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Medical Forum / General / General / January 2006inguinal hernia
I had open surgery (mesh) on an inguinal hernia 10 weeks ago and I am still in more pain than before having the operation. I noticed that many people felt ok after a month (with open surgery and not just laparoscopy). Is it still possible that the operation has been successful? Has anyone else been in pain for several months after, but now completely pain free? Your help would be much appreciated (as I've been in pain now for 3 years and wish it would end soon). Thanks. >I had open surgery (mesh) on an inguinal hernia 10 weeks ago and I am > still in more pain than before having the operation. [quoted text clipped - 6 lines] > Your help would be much appreciated (as I've been in pain now for 3 > years and wish it would end soon). Describe the pain -- location? Sharp/stabbing? Dull aching? Burning/stinging? Present all the time? Worse in some positions than others? Radiating to the testicle? Radiating anywhere else? Pain when crossing your legs? Pain with standing? Pain with walking? Did your surgeon use some kind of mesh? If so, what kind? Is there swelling in the wound? Swelling in the scrotum? Redness? Any drainage from the wound? Any blacl-and-blue discoloration? What did your surgeon tell you when you asked him/her why you're still having this much pain? As I type this, I am again reminded of the problems and inadviseability associated with practicing medicine over the internet... HMc Its just a dull ache like the original hernia 'pain' before the operation with the pain in the same location as before the operation. It hurts at all times and the pain can often radiate to the testical and anus area. There is no swelling, redness, discolouration. It is impossible to speak to my surgeon.... I live in the UK. It is difficult enough to just get the operation in the first place. It took me 3 years. Thanks. > Its just a dull ache like the original hernia 'pain' before the > operation with the pain in the same location as before the operation. [quoted text clipped - 8 lines] > > Thanks. The dull ache you were having before was likely due to the hernia pressing/stretching the ilioinguinal nerve. A lot of that may well have been replaced by swelling and induration in that same area, which would be exacerbated if a polyporpropylene mesh was used, as it likely was. I think it would be a good idea to be working on strengthening your hip flexor muscles on that side, since weakness there can prolong recovery from inguinal hernia. Sitting in a chair with knees ben 90 degree and slowly lift and lower the leg on that side for about 10 minutes three times per day. I would, however, start working on getting a followup appointment with the surgeon, or SOME surgeon. I would say that you may not currently be outside the range of normal for recovery from inguinal hernia, but you're getting close to it. HMc ok thanks for the advice. I tried the exercises and the area hurts a bit more now around the muscles. I'm not sure whether this is a good or bad thing. Is is ok to do other exercises such as sit-ups at this stage or could that do more harm than good? Also, I tend to be sat down a lot at the moment due to work probably for about 14 hours.... is this a good or a bad thing? Would it be better to do a lot more physical exercise? > Also, I tend to be sat down a lot at the moment due to work probably > for about 14 hours.... is this a good or a bad thing? Would it be > better to do a lot more physical exercise? Yes, IMHO. I would suggest standing up every half-hour or and walking around, as well as taking a nice 1-3 mile walk every day. Don't overdo it...light excercise with high repetitions will be far better at this stage than going all out. HMc Also, I tend to be sat down a lot at the moment due to work, probably for about 14 hours a day.... is this a good or a bad thing? Would it be better to do a lot more physical exercise? > Its just a dull ache like the original hernia 'pain' before the > operation with the pain in the same location as before the operation. [quoted text clipped - 8 lines] > > Thanks. A dull constant ache, if unrelated to activity, is not typical for hernia, and radiation to the anus would be odd. It is possible the pain was never entirely due to the hernia. I have worked in the NHS and understand why you asking here. Can you see your surgeon privately, just for further advice? Peter Moran I am 24. The pain is coming from the area of the operation, so I therefore have reason to believe that it is related to that. I have had all the scans that the doctors will allow me to have. I don't have any other options. What else could be causing a pain in this area? Also, no I dont have the money to see a surgeon privately. Thanks. > I am 24. The pain is coming from the area of the operation, so I > therefore have reason to believe that it is related to that. I have had [quoted text clipped - 4 lines] > > Thanks. Sounds like a f'ed up medical system. You have post-operative pain that is chronic and the doctor won't see you anymore. What if you have complication that results in your death? Can the system be sued? Dan The operation was on both sides. The scan showed the hernias are there... thats why I am pretty sure the pain is related to a hernia. Previous to this I saw about 10 different doctors who all gave me an incorrect diagnosis, including IBS and an infection. One doctor told me to stop eating and drinking for 3 days. I went to Australia to try and get faster treatment, but as a result of not being able to do physical work (which is the usual employment for people overseas and staying in a hostel) I ran out of money quickly and became homeless. I had to eat one sandwich a day from a salvation army free food van for 4 months until I wangled a credit card to get me a flight home. In this country you can be waiting up to 6 months for a scan then 4 months after the scan to see the doctor. One lady (on national news) was told that she would be waiting up to 10 years for a hernia operation. I mentioned the terms 'gilmores groin' and 'laparoscopy' to my surgeon (but not the one that actually did the operation) and he looked at me puzzled and then tried to repeat the words to ask me what they meant. The government try to cover up incompetence such as this and many people don't believe it happens in a developed country such as the UK (until it actually happens to them and they crash land into the real world). I have spent hours and hours, months and months trying to get the NHS to just admit that a mistake has been made, let alone financial compensation. I have to say this has completely distroyed 3 years of my life, but by the NHS's standards this is a minor incident.... my grandmother was misdiagnosed and she died. If I had the finances and time to sue, I would. Its not my style and its not the style of a lot of people in this country but I think I deserve the compensation. > The operation was on both sides. The scan showed the hernias are > there... thats why I am pretty sure the pain is related to a hernia. [quoted text clipped - 27 lines] > its not the style of a lot of people in this country but I think I > deserve the compensation. Wait a minute - I must have missed the part where you said previously that your open hernia repair was bilateral. That changes quite a bit. Those tend to be very painful, and the recovery can be quite prolonged - 10 weeks or even more. As to the "scan" you refer to -- what's THAT all about? When did you have it, why did you have it? Who does "scans" for inguinal hernia? HMc ok the left side was a sports hernia (Gilmore's Groin) and the right just a hernia (not sure whether it was direct or indirect) but the left is virtually pain free now. The right is what is causing the majority of the pain. the doctors at the time did not know that I had a hernia. I went to a hospital in Australia. They gave me a CT and Ultrasound scan to check that it wasn't anything more serious. In this country I had a scan that involved them injecting die into my groin and then bearing down to show if a hernia 'lump' showed. I think its called a Herniagram Scan, but not sure. > ok the left side was a sports hernia (Gilmore's Groin) and the right > just a hernia (not sure whether it was direct or indirect) but the left [quoted text clipped - 7 lines] > if a hernia 'lump' showed. I think its called a Herniagram Scan, but > not sure. The so-called "sports hernia" is a torn groin muscle and is not even related to being a hernia. I sincerely hope you didn't have surgery on that side, then. Herniagrams, boy, that's a rather unusual test, at least in this country and in the 21st century. I asked one of our radiologists about it a few minutes ago, he started laughing. Personally, I've never ordered a "herniagram" in 25 years. So, you were having pain in the left groin, they examined you and couldn't find a hernia, did a "herniagram", found nothing on the left and found a hernia on the right. Were you having symptoms on the right? Did they operate on the left? Did they operate on the right? HMc No I was having pain on both sides in the inguinal area but no lump was showing on either side. They did a herniagram and found a hernia on the right but 'investigated' the left by opening me up on that side. He said to me after the operation that he put mesh in on the right and stitched up a hole on the left. I made a photocopy of the surgery report which says 'Gilmore's groin' on the left and 'inguinal hernia' on the right. I'm pretty sure you can have surgery for a sports hernia though cant you? There are records of it on google. by the way, they 'investigated' the left because no lump was present there either and nothing showed on the herniagram (sorry not sure how to edit the post). I've just read up on herniagrams... apparently they are very rarely ordered in the country. Only if a hernia can not be seen by physical examination, CT or Ultrasound scan. I wouldn't say this was a shoddy piece of equipment though... This was a very hi-tech and and time consuming examination. > I've just read up on herniagrams... apparently they are very rarely > ordered in the country. Only if a hernia can not be seen by physical > examination, CT or Ultrasound scan. > > I wouldn't say this was a shoddy piece of equipment though... This was > a very hi-tech and and time consuming examination. And to be honest, I thoroughly question the point of it all. You have presented a surgical case here - diagnostic approach, operative choice, postop outcome, that I consider to be WELL outside the standards of care relative to the management of groin pain that I am familiar with. HMc ok, so could you give any more information on how you would have gone about diagnosing and operating in this situation? Why do you consider it to be outside the standards of care that you are familiar with? > ok, so could you give any more information on how you would have gone > about diagnosing and operating in this situation? Why do you consider > it to be outside the standards of care that you are familiar with? Diagnosis of inguinal hernia is a clinical diagnosis in the vast majority of cases. The findings of herniagram or ultrasound do not correlate well the symptoms of groin pain when compared to physical exam and that is the reason those tests are so rarely used. Most commonly, a hernia that is not detectable on physical exam, or where there is no patient history of a discernable lump in the groin, will not be the cause of groin pain. To operate in those situations most often does the patient a disservice. This is especially true with such operations for groin muscle tears or strains. My distinct suspicion, in someone who complains of groin pain where no hernia is clinically detectable, would be that the original cause of their groin pain was never a hernia in the first place. To explore the groin then opens the patient to the potential complications of such an operation, such as osteitis pubis, nerve entrapments and other less common complications, all to no good purpose. HMc but surely if a herniogram shows that a hernia is present then that is a valid reason for surgery? > but surely if a herniogram shows that a hernia is present then that is > a valid reason for surgery? No. The mere presence of a hernia is not a reason for surgery. A *symptomatic* hernia, yes, if the patient wants the operation. The trick is in trying to figure out if the symptoms are being caused by the hernia or by something else. As I said, a hernia that can't be detected clinically by physical exam alone, or where the patient gives no history of a discernable bulge in the groin, is much less likely to be the cause of severe groin pain, and subsequent hernia operations are less likely to be successful in resolving the groin pain. HMc ok so other using scans how would you go about trying to figure out if the symptoms are being caused by a hernia? Just so that I know incase I need to be examined by another set of corrupt doctors. > ok so other using scans how would you go about trying to figure out if > the symptoms are being caused by a hernia? Just so that I know incase I > need to be examined by another set of corrupt doctors. A question which brings us back to my original point in this thread ... a thorough history and physical exam by an experienced surgeon, neither of which you will be able to get over the internet. HMc well I had my appointment with the surgeon today and he told me 'I'm sorry but there's nothing more we can do for you'. Theres probably only one way out of this problem. > well I had my appointment with the surgeon today and he told me 'I'm > sorry but there's nothing more we can do for you'. Theres probably only > one way out of this problem. Move to the USA. And claim hardship treatment. |
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