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What Causes Muscle Spasm And Nerve Entrapment During Masturbation After Hernia Surgery?

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Posted on Wed, 29 Apr 2015
Question: i had open hernia surgery two weeks ago, masturbation is extremely painful and causes swelling in scar area
it was 14 days after open hernia surgery (mesh) and i hardly had any pain left and almost no swelling left. I masturbated and upon ejaculation i had a sharp pain at the area of the incision, it felt like it was contracting. It was very painful. Then the pain started and the the area began to swell. It is still swollen up to today (a little bigger). And it has been painful. The area is also numb.

Today the pain was much reduced, but the swelling remained. I was a little curious and had an urge, so i 'played with myself' a bit to the point of erection and some excitement. I did not masturbate to the point of ejaculation. But there was excitement. This caused a LOT of pain to the swollen area (where the incision is, just above the penis and to the right). Also, the right testicle hurts and is a little swollen now.

Why is this happening? My doctor is on leave and wont be back until Thursday. I will see him on Thursday. I spoke to the nurse on the phone who said it sounds like i have fluid inside and that the doctor will have to remove it.

Please advise
doctor
Answered by Dr. T Chandrakant (1 hour later)
Brief Answer:
Muscle spasm and nerve entrapment.

Detailed Answer:
Hi.
Thanks for your query and an elucidate history.

Read and understood the history and your concerns.
This is very uncommon for getting such a pain and swelling after 14 days of Hernia open surgery with mesh repair after excitement and actual masturbation.

The most probable causes are:
The excitement and height of excitement in the form of ejaculation cause the lower abdomen muscles to go into rhythmic spams / contractions. This can cause the muscles to have small tear to cause hematoma and the resultant swelling and pain.

Hernia surgery needs lots of dissection for the mesh to be placed properly and stitching is required to do anatomical repair as well as fixing the mesh.

The nerves can get overstretched due to spasmodic activity of the lower abdominal wall muscles. Or can be entrapped somewhere along the course.
This can give referred pain to the testis.

The right testicle can be tender with mild swelling due to the migration of the fluid and the local swelling which can come by the mild infection also.

I would advise you the following:
- Ultrasonography and color doppler of abdominal wall and the scrotum.
- Strict bed rest till diagnosis
- Scrotal Support.
- Anti-inflammatory medicines Ike Ibuprofen .
- And obviously no masturbation till the problem is solved.

Consult the Surgeon ASAP for examination and further management as required.

I hope this answer helps you to get a proper diagnosis, and get a proper further treatment. Please feel free to ask for more or if you need further clarifications or if you feel there is a gap of communication.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. T Chandrakant (17 minutes later)
I have an appointment with my surgeon on Thursday afternoon. is that too late? the pain has somewhat reduced with the cataflam. I dont want to go to emergency since I think I need my surgeon.
doctor
Answered by Dr. T Chandrakant (8 minutes later)
Brief Answer:
Yes, you can wait if no other symptoms.

Detailed Answer:
If there are no other symptoms like pain inside of abdomen, bloating, nausea, vomiting or so on you can certainly wait for your Surgeon till Thursday.
Please continue cataflam thrice daily after some food. You can take some PPI like Pantoprazole to avoid acidity.

(You may please rate this answer before closure of the discussion and can certainly contact me on the bellow link in future, whenever you may need me.
http://bit.ly/askdrtchandrakant)
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. T Chandrakant (6 hours later)
Thank you for your very clear responses. The swelling has gotten a little more but I am managing uncomfortably until I see the doctor. Can he simply take out the fluid with a needle or does it require more invasive measures?
doctor
Answered by Dr. T Chandrakant (17 minutes later)
Brief Answer:
Any other symptoms ?

Detailed Answer:
Hi.
First of all, Your Surgeon will confirm whether this is just an edema or something else. He may aspirate only if he feels the fluid is more.
Most probably the treatment would be conservative.

Is the swelling stationary, I mean is the swelling increasing on coughing and reducing on lying down?

Is it hard or boggy feeling ?
How much is the pain?
I hope you do not have any other symptoms I mentioned above.

you can attach a Photograph if you can at
YYYY@YYYY
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. T Chandrakant (11 minutes later)
The swelling is stationary ..but getting slightly bigger right around that same spot. The area feels numb.
The swelling is firm (not hard). You can press on it and it will do in and then bounce back in a firm way. (not soft or squishy, but firm and will bounce back like a sponge)

The pain is minimal after pain killer. It was really intense after sexual excitation - felt like a contraction pain, like tightening and pulling. pulsing pain.

It is minimal sitting down. But when i stand, it hurts a bit cuz it fees like its stretching. And when i lie down, it pains too since it feels like its pulling





doctor
Answered by Dr. T Chandrakant (16 minutes later)
Brief Answer:
Try to see if it increases on coughing, if yes, please visit ER

Detailed Answer:
Thanks for your feedback.
I was asking these questions just to know whether there is a recurrence of hernia, as this is also one small, very small possibility. In this condition there will be more popping or enlargement on straining and coughing.

The numbness is due to the nerve stretching and cutting and will go away.
If the swelling is not increasing on slight coughing and straining and is as you explained this can be fluid (seroma), and not a major issue.
If it is increasing on coughing or straining it is better to get a consultation at ER, this helps to reduce the stress one gets on such occurrences. and better to take extra care to know the exact diagnosis on examination by a Doctor.

The intense pain on with sexual excitement was there as the nerves are so nearby and connected to each other. It is possible that the masturbation would have been a bit more intense as there was a big gap.

please give feedback.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. T Chandrakant (5 minutes later)
Thank you doctor.

your answers make a lot of sense and seems spot on.

I am not getting any further swelling coughing or straining. (well to be honest i avoid coughing so i really cant say)

I guess i just want to get this fluid (as i believe you are right in that) out of me and to be healed.

I am also concerned about whether I will be able to have normal sexual activity soon. The intense pain with masturbation/excitement really frightened me.
doctor
Answered by Dr. T Chandrakant (7 hours later)
Brief Answer:
Do not be worried so much, everything gets healed up well.

Detailed Answer:
You are most welcome and thanks for appreciation.

Yes, I can understand that you are avoiding coughing, in fact the best post-operative care is to avoid coughing, straining, weigh-lifting or any activity that can increase the tensions on the abdominal muscles.

I asked you to cough only to see if the swelling increases on coughing as a test of recurrence. Well, if no such increase in swelling, this is a good sign.

If this is just seroma, it will heal nicely.
Let you wait for a few weeks for the things to get settled before trying to have masturbation or sex. I know it is a bit problematic now, but there is a full life ahead. Once all the things settle well, I am sure there will be no such problems in future.

Please keep me posted about the actual diagnosis and the management that will be done soon.

Wishing you a great recovery.

(You may please rate this answer before closure of the discussion and can certainly contact me on the bellow link in future, whenever you may need me.
http://bit.ly/askdrtchandrakant )

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. T Chandrakant (1 hour later)
Dear Doctor

I am uploading a picture for you to see. please comment
doctor
Answered by Dr. T Chandrakant (8 minutes later)
Brief Answer:
looks to be fluid collection

Detailed Answer:
From the picture this looks to a seroma (fluid) collection, just a fluid of the blood; there is no redness of the skin.


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. T Chandrakant (8 minutes later)
Thanks doctor. I has gone down a little since last night.

I will let you know what happens when i see my doctor tomorrow and then i will close this thread.

You have been invaluable.
doctor
Answered by Dr. T Chandrakant (1 hour later)
Brief Answer:
Please let me know.

Detailed Answer:
My pleasure.
Thanks for your appreciation.
Just relax, take care.
No hurry to close the thread till you are alright.
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. T Chandrakant (27 hours later)
I just came back from the surgeon. he took a quick look at it and touched it. he said that it isn't fluid. that's it's normal swelling that will go down. he said he can prescribe pain killers if the pain is severe. so I just have to wait it out it seems
doctor
Answered by Dr. T Chandrakant (11 minutes later)
Brief Answer:
Take Ibuprofen 8 hourly (thrice daily) after food and with Ranitidine / PPI

Detailed Answer:
OK !

Noted your visit with your Surgeon- looked - touched - says normal swelling that will go down - can prescribe painkillers.

In such a situation, I would advise you to take Ibuprofen or such medicines which have the the properties of anti-inflammatory (to reduce swelling) in addition to the painkiller properties. This will help to get the swelling reduced as well as control the pain. This will also be helpful for the fluid to get absorbed is present.

Avoid:
Exertion
Masturbation, sex.
Any activity that increases strain on abdominal muscles.
Constipation
Coughing

Take full bed rest for a few days till the swelling is settled well and the symptoms are abated.

I hope the swelling must be lesser today.




Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. T Chandrakant (12 minutes later)
Thanks doctor. I have ibuprofen and will use it as you described.

doctor
Answered by Dr. T Chandrakant (5 minutes later)
Brief Answer:
Wishing you an early recovery.

Detailed Answer:
Do not worry, this will settle down.
Take Ibuprofen 400 mg at 8 hourly duration.

Please let me know the progress.


(You may please rate this answer before closure of the discussion and can certainly contact me on the bellow link in future, whenever you may need me.
http://bit.ly/askdrtchandrakant )
Note: For further inquiries on surgery procedure and its risks or complications book an appointment now

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
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Dr. T Chandrakant

General Surgeon

Practicing since :1984

Answered : 19777 Questions

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What Causes Muscle Spasm And Nerve Entrapment During Masturbation After Hernia Surgery?

Brief Answer: Muscle spasm and nerve entrapment. Detailed Answer: Hi. Thanks for your query and an elucidate history. Read and understood the history and your concerns. This is very uncommon for getting such a pain and swelling after 14 days of Hernia open surgery with mesh repair after excitement and actual masturbation. The most probable causes are: The excitement and height of excitement in the form of ejaculation cause the lower abdomen muscles to go into rhythmic spams / contractions. This can cause the muscles to have small tear to cause hematoma and the resultant swelling and pain. Hernia surgery needs lots of dissection for the mesh to be placed properly and stitching is required to do anatomical repair as well as fixing the mesh. The nerves can get overstretched due to spasmodic activity of the lower abdominal wall muscles. Or can be entrapped somewhere along the course. This can give referred pain to the testis. The right testicle can be tender with mild swelling due to the migration of the fluid and the local swelling which can come by the mild infection also. I would advise you the following: - Ultrasonography and color doppler of abdominal wall and the scrotum. - Strict bed rest till diagnosis - Scrotal Support. - Anti-inflammatory medicines Ike Ibuprofen . - And obviously no masturbation till the problem is solved. Consult the Surgeon ASAP for examination and further management as required. I hope this answer helps you to get a proper diagnosis, and get a proper further treatment. Please feel free to ask for more or if you need further clarifications or if you feel there is a gap of communication.