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Suffering from lower abdominal pain and pain in groin area. Could it be hernia?

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Gastroenterologist, Surgical
Practicing since : 1989
Answered : 883 Questions
Dear Doc, i am 30/M,6ft 80kgs from India(Coimbatore)

I used to have pain in the lower abdomen(before many years) on the groin due to my work being in the armed field, i avoided it by taking painkillers often,

Of late i have a bulge on the scrotum which decreases(becomes soft, cant say decrease) when i lie down and as i continue my physical activity during the day it bulges and there is pain in the groin(right side above the scrotal bulge),

but before 10-14 months it used to almost become normal while lying down, not anymore!

The bulge in the scrotum almost becomes to the size of an XXXXXXX and is quite evident, Now i have sharp pain on the right groin and the scrotal bulge is quite uneasy due to the size, apart from the bulge and nagging pain i do not have nausea or vomit, but can add irregular bowl movement (NOT CONSTIPATION)

Could it be hernia? if so can a laproscopy be done? how long do i have to take rest before joining my duty, since i cant stay away from my work for more than 2 weeks and it involves lot of driving for sure(car,jeep)

Please inform any professional help will be very much helpful

Right now planning to come to APOLLO CHENNAI for consultation since a doc from apollo delhi referred me to apollo chennai
Posted Wed, 25 Jul 2012 in Abdominal Pain
Answered by Dr. Ketan Vagholkar 10 hours later
Thanks for writing in.
From the description you have given , the diagnosis of this bulge is Inguinal Hernia.
As the swelling is increasing over a period of time and becoming symptomatic as well it is a clear indication for you to get operated at the earliest. Otherwise you risk the high chance of it getting complicated requiring emergency surgery with all its fallouts.
Hernia is caused due to an anatomical or structural deficiency (weakness in the bodywall). Therefore it has to be dissected well and after dealing with the bulge a reinforcing prosthesis has to be fixed to add strength to the area of weakness. Though it can be done laparoscopically evidence and results have proved that open repair is the safest , best and the recurrence rate and pain syndromes are the least.
The average stay in hospital is not more than 3 nights. But there are quite a few do's and dont's after surgery to prevent a recurrence.These have to be followed for at least 6 weeks.
I hope this answers your querry pertaining to the swelling.
With regards
Above answer was peer-reviewed by
Follow-up: Suffering from lower abdominal pain and pain in groin area. Could it be hernia? 17 hours later
dear doc, thank for your reply, i am planning to consult Dr. XXXXXXX of Apollo Chennai, He suggested me that laproscpy can be done, after reading your reply i am quite confused on how to proceed,

As my personal and official situation is i cant do the surgery for another 2 months, is there any temporary support like hernia belt or anything that will work, since as you should be aware its quite difficult to suddenly plan in our field, so i surely need atleast 45 days more, please suggest interim solution,

I hope you saw the hernia photos, do you feel its normal or the bulge quite serious, i also heard the reinforcing prosthesis differs from brand to brand and please suggest the best brand in this,

How long would it take before i can drive my car and ride my two wheeler(i own a heavy one BULLET ROYAL ENFIELD) so please suggest me on this,

i am going for brisk walk and cycling will it in anyway increase the hernia, kindly suggest diet to be followed until the surgery

Hope you can answer my queries thanks
Answered by Dr. Ketan Vagholkar 5 hours later
Thanks for the feedback.
I had seen the photos before answering your querry. In view of the large size and early onset of complications as you had described I suggested that open repair would be the safest and the best option for you.
Until you fix the surgery I would advise you to avoid any sort of physical exertion even going out for a morning walk. Besides this avoid coughing, straining at stools and lifting any heavy weights or hectic physical activity.
Hernia belt or truss was used formerly. But now it is never advised as it causes complications in the hernial contents as well as local skin complications and interferes with a meticulous dissection during surgery.
So truss is to be avoided at any cost.
You can start driving a car by 3 weeks and a two wheeler by 6 weeks. Kindly note that you may be misguided by the surgeon with regards this information. Just to lull patients few surgeons give false promises saying that you can commence your daily activities within a week which is absolutely false.
Regarding the prosthesis for open repair a poypropylene mesh marketed by J & J (ethicon) is the best.There are a few lighter products but they do not confer any additional advantages.
If it is possible for you to come down to mumbai I would ensure the best of care for you.
If you have any more doubts please write back.
I hope I have answered all your doubts.
With regards
Above answer was peer-reviewed by
Follow-up: Suffering from lower abdominal pain and pain in groin area. Could it be hernia? 13 hours later
Dear Doc, First of all i am overwhelmed by your response, accept my heart felt gratitude, I never expected such a heartwarming reply, Thank you for your invitation to your clinic as well which i would love to,

I am also worried since you said that from the photo evidence seen that the hernia is large, can i postpone it for another 45 days doc? I do have to ride my two wheeler(bullet) at-least 20kms everyday day now, is that okay? or do you advice me taking my car?

Dear Doc, as per your advice i will immediately stop all exercises and wearing hernia belt,

My diet as of now is as follows
3-4 glasses of water as soon as i get up,
then a glass of warm water with 1tsp of honey and 2tsp of lemon juice mixed

after 1 hour - 1 bowl of fruit salad with little oats and cornflakes mixed (no milk added) or bajra porridge

by 11 - a glass of Fruit juice,
by 13:00 - 2-3 slices of WHEAT BREAD or wheat upma or 2-3 chapati along with some fruit juice or veg juice,
by 16:00 - sweetcorn or XXXXXXX lea or veg/fruit juice
by 19:00 - 20:00 - 2-3 idlis or wheat dosa or chapati or wheat bread or upma
by 21:00 - 22:00 - supplement tablets, honey with lemon juice

Is this fine or do i need to add or subtract anything doc?

after your advice and invitation i am seriously considering coming to you for surgery, but my biggest barrier is my language i do not speak or understand Hindi [being a curse born in tamilnadu :( ], next thing is i can bring anyone along with me due to personal and family situation,

1.Please inform where the surgery would be done if i am to visit your place? I would prefer Apollo or your own hospital, since i can be assured of good care :)

2.Is that okay if i do not bring someone with me, can the hospital arrange someone through guest relation?

3.can i manage without Hindi?

4.How long do i have to stay in hospital or in Mumbai?

5.I would prefer staying there even if its for 2 weeks rather than take the risk of traveling after surgery and get hurt or dislocated, since i can travel all the way back from TAMILNADU for consultation if required once again.

6. Please inform whom to contact to get in touch with you for surgery, I am willing to travel all the way since i feel very lucky to have come across you and that too after your invitation i feel i should get it operated from some caring surgeon,

7. I have my STAR insurance, will your hospital accept it? even if it does not i would still love to get operated from you, please share your contact details,

Sorry for my queries but i am hopeful you will comprehend my apprehensions this being my first surgery,

please do reply to all my queries, Once again thanks and apologizes for the list of questions

Answered by Dr. Ketan Vagholkar 9 hours later
Thanks for the positive feedback.
Do not worry .I will answer all your querries sequentially.
For the time being stop travelling by 2 wheeler. car is preferable. Your diet is fine. continue with the same. You can add a stool softner to be on the safer side. (cremaffin 1 tsf at bed time )
1.Yes surgery can be done at my place. I can offer you the facility of the best corporate hospital at my place wherein the facilities will be at times better than apollo hospitals. You will be continuosly under my surgical care.
2. Yes it is advisable if you bring your spouse or any close relative with you for support.The hospital can arrange for guest accomodation easily.
3. Yes you can manage without Hindi. As it is english is effectively our national working language. In Mumbai you need not bother about language at all.
4. Since you are coming all the way from Coimbatore I would suggest that you stay till suture removal that is for about 12 days appoximately. The reason is that I will be rest assured that your wound has healed completely before discharge.
5. Your plan to stay for 2 weeks would be ideal.
6. You can contact me on my e mail or my mobile
Mobile: 0000
Address: Dr vagholkar Hospital, 229 ghantali Road XXXXXXX -0000 Maharashtra state. This place is just 45 minutes from Mumbai airport.
7. I feel that will be acceptable. But still I will confirm and let you know at the earliest.
I understand the stress you are going through. But you need not worry at all. I will help you in getting cured of the surgical problem.
With regards
Above answer was peer-reviewed by
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