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Diagnosed with Hernias via CT scan only, no bulges or symptoms, huh?

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  • Diagnosed with Hernias via CT scan only, no bulges or symptoms, huh?

    Hi I went to the ER for lower right abdominal pain, I had had digestive distress and itching in the lower right but never groin pain. I had a CT scan that was normal other than "bilateral fat containing inguinal hernias" on both sides. I was never actually examined physically, I have no bulges and have never had any groin pain or lumps. How likely is it that I actually have these hernias? I got a cd with the CT scan and viewer and was unable to see any major hernia bulges but I'm no expert obviously. My GP never examined me after seeing the paperwork of results I gave him but said he would refer me to a surgeon, I have no intention of going under the knife for something that I see no symptoms of. Any ideas?

  • #2
    Yes by all means do not go under the knife. I have been in touch with a bunch of guys who had mesh inserted for hernia repair when they didn't have any symptoms but hernias appeared on a cat scan and they didn't have any hernia symptoms m. They ended up having issues with the mesh had it removed and the surgeon said they didn't have any hernias in the first place. One might of had a lipoma but no hernia.
    get second and third opinions. Dr. Towfigh is a expert at reading cat scans and is someone you might want to get a second opinion from. And from my personal experience I rx dr. Igor Belyanski. He has expertise reading cat scans and can give you his opinion with no charge. Just send a copy of the cat scan on CD.
    finally if you do have hernias and they are small they can be watched if asymptomatic and if you do have them and seecis in surgery please look into and research pure tissue repair insteqad of mesh.

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    • #3
      does dr belyanski do any mesh repairs?

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      • #4
        I totally agree with you and jnomesh about not getting hernias fixed if they arenít causing any symptoms. You could open up a whole new can of worms and cause pain and problems that didnít exist. I know femoral hernias need to be repaired due to chance of incarceration, but think Dr. Towfigh has said inguinal hernias that are asymptotic can be monitored. Best of luck with your issue.

        Ajm222, to answer your question, I know Dr. Belyansky does mesh and non-mesh repairs, depending on the individual needs of the patient. He specializes in all types of hernias and complex abdominal wall reconstruction. He is a brilliant surgeon and super nice doctor. Also, he does read his own CT scans, but not sure about reading them for no charge if you arenít an established patient. I was a surgical patient of his and he did read my scans.

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        • #5
          Originally posted by Momof4 View Post
          I totally agree with you and jnomesh about not getting hernias fixed if they arenít causing any symptoms. You could open up a whole new can of worms and cause pain and problems that didnít exist. I know femoral hernias need to be repaired due to chance of incarceration, but think Dr. Towfigh has said inguinal hernias that are asymptotic can be monitored. Best of luck with your issue.

          Ajm222, to answer your question, I know Dr. Belyansky does mesh and non-mesh repairs, depending on the individual needs of the patient. He specializes in all types of hernias and complex abdominal wall reconstruction. He is a brilliant surgeon and super nice doctor. Also, he does read his own CT scans, but not sure about reading them for no charge if you arenít an established patient. I was a surgical patient of his and he did read my scans.
          Nice, thank you! Just trying to get a sense of whether or not he was totally anti-mesh or anything like that.

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          • #6
            Do not get surgery! Most hernias cause no pain and its like a 1% chance they will strangulate and cause an emergency surgery. Just watch and wait. down the road if you do opt to have it done do not let them use any mesh no matter what! Best of luck!

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            • #7
              Leave them alone.

              Pay attention in the future to pain and/or bulge in the region of the imaging locations of the hernia.

              Lots of people have imaging only hernias without clinical symptoms.

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              • #8
                Dr. Proctor - out of curiosity, do you tend to recommend mesh repair over non-mesh in a typical inguinal hernia patient? I am about to schedule surgery and it seems most surgeons I have spoken with obviously recommend mesh, even your colleagues. But no one seems to really know for sure what the incidence of recurrence is in non-mesh repairs these days or the complication rates beyond three years or so, and at three years it seems they are similar to mesh repairs. I had considered a non-mesh repair, but it seems most surgeons suggest the incidence of recurrence long-term is probably quite high, especially if you get it when younger like myself. And it sounds like recovery is much worse. And there is the fact that most surgeons rarely do non-mesh repair so the skill level and practice level is low which could impact effectiveness, especially given that it sounds quite complicated.

                I know this forum is mostly filled with those who have had problems and a general 'don't use mesh ever' attitude. But from what I can tell the actual surgeons posting here save for maybe one typically recommend mesh for the most part. Just wanted to clear that up and get your opinion on it. Would you generally recommend mesh repair to a younger patient with 'typical' inguinal hernia over non-mesh all else being equal, assuming it is done by a skilled and experienced surgeon who is very familiar with inguinal hernia repairs?

                Don't mean to hijack the thread. But it seemed somewhat related. I have a very clear bulge and starting to have symptoms when standing for long periods of time. Mainly just trying to convince myself that getting a mesh repair isn't a terrible choice , while understanding clearly that complications are an unpredictable possibility.

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                • #9
                  Originally posted by ajm222 View Post
                  Dr. Proctor - out of curiosity, do you tend to recommend mesh repair over non-mesh in a typical inguinal hernia patient? I am about to schedule surgery and it seems most surgeons I have spoken with obviously recommend mesh, even your colleagues. But no one seems to really know for sure what the incidence of recurrence is in non-mesh repairs these days or the complication rates beyond three years or so, and at three years it seems they are similar to mesh repairs. I had considered a non-mesh repair, but it seems most surgeons suggest the incidence of recurrence long-term is probably quite high, especially if you get it when younger like myself. And it sounds like recovery is much worse. And there is the fact that most surgeons rarely do non-mesh repair so the skill level and practice level is low which could impact effectiveness, especially given that it sounds quite complicated.

                  I know this forum is mostly filled with those who have had problems and a general 'don't use mesh ever' attitude. But from what I can tell the actual surgeons posting here save for maybe one typically recommend mesh for the most part. Just wanted to clear that up and get your opinion on it. Would you generally recommend mesh repair to a younger patient with 'typical' inguinal hernia over non-mesh all else being equal, assuming it is done by a skilled and experienced surgeon who is very familiar with inguinal hernia repairs?

                  Don't mean to hijack the thread. But it seemed somewhat related. I have a very clear bulge and starting to have symptoms when standing for long periods of time. Mainly just trying to convince myself that getting a mesh repair isn't a terrible choice , while understanding clearly that complications are an unpredictable possibility.
                  If you read my posts you will see I had a perfect operation,a perfect recovery,and I was very careful in what I did afterwards as far as how much weight I lifted and such.
                  And yet 8 years later I am worse off now.I believe that it is not a matter of if the mesh will fail.....it is a matter of WHEN....it will fail.

                  I have researched so many forums now to find people with recurrence 5-16 years later and even 22+ years later.And most of these people said they did nothing to cause the mesh to fail.

                  If I could go back....I would have never had mesh put in.Now I am unemployed,no insurance....none that anyone accepts on here(Dr. Towfighs office wouldn't accept it)and no money to at least get it out at those who do accept cash...

                  Do not go with mesh

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                  • #10
                    i'll say that i know several people personally who had mesh repair and haven't had any further issues. some of these had the surgery done 5 or ten years ago, and some almost 20. so i guess it depends. the bigger question is: is non-mesh repair any better.

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                    • #11
                      it's all definitely concerning though

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                      • #12
                        Originally posted by ajm222 View Post
                        i'll say that i know several people personally who had mesh repair and haven't had any further issues. some of these had the surgery done 5 or ten years ago, and some almost 20. so i guess it depends. the bigger question is: is non-mesh repair any better.
                        Seems like you, and many of us, might be getting overwhelmed by all of the information out there, and are trying to generalize it down to something useful. You've distilled everything down to "mesh repair" and there might be much more to it than just mesh.

                        Saying that "all mesh is bad" is not good enough to make progress in getting rid of the bad materials and methods. Many people are happy with their mesh implantations. But many are not. We need to find the correlation between the unhappy people and the materials/methods used.

                        If you read through all of the mesh removal and mesh problems threads on the site you'll find that many, 4 of 9 for removal, are for Bard 3D Max. I had problems with Bard Soft Mesh. Bard has a very large presence in the mesh market place. Many surgeons are stuck using the material of the device maker with which their organization has a contract, and contracts are awarded based on cost. So you could find that experienced expert surgeon but he/she will be inclined to use what their organization has contracted to use. One more way the big device makers can control the situation. Read the article in this link, from just two years ago, and you might rethink who you choose. There's a definite view of "any and all mesh is good", and "all that matters is surgeon's skill". It's actually scary to read, considering all. http://www.generalsurgerynews.com/Ar...rticleID=34826


                        Alternatively, if all mesh really is the same, then the 15-20% chronic pain number is your chance of getting it. If you thought you had a 1 in 6 chance of chronic pain would that sway your decision? Because without a correlation to specific brands of material, that's where we're at. Take a single die and roll it one time.

                        So, besides the general advice to find a happy person and use their surgeon, it would be reasonable to avoid Bard 3D Max. It seems to be one that often causes problems.

                        Good luck. Whatever you do, don't just decide to roll the dice and see what happens. There are no do-overs.

                        Comment


                        • #13
                          Here is a good overview, from somebody who's apparently been around long enough to see the whole field develop (edit - no offense to those who are fairly new to the field). Published less than 2 years ago, ~July, 2016. After I had my surgery, in late 2014.

                          https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5000866/

                          Here's an excerpt -

                          "If the incidence of chronic pain after mesh repair approximates 16.5%, then a very significant number of patients will have debilitating pain resulting from the procedure when most patients likely had little or no preopertive [sic] pain.

                          This possibility presents a potential time bomb for the surgical community and medical device suppliers. Hernia recurrence has been largely reduced by the use of synthetic mesh for repair, but a new problem, chronic postoperative pain, has arisen to rival recurrence as a serious consequence of surgical intervention. "

                          From Chronic Pain Following Inguinal Hernioplasty by Michael S. Kavic, MD.
                          Last edited by Good intentions; 01-11-2018, 02:49 PM.

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                          • #14
                            Two other ways of looking at the mesh VS non mesh dilemma.
                            1) it's not only about whether something will go wrong if you get implanted with mesh but that if it does your really screwed. You have a permanent device intertwined in your body that isn't meant to come out. You will face a medical community that will pass you off as you try to figure out what is causing you your pain. And eventually you may be faced with having to roll the dice on getting the mesh removed. So it's much more than what's the odds of something going wrong. To me it's more the magnitude associated with something going wrong and not just the odds. I know people who have had mesh and are doing fine and have done fine for many years.to me that's not the point.
                            2) i really believe the modern day surgeon has it all wrong when they quote statistics or reference pure tissue repairs-they always quote low recurrence as the primary benefit of going with mesh. But if you google the shouldice hospital in Toronto you will see that their method has a less than 1% recurrence rate which blows away the 3% quoted recurrence rates with mesh. Their chronic pain results are also less than 1%. This not only blows away mesh but destroys it in terms of chronic pain which can be as high as 15-30% with mesh.
                            so what's the takeaway, what's the read between the lines: pure tissue repair is superior to mesh repair in the hands of surgeons who specialize in pure tissue repairs. And there lies the rub-there are very few who do this specialty in the US. They are not trained anymore on how to do them and they certainly don't practice it often.
                            I also think most surgeons who use mesh and will do a pure tissue repair white the higher recurrence rate Bc they aren't confident enough that they can do a good job tissue repair.
                            Again the stats from the shouldice hospital closes the debate on mesh VS mom mesh. And anyone who quotes mesh as better really means mesh is better then getting a pure tissue repair from someone not qualified.
                            personally if I could do it all over again I'd probably travel to the shouldice hospital and have my repair done there. Why play with fire. I did and I got burned.
                            if you choose either method make sure whoever you pick is the best at doing either procedure.

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                            • #15
                              Iíve chosen a guy here who uses both bard 3D but also progrip. He uses the latter much more often, and says they actually donít have any of the Bard right now. Heís know as ĎMr. Herniaí around here because itís one of his specialities (though he also does a lot of cancer-related surgery). Heís highly recommended and well regarded and has done mesh removal before. Heís also been doing hernia operations for decades and used to do a fair number of tissue repairs.

                              Comment

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