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What is the treatment for pain near belly button and testicle after surgery for Inguinal Hernia?

DOCTOR OF THE MONTH - Jul 2016
Jul 2016
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Urologist
Practicing since : 1971
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A few years ago i caused my self a hernia by straining a the bowels while constapated .16 mths ago had hernia repair (apendics in scrotum) and still have same pain i had before op . Ache runs from just to right of belly button down into right testical . Had ultra sound to check repair , all ok . My consultant says i may have ilioinguinal nerve distribution pain but has discharged me from their care . I was then referred to the pain clinic and prescribed Gabapentin which i have not yet taken and do not wish to .The pain clinic doctor thinks there is a muscular component to my pain as it is aggravated mainly by movement but also thinks there may also be a neuropathic element given my description of pain being aching and burning . Im not happy with the out come of my treatment and my GP seems frustraited that i want to persue more screening to find an awnser to my pain and get it treated rather than taking drugs to hide the pain . I feel like im back at square one ive had the op but no further forward . so my question is , is it worth me persueing this maybe getting a private consultation , is there any other worth while screening i could get maybe an mri scan , can mri scan detect muscle damage or nerve damage . What do i do now any advise appreciated cheers XXXXXXX
Posted Wed, 25 Dec 2013 in Testicle Problems
 
 
Answered by Dr. P. T. Patil 7 hours later
Brief Answer: It could be due to injury to Ilio Inguinal Nerve. Detailed Answer: Hello Thanks for your query,based on the facts that you have posted it appears that you have undergone surgery for Inguinal Hernia and now getting pain near belly button radiating down to your testicle getting aggravated on movements. Some times a subcutaneous nerve IlioInguinal nerve which is there in inguinal canal gets injured during surgery while dissecting the hernial sac.The pain that you have may be referred pain along the distribution of genito femoral nerve having the same nerve root innervation . However I would suggest to get ultrasound scanning of the scrotum and colour Doppler study of the scrotum done to rule out any varicocele or pathology in testicle before going for more precise investigation like MRI. In the mean while continue taking pain killers. Hope I have answered your query. If you have any more questions please feel free to ask me I shall be happy to help you . Thanks and Regards. Dr.Patil.
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Follow-up: What is the treatment for pain near belly button and testicle after surgery for Inguinal Hernia? 42 hours later
Yes your right I had inguinal hernia repair . Im not sure that damage was done to these nerves during surgery as I have had this pain long before my op . Infact ive had it since I strained at the bowels and wonder if this caused the damage to the nerves , can this be possible . I still have the very same pain now as before op , seems like op was waste of time .I have had two ultra sounds since op to check repair and also to check testicals because I recently found lump on right testical and have also had pain in left. Lump was just a cyst and no explanation for pain in left .I do not think pain in my left testical is connected to problem with my right as they both started at different times .My GP did prescribe me antibiotics for four wks to clear pain in left but did not work . Pain in my left testical feels like its more in spermatic tubes above testical ,this pain is some times mild and can then flair up for a while and become uncomfortable , also my scrotum can become really red and can feel sticky to touch , could this be a varicocele .So since ive already had ultra sounds on testical is it worth getting mri to check for nerve and or muscle damage or should i try and get my GP to refer me back to consultant and if so would you recommend general surgeon or urologist . I hope what ive writen is clear thanks for your help XXXXXXX
 
 
Answered by Dr. P. T. Patil 4 hours later
Brief Answer: The pain is not due to straining while constipation Detailed Answer: Hello Thanks for follow up. You have done ultrasound scanning of the scrotum which shows cystic swelling on Rt side which looks to be a benign cyst called as spermatocele . As regards pain in Left side you need to get Colour Doppler study of the scrotum to rule out Varicocele. Please use scrotal support to support your scrotum that will help to relieve the pain. Please consult qualified General Surgeon or Urologist for proper evaluation and let him take the decision regarding need for MRI . Thanks and Regards. Dr.Patil.
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Follow-up: What is the treatment for pain near belly button and testicle after surgery for Inguinal Hernia? 18 hours later
I do understand that my pain is not due to straining when constipated and is because of nerve damage . The question is was damage caused by surgery as you sugest or when i strained and caused hernia . If caused by surgery then why was i in pain before surgery , as its exact same pain . Please explain , confused .Also i have had ultra sound of testicals , is Colour Doppler ultra sound a different type of ultra sound please awnser .Last question , can mri scan show nerve or muscel damage and if so can it be treated .Thanks so much for your help XXXXXXX
 
 
Answered by Dr. P. T. Patil 6 hours later
Brief Answer: Pain is not due to Nerve injury during surgery. Detailed Answer: Hello Thanks for follow up. Since you had pain before surgery it is certain that it is not due to nerve injury during surgery. Ultrasound and Colour Doppler are different test coloured Doppler reveals any vascular abnormality in blood circulation of testicles and cord. The pain that you have may be due to pulling of the mesentry or omentum due to adhesions which can be detected in MRI study.and can be treated appropriately. Thanks and Regards. Dr.Patil.
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Follow-up: What is the treatment for pain near belly button and testicle after surgery for Inguinal Hernia? 17 hours later
thanks for your awnser but could you lpease explain what pulling of the mesentry or omentum due to adhesions means and would this be in the field of general surgery or urology . thanks so much XXXXXXX
 
 
Answered by Dr. P. T. Patil 8 hours later
Brief Answer: Consult General Surgeon. Detailed Answer: Thanks for follow up. The adhesions are the band of fibrous tissue that are formed between abdominal organs which cause pulling of the organ giving rise to pain.Pain can be relieved by excision of these adhesions if the pain is very severe. Thanks and Regards. Dr.Patil.
Above answer was peer-reviewed by
 
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