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  • Recurrent hernia?

    About 9 years ago I had an open surgery for right inguinal hernia where mesh was placed.

    Two months ago after gym, I had severe discomfort in the location, following which it was difficult to properly stretch or even lie on my stomach.

    Those symptoms have largedly subsided and I am left with nothing more than slight heavyish feeling in the area and "tension feeling" (it feels like groin spasms and also a pulling feeling) whenever i ejaculate from masturbation.

    I am wondering if my hernia may have reoccurred? I don't lift heavy in the gym and I can't feel any bulge or lump near the area. Apart from the ejaculation pain, I feel ok.

    Also, reoccurring hernia surgeries sound like a nightmare and highly risky. Are they really that bad? I've seen stories of people having 5+ surgeries in the area and not reporting loss of testicles etc.

    Is it possible that I stretched the scar tissue or something and if that is possible? Should I try anti inflammatory medication for relief?

    How does one confirm a recurrent hernia without significant bulge? Does it come through the mesh or does it protrude through a secondary hole? Would it ever descend into the testicles or would looking for these symptoms be pointless at this point?

    Any information would be useful at this point. Also, I don't reside in the USA and where I am laparoscopic surgery for hernias are rare. What are the risk for a second open surgery to repair a hernia? Are there significant risk?

  • #2
    Damien10,
    Thanks for contacting us here at HerniaTalk. Will try to answer your questions in order but have to ask exactly where the pain is located and where the "tension feeling" is located (above the base of the penis, slightly more lateral toward the hip bone, halfway to the hip bone, or much more lateral) and does it hurt when you push on it with your hand?. Also what were you doing in the gym? (lunges, squats, etc with your lower body/core)

    1. Your hernia could have recurred but impossible to know for sure without exam/imaging. You could have athletic pubalgia also.
    2. Recurring hernia surgery can be challenging. I would recommend Dr. Towfigh, Dr. Orenstein, Dr. Chen, Dr. Jacob, myself or someone who specializes in it to get the best results.

    3. Stretch scar tissue: Yes it is possible. IF you would like to consider an online rehab program for this we are currently beta testing one and I would be glad to work with you to arrange this and go over your issue more in depth via a telehealth visit. You can find us at www.indianahernia.com, fill out your information and we will get things set up.

    4. Ultrasound, CT, MRI all can work to confirm. It can come through the mesh or most often an area that was not covered by the mesh completely. It could descend into the scrotum but unlikely at this point as that usually takes a bit of time.

    5. Usually I would not recommend a second open repair unless you have chronic groin pain that I suspect the mesh is causing the problem and needs to come out. We would approach these Laparoscopic/Robotic.

    Thanks!
    Dr. Szotek
    pszotek@indianahernia.com
    www.indianahernia.com

    Comment


    • #3
      Doc

      Thanks for your prompt and informative response. I don't have any recurring pain etc. I had pain a couple months ago but that has largely subsided. I stopped all physical activity when it occurred. The tension feeling occurs during ejaculation(I did it today and observed no pain at all and barely noticeable tension) and feels like it is right below my surgical area but moving towards my hip bone. I don't feel any pain whenever I push on the area with my hand, sneeze or cough.

      I can't remember the exact exercise but I was doing possible overhead shoulder press/ hammer curls when I got the pain. I may have exacerbated the pain the following day by doing abs and very light deadlifts with poor forms ( I should know better).


      Recently, I haven't even gotten the heavy feeling. I spent yesterday shoveling dirt etc and I don't feel any pain or sensation etc.

      Any idea the type of costs associated with this type of procedure. I am outside the USA so if I were to travel then I would have to pay out of pocket. London(United Kingdom) may be more realistic to me since I will have to go to further my studies there in the immediate future. Do you have any references for doctors or hospitals in London?

      Regards
      Damien

      Comment


      • #4
        UK has very few surgeons who see and treat chronic pain after hernia repair. There are a couple of my colleagues who I will reach out to to see if they will see you. Stay in touch.
        #ItsNotJustAHernia
        www.BeverlyHillsHerniaCenter.com

        Comment


        • #5
          You're in luck:

          Try Dr. Aali Sheen of the Groin Pain Clinic based in Cheadle, Cheshire. Find him on www.groinpainclinic.co.uk
          #ItsNotJustAHernia
          www.BeverlyHillsHerniaCenter.com

          Comment


          • #6
            Hi Doc

            I don't have any groin pain.

            I am just trying to see if this can be a recurrence.

            The area feels weird but I don't experience any pain whatsoever.

            If I get any discomfort then I get it when I bed down and then it's barely noticeable.

            I'm just trying to see if maybe the area was stretched resulting in tissue coming apart etc.

            I don't see or feel any bulges either and pushing down on the area doesn't result in pain.

            Something is definetly different though. When the symptoms started I felt what felt like a burning sensation in my stomach and it was difficult to fully stretch the area. Leaning back was problematic etc.

            Now those symptoms have largely disappeared.

            If it is a recurrence, would additional mesh be placed etc and the old one removed?

            Regards

            Comment


            • #7
              Also I don't have any pain or tension whenever I ejaculate anymore.

              Comment


              • #8
                The pain and tension is still there. I'm taking some ibuprofen and the pain has lessen. I am now finding it difficult to get an maintain an erection...would a recurrent inguinal hernia or "sports hernia" cause that? Can I be experiencing some "mesh issues". I dont feel a bump or even pain when I cough or sneeze etc.

                When I do ejaculate, it's in very minute amounts almost nothing. I am beginning to worry continuously.

                Any ideas? I hope to visit the doctor soon but at this time I simply cant afford it.

                Comment


                • #9
                  If your symptoms started 9 years after your hernia surgery, then a hernia recurrence is top on the list of why you are having symptoms.
                  #ItsNotJustAHernia
                  www.BeverlyHillsHerniaCenter.com

                  Comment


                  • #10
                    Thanks for the response Doctor

                    Would a regular doctor be able to do the appropriate test if there is no bulge etc present.

                    Where I live there isn't any hernia specialist so I am wondering if they GP would be able to identify a hernia and request the appropriate test.

                    I have read other persons' experiences online where no bulge was present, the doctors were adamant that there wasn't a hernia.

                    What should I do or expect my doctor to request? Any questions I should ask?

                    Regards

                    Comment


                    • #11
                      Also

                      Can it be anything else such as an Abdominal strain, scar tissue injury, sports hernia?

                      Most likely I would be undergoing the surgery in London when I go there for postgraduate study. The British Hernia Center seems to be the go to place for surgeries of this nature. Anyone familiar with this hospital? My main worry is damage to my testicles etc and any other injury that may cause erectile dysfunction. I am already finding it difficult to maintain an erection obviously this "thing" has begun to have adverse effects.

                      They claim to use a posterior or pre-peritinoeal approach to a recurrent hernia to avoid scar tissue etc. Is this standard operating procedure for these types of hernias or is this specialist expertise that only a few have? Should I ask my doctors here at home if it's possible to have this approach for the prospective surgery? It may be up to 15 months before I am able to relocate to London etc so time is of the essence.

                      I'm sorry if I appear to be spamming this board, seems that recurrent hernias are a rarity so information on surgical approach and treatment is scarce. By the way, I am only 28 years old and haven't even got around to having children so any complications down there worry me.

                      Regards
                      Last edited by Damien10; 07-30-2017, 04:33 PM.

                      Comment


                      • #12
                        If you have a recurrence from an anterior approach, then a posterior approach is indicated as the next way to repair it, for the reasons you mentioned (less scar tissue, so less risk of injury.)

                        In the US, this is usually done laparoscopically. That said, an open posterior approach is also an option, though with longer recovery time, usually.

                        Dr. Sheen can perhaps help you find someone in London or perhaps it is worth traveling.

                        By the way, erectile dysfunction is not directly affected by any hernia-related problems or complications. Any ED you may have is secondary (e.g., there is pain, so erection is painful and therefore difficult). Do not fear that ED will be maimed by a hernia repair.
                        #ItsNotJustAHernia
                        www.BeverlyHillsHerniaCenter.com

                        Comment


                        • #13
                          Just a quick update.

                          I went to the doctor and he did both an examination and ultrasound. Nothing was felt but the ultrasound showed a swollen lymph node in the area so the belief is that it/they were reacting to inflammation in the area. Does that sound like a reasonable diagnosis? All of my symptoms(pain/erectile dysfunction) have pretty much decreased and I haven't taken any pain medication recently as well. I was taking ibuprofen so I guess that cleared up the inflammation.

                          Comment


                          • #14
                            As long as your pain is gone, there is no need for surgery.
                            #ItsNotJustAHernia
                            www.BeverlyHillsHerniaCenter.com

                            Comment


                            • #15
                              Hi Doc. I hope that all is well.

                              Is it possible that I may have damaged my suspensory ligament of penis due to over-extending during deadlifts(poor form etc). My The "hernia" pain is none existant but my penis doesn't get as erect as it used to and the pain does seem to have come from that area. Could this be the cause of my problem? Could the mesh have maybe migrated whilst deadlifting and cut the ligament or something?

                              Comment

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