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Management of occult/hidden inguinal hernia

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  • Management of occult/hidden inguinal hernia

    I seem to have a non-palpable hernia. There are some indications of one on an ultrasound. Although that is not 100% identifiable.

    My symptoms are a soreness and a slight burning sensation. More so at the end of the day or after sitting a long time. Almost no symptoms in the morning or after lying on my back for a while.
    Some days can feel worse than others.

    My GP and the surgeon I spoke with, say that they want me to wait until the it is palpable before they do anything (basically just live with the discomfort for now). This is because often when testing positive on an ultrasound they still find nothing in surgery, about 50% of the time. Otherwise, I'd go straight for surgery and get past this asap.

    My question is, has anyone managed discomfort of a small hidden/occult hernia with exercise. Looking to making it easier to work until it is palpable and ready for surgery.

    Thanks!

  • #2
    Originally posted by nonPalpableHernia View Post
    Otherwise, I'd go straight for surgery and get past this asap.

    My question is, has anyone managed discomfort of a small hidden/occult hernia with exercise. Looking to making it easier to work until it is palpable and ready for surgery.

    Thanks!
    Be careful. Take your time and read up on what you might be getting in to. I thought something similar, about getting my direct hernia fixed, so that I could move on with my life. It had the opposite effect, consuming my life for three years, still affecting it today, after mesh removal. I was very healthy, and should have been a great candidate to show how advanced the state of the art in hernia repair was. It sounded so easy.

    Read through the threads on the site. Things are not as simple as many surgeons will lead you to believe. The true numbers are undefined, almost hidden. Don't trust what you're told, verify that it is true.

    If you're an active person, you could have athletic pubalgia, aka "sports hernia", which, apparently, can lead to a real hernia. There is a sticky at the top of the first page about it. Treatment for it might not involve mesh.

    And your symptoms of soreness and discomfort after sitting are some of the problems that I had after my hernia repair. The focus of hernia repair today is on the mechanics of the defect. Patching the hole. Not the comfort or life quality of the patient. That's probably why they want to wait until there is a visible defect. Then they can show that they "fixed" something. My cynical view.

    Good luck.

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    • #3
      At some point may be best to get a MRI as ultrasounds are very administrator specific .
      not to say MRI arenít radiologist specific too but you could send the MRI results to dr. Towfigh who has expertise in not only reading MRIís but finding and treating occult hernias.

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      • #4
        Thanks for the quick response I'll keep these things in mind for sure.

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        • #5
          How long have you had symptoms? Was there an event that brought the symptoms on suddenly?

          If it is not particularly painful or interfering in your daily life much, and approved by a doctor/surgeon, using the "watchful waiting" method seems reasonable. Many surgeons take the approach of "no palpable bulge = no hernia" so that also may be why they're telling you to wait.

          Where are you located? Perhaps someone could recommend a regional expert near to you.

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          • #6
            I should also mention that I had a right (opposite side) inguinal hernial repaired when I was a small child, 6 or 7 years old.

            (FYI there is another post waiting for approval before this. I think it was flagged since I mentioned a famous clinic in it )

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            • #7
              Ok seems last post was not approved yet. Let me try again...


              Not sure if related, I had an event about 8 - 10 months ago, where I fell while cycling, that day I was fine but as of the following day sitting at a desk I felt pressure in the area. I though little of it as I could get relieve the symptom but getting up and having a short walk. Overtime this would come an go but not be a consistent pain. And eventually I did not experience it for 3 - 4 months.

              Now about about a month ago I started feeing a similar pressure, again when sitting in the inguinal area, only this time it was much harder to relieve the feeling. Over the next couple weeks the pressure would quickly become burning or soreness. It's at the worst if I end up rolling onto my stomach in my sleep, the sensation will wake me and at this point it seems slightly swollen or slightly more dense, but not really a bulge.

              I went to see a PT yesterday to start carefully treating it like a sports hernia. The PT did say my abdominals are over developed on that side. Which he suggested that may increase the abdominal pressure and contribute to a hernia.

              I live in Rural British Columbia, ( FYI Closest US city is in Spokane WA)
              Last edited by nonPalpableHernia; 05-09-2018, 03:17 PM.

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              • #8
                I have family in Toronto and a few older family members have had repairs at S.h.o.u.l.d.i.c.e, with success. I'd consider going there as I would be able to stay with my family to recover. However, the clinic is also very clear about only treating palpable hernias.

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                • #9
                  Shouldice in Toronto is well known and a great choice for hernia surgery, but as you said they will only do surgery based on a palpable hernia.

                  I wonder if, under doctor supervision of course, you could try and make the hernia appear through valsava or some other effort? Was the ultrasound done with valsava?

                  Have you ruled out any other possible causes/problems in the region? Anything GI or digestive going on?

                  I have read anecdotal reports of people "managing" small hernias with physical therapy, so if a doctor approved it that may be a reasonable interim action while you wait anyway.

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                  • #10
                    The only other running theory I have from my GP is damage to the inguinal ligament, but seems unlikely do to lack of a recent trauma event. Infection, causes are ruled out.

                    My GP is confident that it's a hernia, but needs to wait.

                    I guess in the meantime I'll do the PT and look for another opinion.

                    Thanks.
                    Last edited by nonPalpableHernia; 05-09-2018, 08:29 PM.

                    Comment


                    • #11
                      I've had ultrasound imaging confirmed with another physician and I do have a very small hernia. Still told it's not operable.

                      I'm fine now but will go bat to work next week. And it's worst when I'm at the desk.

                      Still hoping the pain won't be as bad as before. I have lost 20lbs since my first diagnosis.

                      Comment


                      • #12
                        Good luck. Here is a story somewhat similar to yours, as far as making the decision. There are many. We are all about the same physically. I didn't believe what I was reading on the internet either, plus I had a surgeon who had had his own hernia repaired, advising me. I didn't think that things could be so wrong, fundamentally. It's like a horror show. Get that evidence of success from your surgeon before you have the surgery done.

                        https://www.herniatalk.com/7381-mesh-removal

                        And Chaunce's recent post and link is worth reading. It's about the medical device makers and the FDA.

                        https://www.herniatalk.com/7383-the-...y-vaginal-mesh

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                        • #13
                          So I'm still in a non palpable state. Since I travel frequently to Toronto for business I have been able to see shouldice surgeons, but as mentioned earlier they only treat if they can palpate. I am scheduled to see a surgeon in my home province of BC, but appointments are slow in my rural area, We only have one General surgeon here, Doctors if you like to ski and live a breath taking part of Canada ;-).

                          My GP assures me that even that our General Surgeon will not likely want to operate until there is more of a lump, even though a small .07cm hernia was visible on an ultrasound, as they are concerned that I would be in a similar discomfort after surgery.

                          I spent 8 months on slow weight loss and abdominal strengthening, I lost 40lbs and now I'm only in minor discomfort, some days none at all, but other days are quite annoying, I can continue to, wait but my concern is it may be years before it meets the criteria of operable.


                          drtowfigh , Since you operate on occult hidden hernia's, is it possible that surgery on such a small hernia would leave me in the same discomfort? What is your opinion on waiting?

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