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  1. #1651
    Registered User Lmasterz's Avatar
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    Great posts guys. Here's my experience, any input is appreciated.

    I had my left inguinal hernia surgery done laparoscopically (TEP, not TAPP, if anyone is interested in the technicalities) on 7th Dec 2019. It'll be 8 weeks tomorrow. First 7-10 days had some pain in the abdomen and took the usual pain killers. Had a follow up with my surgeon 2 weeks in, he said i'm doing very well. By the 4th or 5th week i'd say I had zero pain except next to my belly button if i apply pressure i can feel mild pain. I walk and move a lot but haven't been to the gym since, simply because I'm worried.

    I'm planning to start tomorrow and will be starting light of course. But as I go back to my routine, what exercises should I avoid, to remove any doubt of recurrence? It seems one arm dumbbell row to be one of the causes youtube.com/watch?v=GLHGa2MCI_A
    Last edited by Lmasterz; 01-24-2020 at 09:49 AM.
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  2. #1652
    Registered User Bell0c's Avatar
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    Originally Posted by Lmasterz View Post
    Great posts guys. Here's my experience, any input is appreciated.

    I had my left inguinal hernia surgery done laparoscopically (TEP, not TAPP, if anyone is interested in the technicalities) on 7th Dec 2019. It'll be 8 weeks tomorrow. First 7-10 days had some pain in the abdomen and took the usual pain killers. Had a follow up with my surgeon 2 weeks in, he said i'm doing very well. By the 4th or 5th week i'd say I had zero pain except next to my belly button if i apply pressure i can feel mild pain. I walk and move a lot but haven't been to the gym since, simply because I'm worried.

    I'm planning to start tomorrow and will be starting light of course. But as I go back to my routine, what exercises should I avoid, to remove any doubt of recurrence? It seems one arm dumbbell row to be one of the causes youtube.com/watch?v=GLHGa2MCI_A
    Thanks for that video. Someone else here mentioned that, I think, but I had forgotten about it, and that makes a lot of sense.

    I had Desarda repair on a bilateral about 15 months ago. I started back light, as you say, watching anything that stretched or strained the core, like chin-ups, farmer's walk, dips, overhead press, etc. Also, movements that required hard Valsalva, like deadlifts. I don't compete or anything, so didn't really care if it took months to return to my former weights - I just wanted to avoid sudden movements or overloads that might tear something before scar tissue had really fully formed. Repairs don't have a great track record. I did try to gently move through complete range of motion over time to keep scars from setting up too tight. Of course, I'm in my 50's (contrary to the info on the side panel), so I'm accounting for a longer heal time. In any case, I'm back to where I was, and all is well. Impatience is your biggest enemy here, I think. Good luck!
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  3. #1653
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    Hello,

    I have some update. I went to a different place (biohernia.com), which is the private clinic of Dr Andreas Koch (chirurgie-cottbus.com). They saw left part is ok, but right part has a recurrence although not alarming, so to speak… It’s a meshless Shouldice based procedure. Do you think I should go for it?

    In treatment plan they propose a complete mesh explantation, also a
    neurolysis of the inguinal Nerves, e.e. ileoinguinalis, ileohypogastricus and
    genitofemoralis, lysis of the spermatic cord and restoration of the
    inguinal floor with a component separation of the intern oblique
    muscle and the transverse muscle without mesh or with a
    reinforcement with long term resorbable mesh.

    Do you think this is ok? Is it necessary the neurolysis and the lysis of the spermatic cord? Does it imply losing of sensitivity and/or sexual impotence

    Thanks a lot and Best Regards!!
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  4. #1654
    Registered User Bell0c's Avatar
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    Originally Posted by SpanishRPG View Post
    Hello,

    I have some update. I went to a different place (biohernia.com), which is the private clinic of Dr Andreas Koch (chirurgie-cottbus.com). They saw left part is ok, but right part has a recurrence although not alarming, so to speak… It’s a meshless Shouldice based procedure. Do you think I should go for it?

    In treatment plan they propose a complete mesh explantation, also a
    neurolysis of the inguinal Nerves, e.e. ileoinguinalis, ileohypogastricus and
    genitofemoralis, lysis of the spermatic cord and restoration of the
    inguinal floor with a component separation of the intern oblique
    muscle and the transverse muscle without mesh or with a
    reinforcement with long term resorbable mesh.

    Do you think this is ok? Is it necessary the neurolysis and the lysis of the spermatic cord? Does it imply losing of sensitivity and/or sexual impotence

    Thanks a lot and Best Regards!!
    Hey, man, I'm glad you found someone else to take a look at your situation, and I'm glad you caught the recurrence. But you may be asking too much for anyone on this thread (forgive me if there are any exceptions to this) to give you feedback on so many technical points. It was hard enough for me just to get some kind of statistics on basic procedures, and it is hard to compare one case with another in any case. What I would recommend is to try to determine whether that doctor specializes in old mesh and scar tissue removal and what kind of success rate he has, along with success/fail statistics on the other procedures he wants to do. I was under the impression that Shouldice used permanent stainless thread under tension for part of the repair, but it's been a while since I researched and I could be wrong. It's hard to get a feel for what works and what doesn't on this thread because every method has successes and failures and even with 56 pages, it's all anecdotal. I've been very happy with the Desarda repair by Dr. Tomas, and I believe he specializes in scar/mesh removal as well, but I don't know if a trip to Florida is something you can or want to do. At least a second (informed) opinion would be good, but you've had so much trouble just finding one good place. Good luck, man, and let us know what you end up doing.
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  5. #1655
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    Quick update:

    I asked and they replied that the neurolysis means “taking care of your nerves and replacing them outside the suture line”. Do you think it makes sense? I’m a bit lost.

    Thanks and Regards.
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  6. #1656
    Registered User Bell0c's Avatar
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    Originally Posted by SpanishRPG View Post
    Quick update:

    I asked and they replied that the neurolysis means “taking care of your nerves and replacing them outside the suture line”. Do you think it makes sense? I’m a bit lost.

    Thanks and Regards.
    Sorry, man, I don't get notifications from this site from some reason, and I haven't checked back recently. Re: neurolysis, a google search gives this dictionary definition, "1. destruction or exhaustion of nerve tissue. 2. the freeing of a nerve from adhesions." So... it means both? Not sure what you can do with that...
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  7. #1657
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    I haven't been here for a long time. I will provide with an update.

    When I was eleven years old: Right-side open hernia surgery without mesh (tissue repair, exact technique unknown) to fix an indirect inguinal hernia
    June 2018: Left-side open hernia surgery with flat mesh (Lichtenstein technique) to fix an indirect inguinal hernia

    Four-month-long break from the gym after the surgery

    Summer 2019: No pain, no discomfort. I was stronger and in better shape than before the surgery. The two-inch-long incision scar is barely visible. The only complaint is some permanent bulge in the groin, possibly the result of the buckling of the mesh. However, it seems to be only a cosmetic problem.

    August 2019: Coming from the grocery store, some hit-and-run driver hit my car on the rear side, sent it spinning, making me crash, resulting in multiple neck fractures.

    I consider myself lucky because there was no brain or nerve injury, not even a concussion, despite the heavy hit I took on top of my head. I used a collar for about seven weeks. Still some stiffness, with a permanently broken tip of a bone. However, I'm almost normal. I started lifting weights again after a five-month-long break, and I am hoping to get back to where I was. Incidentally lifting weights probably saved my life. I will take a hernia surgery any time over a car accident. I should post my neck recovery in an appropriate thread.
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  8. #1658
    Registered User Bell0c's Avatar
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    Originally Posted by drgephys View Post
    I haven't been here for a long time. I will provide with an update.

    When I was eleven years old: Right-side open hernia surgery without mesh (tissue repair, exact technique unknown) to fix an indirect inguinal hernia
    June 2018: Left-side open hernia surgery with flat mesh (Lichtenstein technique) to fix an indirect inguinal hernia

    Four-month-long break from the gym after the surgery

    Summer 2019: No pain, no discomfort. I was stronger and in better shape than before the surgery. The two-inch-long incision scar is barely visible. The only complaint is some permanent bulge in the groin, possibly the result of the buckling of the mesh. However, it seems to be only a cosmetic problem.

    August 2019: Coming from the grocery store, some hit-and-run driver hit my car on the rear side, sent it spinning, making me crash, resulting in multiple neck fractures.

    I consider myself lucky because there was no brain or nerve injury, not even a concussion, despite the heavy hit I took on top of my head. I used a collar for about seven weeks. Still some stiffness, with a permanently broken tip of a bone. However, I'm almost normal. I started lifting weights again after a five-month-long break, and I am hoping to get back to where I was. Incidentally lifting weights probably saved my life. I will take a hernia surgery any time over a car accident. I should post my neck recovery in an appropriate thread.
    Wow, man, glad to hear that your hernia recovery is solid, sorry about the wreck, but glad that recovery seems solid as well. You've had a rough time! Keep on keeping on, man. Good that you're back at the weights - best thing for it.
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  9. #1659
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    Originally Posted by Bell0c View Post
    Wow, man, glad to hear that your hernia recovery is solid, sorry about the wreck, but glad that recovery seems solid as well. You've had a rough time! Keep on keeping on, man. Good that you're back at the weights - best thing for it.
    Thanks! Taking a five-month break, wearing a collar for two months, and not eating well aggravated a shoulder injury. I don't know if the car wreck otherwise had anything to do with that (like through the impact by the seat belt). I hope it will get better.
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  10. #1660
    Registered User Bell0c's Avatar
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    Originally Posted by drgephys View Post
    Thanks! Taking a five-month break, wearing a collar for two months, and not eating well aggravated a shoulder injury. I don't know if the car wreck otherwise had anything to do with that (like through the impact by the seat belt). I hope it will get better.
    That sucks, but of course the worst thing you can do is stop working it. Take it easy, do what it lets you, and slowly and carefully increase weight and range of motion. Unless you've got a competition coming up, sustainability over time is the first priority. But I'm sure I'm preaching to the choir. Good luck!
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  11. #1661
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    Originally Posted by Bell0c View Post
    That sucks, but of course the worst thing you can do is stop working it. Take it easy, do what it lets you, and slowly and carefully increase weight and range of motion. Unless you've got a competition coming up, sustainability over time is the first priority. But I'm sure I'm preaching to the choir. Good luck!
    Yeah, lifting weights is the best thing I do for myself, helping me keep and look young and healthy. Definitely sustainability is the goal.
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  12. #1662
    Registered User JAMIEMUFF's Avatar
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    Had my right side done today at Murrayfield Edinburgh by miss Collie. She fixed my left side in 2016. Very good surgeon. Highly recommend for anyone in this area with private healthcare through work. Last time I was back lifting gingerly after 9 days. Hard getting into and out of bed for a few days but nothing horrendous. Any questions ask away. Both my hernias were small with no visible lumps but had that weird feeling like something was moving down there.
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  13. #1663
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    Does anybody have any advice on how to start working out after hernia surgery. I had my laparoscopic surgery 4 weeks ago and really want to start lifting. Which workouts should I stay away from and which should I do?
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    Originally Posted by weezyouttahere View Post
    Does anybody have any advice on how to start working out after hernia surgery. I had my laparoscopic surgery 4 weeks ago and really want to start lifting. Which workouts should I stay away from and which should I do?
    Just start everything light and use strict form so you don’t cheat and start using too much abdominal muscles while lifting. With squats and deads just be careful and listen to your body. Last time I was back after 9 days and just took care to isolate the muscle being worked. I also tried to sit while doing exercises to reduce pressure on the stomach
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  15. #1665
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    Originally Posted by ShoulderBrah View Post
    It has been about 10 months since my surgery and I am starting to do ab work. All of my lower abs are so sore, that they feel injured, probably just because I have not done any ab work at all for the past 10 months, in addition to me cautioning myself and protecting my abs in daily activities. However, I told myself that I knew that I was going to have to go through pain in my lower abs wear the 5 inch incision was made in order to make it better and stronger until hopefully one day, I won't have pain in my lower abs like I do today when I work them out.

    This is not the pain of soreness of a regular ab workout I've done prior to surgery. I am very familiar with abs workouts recovering the next day to where sneezing hurts because i worked them good the day before. haha... the pain that I experience is pain in the whole area to where it "feels" like I reinjured the area. This is why it is so hard for me mentally to get back into ab workouts again. However, I know that it needs to happen in order to keep myself safe in other lifts since core means so much in lifting weights.
    WoW, graet job
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  16. #1666
    Registered User Bell0c's Avatar
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    Originally Posted by weezyouttahere View Post
    Does anybody have any advice on how to start working out after hernia surgery. I had my laparoscopic surgery 4 weeks ago and really want to start lifting. Which workouts should I stay away from and which should I do?
    . I agree with Jamie. Being in a hurry to get back to where you were will cost you a lot of time if you tear something. Eat well, lift consistently, progress sloooowly. The things that strained my gut the most were things that stretched it, like pull-ups and overhead press. I waited a few weeks on deadlifts and did leg press machines or something, then started back light and didn't do the valsalva for months. Machines are a good way to do a lot of things since you don't need to stabilize so much (even bench press, for example, requires a tight core, so do it, but do it veeeery light - then do chest on a machine, being careful not to strain your gut too much). There are guys here who said they went back and started lifting hard after a week or something with their doctors' blessings, but I think they're the exception. For me, I took the most common advice to walk, walk, walk, a couple of times a day minimum for about 8 weeks. When you can walk a couple of miles without favoring anything, with vigor, I think that's a good sign that your gut is workably healed. Then hit the gym and start working your way back up. I'm about a year and a half post-surgery and haven't had any problems. Everybody has a different opinion though - even the doctors - so you're the one that gets to lay bets on your own gut. Good luck!
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  17. #1667
    Registered User JAMIEMUFF's Avatar
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    Originally Posted by Bell0c View Post
    . I agree with Jamie. Being in a hurry to get back to where you were will cost you a lot of time if you tear something. Eat well, lift consistently, progress sloooowly. The things that strained my gut the most were things that stretched it, like pull-ups and overhead press. I waited a few weeks on deadlifts and did leg press machines or something, then started back light and didn't do the valsalva for months. Machines are a good way to do a lot of things since you don't need to stabilize so much (even bench press, for example, requires a tight core, so do it, but do it veeeery light - then do chest on a machine, being careful not to strain your gut too much). There are guys here who said they went back and started lifting hard after a week or something with their doctors' blessings, but I think they're the exception. For me, I took the most common advice to walk, walk, walk, a couple of times a day minimum for about 8 weeks. When you can walk a couple of miles without favoring anything, with vigor, I think that's a good sign that your gut is workably healed. Then hit the gym and start working your way back up. I'm about a year and a half post-surgery and haven't had any problems. Everybody has a different opinion though - even the doctors - so you're the one that gets to lay bets on your own gut. Good luck!
    Yip your right about the machines. This is a great time to utilise them. As you mentioned bench press takes a lot of core and is actually one of the exercises that made me notice my hernia the most. Seated press is a great way to work the chest without using abdominals too much. Machines are definitely our friends in the first few weeks back training. The Coronavirus is giving me an extra reason to rest a bit longer. I don’t fancy coughing after hernia surgery. I had a lot of pain in my hip area yesterday but I think that’s due to me being heavy and walking awkwardly after the surgery along with awkward movements trying to get in and out of bed etc.
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    Registered User JAMIEMUFF's Avatar
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    Originally Posted by jamesrobert1997 View Post
    I think the main reason for this is exercising with poor posture. My friend in the gym got the same problem, but the doctor advised him for rest and he said that it does not occur suddenly, while stress for a long time can be the reason. I think proper doing exercises with consulting from coach and nutritionist can prevent this issue, while old people can be injured.
    I think it can be a genetic issue as a lot of males on my dads side have also had this. I tend to train heavy with sometimes not the best form so you may have a point. I think there is a few factors which contribute and the inguinal area seems to be the weakest area which tends to fail first.
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  19. #1669
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    Originally Posted by jamesrobert1997 View Post
    I think the main reason for this is exercising with poor posture. My friend in the gym got the same problem, but the doctor advised him for rest and he said that it does not occur suddenly, while stress for a long time can be the reason. I think proper doing exercises with consulting from coach and nutritionist can prevent this issue, while old people can be injured.
    No.

    Indirect inguinal hernias, which are the most common form, are definitely always congenital, not age- or lift-related. You're born with them. They are caused by congenitally enlarged inner inguinal rings, from which part of an intestine can protrude. I posted a scientific study proving this somewhere in this thread. I got the right-side indirect inguinal hernia (usually comes earlier) at age 10 and the left-side indirect inguinal hernia at age 45.

    Direct hernias, which are direct weakenings of the abdominal floor not involving the inguinal rings, can certainly be age- or lift-related. However, my doctor told me that all hernias were genetic and some people had weaker abdominal floors than others due to genetic reasons. Therefore, if you're genetically inclined for direct hernias, stars will align in a certain way one day and no matter how you lift, you will get them.

    Moreover, hernias happen not in the abdominal muscles but the abdominal floor, the latter of which can't be strengthened through lifting and exercise.

    Of course, good lifting techniques and form is always crucial for healthy and effective bodybuilding.
    Last edited by drgephys; 03-19-2020 at 02:09 PM.
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    Registered User JAMIEMUFF's Avatar
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    Originally Posted by drgephys View Post
    No.

    Indirect inguinal hernias, which are the most common form, are definitely always congenital, not age- or lift-related. You're born with them. They are caused by congenitally enlarged inner inguinal rings, from which part of an intestine can protrude. I posted a scientific study proving this somewhere in this thread. I got the right-side indirect inguinal hernia (usually comes earlier) at age 10 and the left-side indirect inguinal hernia at age 45.

    Direct hernias, which are direct weakenings of the abdominal floor not involving the inguinal rings, can certainly be age- or lift-related. However, my doctor told me that all hernias were genetic and some people had weaker abdominal floors than others due to genetic reasons. Therefore, if you're genetically inclined for direct hernias, stars will align in a certain way one day and no matter how you lift, you will get them.

    Moreover, hernias happen not in the abdominal muscles but the abdominal floor, the latter of which can't be strengthened through lifting and exercise.

    Of course, good lifting techniques and form is always crucial for healthy and effective bodybuilding.
    Interesting post. Now that I have had both sides repaired, am I correct in thinking they should be a bit stronger than before any hernia was present? Or am I way off and more likely to reoccur? Seem to find conflicting info on this?
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    Originally Posted by JAMIEMUFF View Post
    Interesting post. Now that I have had both sides repaired, am I correct in thinking they should be a bit stronger than before any hernia was present? Or am I way off and more likely to reoccur? Seem to find conflicting info on this?
    I don't know what the repair technique was in your case -- probably Lichtenstein -- but if the hernia repair is done right, you should never get a hernia again, especially with a mesh, which is far stronger than the human tissue. I wouldn't worry about a recurrence. Recurrence usually happens because the repair is not done right.
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    Registered User JAMIEMUFF's Avatar
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    Originally Posted by drgephys View Post
    I don't know what the repair technique was in your case -- probably Lichtenstein -- but if the hernia repair is done right, you should never get a hernia again, especially with a mesh, which is far stronger than the human tissue. I wouldn't worry about a recurrence. Recurrence usually happens because the repair is not done right.
    That’s good to know. She gave me the option of open or laparoscopic surgery both times and I told her to go with whatever she felt was best suited. She explained she felt for this kind of surgery open was far more straightforward and I got the impression she felt laparoscopy was a lot more messing around. However most literature I’ve read suggest laparoscopic techniques are much stronger.
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    Originally Posted by JAMIEMUFF View Post
    That’s good to know. She gave me the option of open or laparoscopic surgery both times and I told her to go with whatever she felt was best suited. She explained she felt for this kind of surgery open was far more straightforward and I got the impression she felt laparoscopy was a lot more messing around. However most literature I’ve read suggest laparoscopic techniques are much stronger.
    Interesting. Mine recommended laparoscopic for slightly (by one and a half days) faster healing, but I went with open. They both have advantages and disadvantages.

    Since the laparoscopic mesh is a lot larger, it covers more area, including the femoral hernias. However, you will be fine with the open Lichtenstein mesh.

    My main concern right now is the coronavirus shutdown. I took a four-month break after my surgery. I had got in top shape again in a year, but I got in a car wreck. Then I took a five-month break. I was working out for two months and getting strong and in shape again, but they closed the gyms indefinitely on Monday!
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    That’s all the gyms closed up here also. **** is getting serious.
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    Originally Posted by Bell0c View Post
    Sorry, man, I don't get notifications from this site from some reason, and I haven't checked back recently. Re: neurolysis, a google search gives this dictionary definition, "1. destruction or exhaustion of nerve tissue. 2. the freeing of a nerve from adhesions." So... it means both? Not sure what you can do with that...
    Thanks and sorry for the late reply. I decided, finally, the Dr Koch as long as it was close to where I live. I made an appointment. At the moment with all this coronavirus thing I wanted to postpone the procedure. They replied me that they already had cancelled my surgery (they cancelled without telling me, thank god I didn't go to the clinic, after 800 km, to see they already stood me up without notice). The reason was that I was insulting the doctor in the herniatlak forum. Something I never did. I checked and yes, one of my messages had been edited saying that Dr Koch is Dr Mengele or something. You can see there, all the conversation is still there. Even though I complained in that forum asking for the reason why someone with admin rights edited my messages, I never received any answer from that forum. Furthermore, the Dr Koch clinic never replied when I told them...

    So now, I have to wait and see, at least my hernia doesn't seem to get worse. I really have to be careful to what doctor I find, I really have had the jinx so far with all this thing.
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    Originally Posted by SpanishRPG View Post
    Hello,

    I have some update. I went to a different place (biohernia.com), which is the private clinic of Dr Andreas Koch (chirurgie-cottbus.com). They saw left part is ok, but right part has a recurrence although not alarming, so to speak… It’s a meshless Shouldice based procedure. Do you think I should go for it?

    In treatment plan they propose a complete mesh explantation, also a
    neurolysis of the inguinal Nerves, e.e. ileoinguinalis, ileohypogastricus and
    genitofemoralis, lysis of the spermatic cord and restoration of the
    inguinal floor with a component separation of the intern oblique
    muscle and the transverse muscle without mesh or with a
    reinforcement with long term resorbable mesh.

    Do you think this is ok? Is it necessary the neurolysis and the lysis of the spermatic cord? Does it imply losing of sensitivity and/or sexual impotence

    Thanks a lot and Best Regards!!
    That sounds too invasive on your nerves and spermatic cord. Don't do it. Find another surgeon. Conservativeness is the most important thing in hernia surgery, and his approach is the opposite with his invasive procedures. It reminds me of surgeons joking in conference talks about surgeons in the old times chopping off testicles to repair hernias.
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    Originally Posted by SpanishRPG View Post
    Thanks and sorry for the late reply. I decided, finally, the Dr Koch as long as it was close to where I live. I made an appointment. At the moment with all this coronavirus thing I wanted to postpone the procedure. They replied me that they already had cancelled my surgery (they cancelled without telling me, thank god I didn't go to the clinic, after 800 km, to see they already stood me up without notice). The reason was that I was insulting the doctor in the herniatlak forum. Something I never did. I checked and yes, one of my messages had been edited saying that Dr Koch is Dr Mengele or something. You can see there, all the conversation is still there. Even though I complained in that forum asking for the reason why someone with admin rights edited my messages, I never received any answer from that forum. Furthermore, the Dr Koch clinic never replied when I told them...

    So now, I have to wait and see, at least my hernia doesn't seem to get worse. I really have to be careful to what doctor I find, I really have had the jinx so far with all this thing.
    No, I think you got lucky to escape it!
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    bilateral inguinal hernia - first hernia - thoughts/advice?

    I’ve been blessed with my first hernia! It is a bilateral inguinal. Not sure if a direct or indirect but appears to be an indirect.

    I’m a male age 43 with low bodyfat and in very good shape, very active and enjoy working out 6 days a week. The left side hernia is very small and stays out most always. The right side is approximately 75% the size of a ping pong ball. Right side is very soft and goes in and out very easily. I experience no discomfort from the left side. I experience 15% pain which is all in the right testical…ferls like a throbbing. The right side comes out very easily with standing up to walk or immediately after meal. When it is out my right testical comes up about 1 inch. When I inhale and exhale the right side will inflate and deflate along with my right testical.

    After reading the war stories associated with mesh im convinced a pure tissue repair is best, likely the shouldice. So a few questions to help me figure out how to proceed:

    1. I’m considering watchful waiting but I’m not used to seeing my testical move when breathing like this. I’m worried waiting can cause damage to the right testical. I’m also worried waiting can give this time to get larger which prevents me the ability to have the shouldice even done. But with covid I’m scared to go to the doctor for a physical exam, diagnostic tests ( which I’m not sure which ones are best to determine if these are direct or indirect) and the fact I have no good quality hernia Doctors close by me in west virginia. General thoughts, advice?

    2. Is there a master list on the forum that has all updated surgeons who perform the shouldice repair in the USA? Would love going to the shouldice hospital but being they don’t take my insurance, united healthcare, is a pass. I know of dr Sbayi in new york but he seems too confident telling me he has performed 1000+ shouldice repairs and has a 0% reccurances and 0% complications. I’ve read good things of dr. Brown, towfigh, Grischam, and peterson. I know some of these surgeons do the repairs well but not a high volume of the shouldice specifically. Not to mention most surgeons have not been running full steam ahead with covid.

    3. Say the hernias are indirect, I believe I’m good to go with the shouldice. But confused if they are direct I’ve read mesh is best for direct bilaterals. Reading also contradicts this saying direct bilaterals are fine with the shouldice if a first time repair. Thoughts?

    General thoughts, remarks are very great appreciated! I’m close to early retirement and now spend every waking moment reading in this or holding my abdomen so it don’t get worse. Not sure which is worse, not doing my biking and workouts in fear or having this done and having complications or a recuurrance.
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    Originally Posted by naturemanmh View Post
    I’ve been blessed with my first hernia! It is a bilateral inguinal. Not sure if a direct or indirect but appears to be an indirect.

    I’m a male age 43 with low bodyfat and in very good shape, very active and enjoy working out 6 days a week. The left side hernia is very small and stays out most always. The right side is approximately 75% the size of a ping pong ball. Right side is very soft and goes in and out very easily. I experience no discomfort from the left side. I experience 15% pain which is all in the right testical…ferls like a throbbing. The right side comes out very easily with standing up to walk or immediately after meal. When it is out my right testical comes up about 1 inch. When I inhale and exhale the right side will inflate and deflate along with my right testical.

    After reading the war stories associated with mesh im convinced a pure tissue repair is best, likely the shouldice. So a few questions to help me figure out how to proceed:

    1. I’m considering watchful waiting but I’m not used to seeing my testical move when breathing like this. I’m worried waiting can cause damage to the right testical. I’m also worried waiting can give this time to get larger which prevents me the ability to have the shouldice even done. But with covid I’m scared to go to the doctor for a physical exam, diagnostic tests ( which I’m not sure which ones are best to determine if these are direct or indirect) and the fact I have no good quality hernia Doctors close by me in west virginia. General thoughts, advice?

    2. Is there a master list on the forum that has all updated surgeons who perform the shouldice repair in the USA? Would love going to the shouldice hospital but being they don’t take my insurance, united healthcare, is a pass. I know of dr Sbayi in new york but he seems too confident telling me he has performed 1000+ shouldice repairs and has a 0% reccurances and 0% complications. I’ve read good things of dr. Brown, towfigh, Grischam, and peterson. I know some of these surgeons do the repairs well but not a high volume of the shouldice specifically. Not to mention most surgeons have not been running full steam ahead with covid.

    3. Say the hernias are indirect, I believe I’m good to go with the shouldice. But confused if they are direct I’ve read mesh is best for direct bilaterals. Reading also contradicts this saying direct bilaterals are fine with the shouldice if a first time repair. Thoughts?

    General thoughts, remarks are very great appreciated! I’m close to early retirement and now spend every waking moment reading in this or holding my abdomen so it don’t get worse. Not sure which is worse, not doing my biking and workouts in fear or having this done and having complications or a recuurrance.
    Indirect hernias are more common than direct hernias. Right-side indirect hernias are more common than left-side indirect hernias. Indirect hernias are always congenital. Direct hernias are caused by aging and/or heavy lifting etc. In an indirect hernia, the hernia sac (peritoneum with intestine inside) comes through the spermatic cord, which in turn comes through a congenitally enlarged inner ring of the inguinal canal. A congenitally enlarged inner ring can cause your intestines to descend into your spermatic cord. They need to split the spermatic cord to push the contents of the sac inside and then to excise the empty sac made of peritoneum. After excising the sac, the remaining hole in the peritoneum is tied. They usually put a "purse string" around the inner ring to reduce its diameter. Then the two flaps of the mesh are wrapped around the spermatic cord at the base of the inner ring to prevent a future sac coming through. The flat part of the mesh supports the inguinal floor weakened by the indirect hernia and prevents the occurrence of a direct hernia because of the weakening. In a direct hernia, spermatic cord is not involved and the hernia sac comes through the floor of the inguinal canal where there is a tear in the transversalis fascia. In tissue repairs, tissue flaps are used instead of the mesh. Both such mesh and tissue repairs are anterior repairs because the mesh goes above the transversalis fascia (inguinal floor) or the tissue repair is done above the inguinal floor.

    It's easier to repair bilateral hernias with laparoscopic surgery because both sides can be repaired simultaneously through the same tiny incisions, whereas in an anterior repair with or without mesh, there will be two larger incisions and the procedure will be twice as long as a single-side repair. In a laparoscopic surgery, the mesh goes between the peritoneum and transversalis fascia. Therefore, it is a posterior repair.

    There is an excellent mesh made of PVDF (polyvinylidene fluoride) called DynaMesh®—Lichtenstein that doesn't have any of the possible complications of the standard PP (polypropylene) mesh, but, of course, FDA won't approve its use in USA.

    https://en.dyna-mesh.com/lichtenstein-gb/

    Surgery has always its risks, potentially serious. Currently laparoscopic surgery is recommended by the international hernia association of surgeons. It may be the best to go with a good doctor and laparoscopic surgery. A good doctor will have done at least 500 laparoscopic surgeries before he/she operates on you. At the end it's your call to choose the hernia-repair technique, and no hernia-repair technique is risk-free. If something goes wrong, you will always regret and wish you had done it another way.

    Good luck!
    Last edited by drgephys; 06-15-2020 at 11:37 PM.
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    I was diagnosed Monday with 2 inguinal hernias. After my ultrasound I went and saw my doctor. He wants to use a mesh to repair it and the surgery itself will be laparoscopic(sp)

    The one on the left is more pronounced and causes lots of pain.


    Questionsfor those who have gone through this-
    did you have testicular And lower abdominal pain?
    What other symptoms did you experience?
    If you had yours repaired with mesh-does it dissolve or is it perm?
    Do you still have pain following the surgery?
    Were there any complications?
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