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Umbilical Hernia, Best Course of Action?


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  • Umbilical Hernia, Best Course of Action?

    Hello all,
    I find myself in the sorry situation of having a hernia and am hoping to find some advice regarding my best course of action.
    I am a 35 year old male and believe my hernia is due to being overweight to obese for periods in time and due to heavy weightlifting. Over the years I have always felt “twinge” pain—as I call it—in my abdomen while doing certain exercises or coughing. Until a few weeks ago I could see nor feel any signs of a hernia, but I now clearly have an umbilical hernia.
    The hernia is quite small, is on one side of my navel (innie), and moves in and out freely. It causes me no pain other than the occasional “twinge” or a dull ache while seated in a certain way, but honestly, if I’m not thinking about it, I don’t feel it.
    My plan was to have it repaired now while it is small, but in doing research on procedures I came across the realities and risks of hernia repair. Although I’m sure my hernia will progress, the thought of having a procedure that could leave me in pain while coming from an asymptomatic position is quite unsettling.
    I have a consultation visit with a surgeon in the coming weeks. It’s a group practice and all members have over 30 years of surgical experience; they are also professors at a top tier medical school. From what I currently know they do not overtly specialize in hernia repair surgery. I’m expecting to be offered the standard mesh repair, but we will see.
    I am currently overweight by about 85 lbs, so my other thought was to change from heavy weights in the gym to high volume (to prevent worsening the hernia), slimming down to a normal healthy weight and then exploring my options. I’m also curious to see if the pending mesh lawsuits set to begin this summer will advance additional options for hernia repair.
    Is it foolish to not repair an early/small asymptomatic umbilical hernia? Is it wise to wait and lose weight before having a hernia repair procedure? I am not wealthy, but I could afford to pay out of pocket for specialized care if need be. I'm also not very far from Shouldice.
    Any advice is greatly appreciated and I will share my eventual outcome on this thread for others to consider.

  • #2
    If you get a suture repair and it fails they can always go in and put "mesh" behind the failed repair. Just like starting over. "Mesh" was developed for that type of problem, mainly for inguinal hernias.

    But, if you get a mesh repair and have chronic discomfort and pain issues, a "mesh" reaction, you might have to have the mesh removed. You might have more extensive reactions than just discomfort and/or pain. So, logically, from the standpoint of your personal welfare and future, it seems to make sense to try a suture repair first, since it has the least risk as far as chronic pain is concerned, both in probability and it having it fixed. If you believe the recent reviews about the growth of chronic pain with the growth of the use of mesh, as described by both Kavic, and Bendavid, both former presidents of the Americas Hernia Society.

    I've realized fairly recently, it's kind of crystallized for me over the last few weeks, that many of the surgeons that recommend the mesh repairs, in all of their variations of methods and materials, don't really understand pain, they conflate mesh-induced pain with the pain of a recurrence or other suture-repair types of pain. They consider them all as one "pain" just like they consider all types of mesh and methods as "mesh". I don't think that they really understand the difference between the two problems. They don't distinguish between the hopelessness of trying to find a solution to mesh-induced pain, as opposed to the ease of finding help for a recurrence. The two efforts are not even comparable, one is almost impossible as mesh-induced pain is mostly denied, even today, while the other, recurrence, is coded in to the "system". So you'll see many comments comparing suture-based pain with mesh-induced pain, essentially describing them as comparable, but without considering the vastly different solution paths to the problems.

    If you have a recurrence you'll find thousands of surgeons ready to fix it. If you have mesh-induced pain you'll be in a whole different world, alone.

    Good luck. That's my view, as of today.


    • #3
      As you know Good Intentions, I totally agree.
      Ive been trying to nail home this point for a while.
      pain sucks and I never try to minimize different types of pain. However, I believe that there is pain as it pertains to the human body itself and then after going through what I went through with my mesh ordeal-there is pain that is caused by implant materials.
      i kept telling docs, friends and family that what I was feeling was so unnatural. I remember telling people I felt like I had a alien inside of me that was killing me. And In reality I did-a plastic piece of mesh, balling up and taking with it muscles, nerves and tissue.
      i think surgeons think in terms of typical natural pain-I think they are cluelsss as it regards to mesh pain.
      i guarantee if they could feel what I was going through, even for a few mins they would highly rethink the over usuage of mesh implantation..
      i still wonder to myself would these surgeon who are seeing and helping mesh victims- would they use mesh on their children or loved ones?
      Highly doubt it.


      • #4
        Thanks for the comments.

        I think I've decided to touch base with the local surgery group I have an appointment with in order to have a known place to go in the event of complications (strangulation etc.). I assume they will at least have my info and any diagnostics they perform on file in the hospital they work out of.

        I'll likely be heading to Shouldice later this year after some weight loss. I plan on sharing the experience results.


        • #5
          Dear Holeinthewall.
          99% of the time, when something pops out of an Umbilical hernia, it is omentum. If omentum becomes incarcerated or even strangulated it is not dangerous. When something pops out of an inguinal hernia, it is usually intestines If intestines become incarcerated, that is dangerous.
          Get you weight down, that is more dangerous to you than the hernia.
          Bill Brown MD


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