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HERNIA REPAIR PAIN

Lawrenceville, NJ (Dr Simone) – I recently sent a patient to a surgeon for left inguinal hernia repair that caused severe pain (8 out of 10) after the repair in the left lower abdomen, groin and scrotum, especially at night when lying flat. He went back to the surgeon who was perplexed. The surgeon sent him to a urologist who found nothing on work-up, including an MRI. The urologist sent him to a colo-rectal surgeon who did a work-up and found nothing. Tens of thousands of dollars later, I told the patient to do sit-ups, squats, and mountain climbers. The pain abated gradually and then was completely gone. (BODY WEIGHT CONDITIONING CHALLENGE – COACH JOHN MCKENNA  http://www.simonesuperenergy.com/body-weight-conditioning-challenge-coach-john-mckenna/ ) 

About 15% to 20% of people who undergo inguinal hernia repair experience pain probably due to damage or entrapment of nerves in the mesh of the repair. 

PAIN IN THE SKIN OF THE UPPER AND INNER THIGH, ROOT OF THE PENIS AND UPPER SCROTUM (men), MONS PUBIS AND LABIA MAJORA (women) is from damaged or entrapped ilioinguinal nerve.

PAIN IN THE SKIN OF BUTTOCKS (sides) AND MUSCLES OF THE ABDOMEN is from damaged or entrapped iliohypogastric nerve.

PAIN, WEAKNESS, OR NUMBNESS OVER THE LOWER ABDOMEN, mostly on one sideGROIN, INNER THIGH, SCROTUM, LABIA MAJORA is from damaged or entrapped genitofemoral nerve. This nerve can intertwine with the ilioinguinal and iliohypogastric nerves. PAIN IS WORSE WHEN LYING FLAT (extension of spine) OR WHEN PRESSING ON THE GROIN OVER THE INGUINAL AREA and LESS SEVERE WHEN FLEXING THE SPINE (pillow under leg when lying flat, or sitting). 

Traditional treatment: Amitriptyline either alone, or in combination with Methylprednisolone/Chirocaine in few patients with good results. 

Exercise – sit-ups, squats, and mountain climbers.

 

(c) 2017 Charles B. Simone, M.MS., M.D.