ve never seen this particular symptom mentioned in that context.

[Watchful]

Thanks, Pinto. I’m staying optimistic. Luckily, I manage reasonably well most of the time even with these annoying symptoms.

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Herniated – thanks, but my symptoms aren’t consistent with any of those things. My surgeon wasn’t surprised by my symptoms during my follow-ups with him – they are evidently quite used to seeing these in some cases.

If I wanted to look further into it with imaging or other methods, I would need to fly somewhere to a specialist with the right expertise and experience. There are very few of them, and none in my area. I’ll probably do that in a few months if I see no improvement.

[Watchful]

Thanks, GI. I do try a large variety of exercises as well as hot compresses and massages of the area.

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@oceanic

It has been a rough ride, unfortunately. I’m about 7 months out from surgery.

Currently, I don’t have trouble with walking. However, I do have trouble when sitting – pressure builds up gradually which leads to discomfort and then pain. I didn’t have this in the early months of recovery. I have no idea what’s causing it – scar tissue, tension of the repair, who knows… It doesn’t feel like a recurrence. I also have some other symptoms which are classic nerve injury symptoms, but I think that’s just an added bonus rather than the root cause of everything.

[Watchful]

Tightness sensation wasn’t the issue that I was dealing with right after surgery. I was developing severe pain after a few minutes of standing or walking, and the method I shared with you helped me with that. What has happened since then is a long story, and I don’t want you to assume that you will go through something similar, particularly since it sounds like our symptoms have been a bit different.

[Watchful]

I don’t think pressure is a common symptom of nerve damage, but I don’t know for sure. All sensations are carried by nerves, so I guess anything is possible.

I believe typical symptoms of nerve damage are pain, pricking, burning, itching, numbness, and sensitivity to contact in the area. Of course, some of these can be caused by damage to non-nerve tissue as well.