My urologist fixed a hernia while he was removing my prostate.  Recently
my primary care physician thought he found something on the same side.
My urologist confirmed that it was the beginning of a hernia, not
needing treatment right now, but it was in a different location from the
one he fixed, so it was unrelated.  I don't know if my current hernia
was related any way to my RP in 2000.  I didn't ask about that, and he
didn't volunteer anything along those lines.

Hernias do happen to men, and engaging in any kind of activity lifting
things can do it.  In my case, because of spinal stenosis,  I seldom
lift anything heavier than 15 lbs and never anything heavier than 25
lbs.  But I somehow managed to get one anyway.

Both.

I had both sides repaired 20 years ago, and the surgeon said he
corrected old problems and both sides should now last a lifetime. Of
course, I surpassed my first normal lifetime decades ago, so maybe he
was right even though I am getting familiar twinges in my lower abs
lately. I'm referring to slight muscular discomfort in my lower
R and L abdominal wall, from a 1 to a 3 on the 10 pain scale --
noticeable, maybe sometimes almost painful, under exertion for a few
days and noticeable for weeks at a time.

My first thought was, "Oh, crap ... is MORE surgery coming up?" So I
paid close attention to my body and my gym routine, identified the
exercise that seemed to most closely relate to the twinges, and cut or
greatly reduced it from my exercises. It faded from perception in a week
or so, implying to me it was probably just a slight muscle strain. But
even though I don't do that exercise any more, the twinge still exists
sometimes at a barely perceptible level. I suspect it may be a slight
weakness in the abdominal muscle wall right where it was when I needed
my hernias repaired.

In my case, the exercise that seemed most likely to induce a week of
mild pain was high-effort work on a Nautilus torso twister. I dropped
that exercise (trainers say it's not that practical anyway) and the 2
and 3 twinges went away. So your first effort might be to identify the
exercise(s) triggering the symptoms and eliminate it or greatly reduce
its level of effort.

Or maybe your lifting is at the body-building level, ultimately more
strenuous than mine. I shoot for muscle failure at 11-12 reps one day a
week to build some muscle and go for failure at 18-20 reps with fast
concentrics/slow eccentrics once a week to hit the fast-twitch muscles
and develop endurance. I'm nowhere near the 2-3-reps-to-failure a body
builder would target, and I do only one set of each exercise because it
provides the greatest bang for the buck. Mine's more like high-effort
circuit training, and, I hope, is less likely to cause injury than body
building.

I don't know how sensitive the turn-your-head-and-cough test is; maybe
your doctor can discern a meaningful difference between your right and
left sides. If so, these days I might seek MRI conformation before
letting them repair me if the diagnosis was not definitive and if an MRI
is.

I.P.

Here are simple solutions, cheap, relatively risk free,
and non-invasive.

1. Always wear a jockstrap.

That may solve most of your problems.

2. When working out, wear a hernia belt.

You can buy a hernia belt in some of the better drug
stores or over the web.  If you get the right one, it
really can work - eliminating pain and making it possible
to do any exercise you like.

I suffered from incipient hernia pain throughout my
youth, never getting surgery for it.  In my late
20's I discovered belts and I've never had a problem
since.  I rarely wear them, but if I'm shoveling snow,
carrying heavy items, or doing something else that
would cause pain, I put one on and it does the trick.

Some people have told me, "I don't want to rely on
a belt."  I suppose some people see a problem there,
but I don't, any more than I rely on shoes when walking
outside to protect my feet, or a coat to protect me
from the cold, or an umbrella to protect me from the
rain.  I'd personally rather wear a hernia belt than
go to sleep on an operating table while a surgeon
picks up a scalpel and goes to work on me.

If you've got a real hernia, you may need a real
operation.  Hernias can be dangerous.  However if you've
just got some incipient weakness in the inguinal wall,
and the associated pain, a belt may be just the thing.

   Alan