Patients often come see Dr. Jacob after experiencing chronic pain for weeks after a hernia repair. They are typically at their wit’s end, wondering why they had hernia surgery at all if this level of pain was the result. Dr. Jacob has extensive experience addressing this kind of pain in patients. Sometimes a hernia mesh, tack, or suture implant can be the cause of the pain.
That’s not to say that this is the norm. The overwhelming majority of mesh, tack, and suture implants used in hernia repair don’t cause any harm or pain. But in some cases, these implants are behind the pain, and it is necessary for Dr. Jacob to remove them.
What is chronic pain?
After repair surgery for an inguinal hernia, there will be some mild to moderate incisional pain and mild groin discomfort. This may last from 2-14 days, but the pain is almost always gone by the third or fourth week after surgery. This enduring pain may be due to the mesh material or tacks used in the surgery.
If the patient has dealt with pain for at least 12 weeks, this is classified as chronic pain.
What are the surgical treatment options for addressing chronic pain?
After hearing your detailed history of your pain and hernia surgery, conducting his own physical examination, and possibly ordering diagnostic imaging, Dr. Jacob may consider various surgical options to resolve your pain:
These may include:
- Hernia mesh removal
- Suture and surgical tack removal
- Recurrent hernia repair
- Removal of lipoma
- Spermatic cord adhesiolysis
- Neurectomy (nerve removal)
Nerves behind the pain
When searching for the nerve causing the patient’s chronic groin pain, Dr. Jacob will look at these six nerves:
- Lateral femoral cutaneous nerve — If irritated, the patient may have pain or hypersensitivity along the lateral thigh.
- Genitofemoral nerve — Irritation of this nerve is perceived through a hypersensitive scrotum in men and hypersensitive labia majora in women.
- Femoral nerve — If irritated, the patient’s leg muscles may feel heavy or weak, with possible pain along the leg.
- Iliohypogastric nerve — Pain or sensitivity to the suprapubic region or groin accompany injury to this nerve.
- Ilioinguinal nerve — Rare injuries to this nerve lead to pain or hypersensitivity to the medial thigh, shaft of the penis, or groin.
- Paravasal nerve fibers — Irritation of these nerve fibers will cause testicular discomfort.