The two major causes of groin pain in men are not just inguinal hernia but also the long-term effects of hernia repair surgery. Until recently, most men have taken it for granted that at the first sign of an inguinal hernia, your medical team whisks you off for surgery as soon as possible, and you resume a normal life within a few weeks.
But medical views are changing, and you may find that your doctor or surgeon is no longer quite so keen to recommend an operation if your hernia is small or asymptomatic.
The fact is that hernia repair surgery is not as safe as was once believed. Recently published statistics are showing that up to 30 per cent of these operations can lead to complications such as long-term pain and sexual dysfunction. And these statistics are not just coming out of one or two medical centres. They are a worldwide phenomenon, with similar figures having so far being reported in the US, UK, Sweden and the Netherlands.
It’s great if you don’t end up as one of these statistics, but, as one surgery-damaged person has put it, “Your operation may go well. However it may also go badly, but there is no returning to your pre-operative state.”
Severe, chronic pain is the most serious complication reported after inguinal hernia surgery. This problem has been estimated to affect over 60,000 patients per year in the US. Yet the reason is still not clear. Surgeons are still debating whether these pain syndromes are caused by the skin incision, by inflammation, damage to the muscle, or to the nerves. Sometimes the pain clears up, but in many cases it is still present six years later. (Six years is the longest follow-up study which has been carried out so far.)
Personal accounts of these post-operative horrors are now appearing on the internet. It is both sad and worrying to read how young mens’ lives have been destroyed by this operation. They have nothing left to look forward to but a lifetime of painkillers; but with this particular type of pain, even morphine can be ineffective.
Surgeons should warn of the possible consequences
In the words of a professor of surgery from the world-renowned Radcliffe Infirmary in the UK: “Why would someone with an asymptomatic inguinal hernia trade that state for a chance to have chronic pain, hypoesthesia or any degree of sexual dysfunction? Surely this is a clinical situation for which joint decision-making is appropriate. The patient decides but the surgeon offers, rather than recommends an operation”. Professor Meakins goes on to comment that a surprising number of his patients terminate the consultation immediately on hearing of the potential consequences of this operation.
It is time for all doctors and surgeons to be more open and honest. Many are indeed changing their strategy and now advocate “watchful waiting” instead of immediate surgery. Watchful waiting consists of monitoring the hernia with a view to delaying surgery for as long as possible. Research is showing that this approach can work very well and does not put the patient at risk. It may take 20 years for the hernia to become so uncomfortable or painful that the risk of surgery becomes worthwhile. In the meantime you can have 20 years of relatively normal life.
A hernia support can improve your quality of life
With the advent of watchful waiting, many doctors are now beginning to recommend wearing a hernia support or truss to keep the hernia in. The right kind of truss can make a real difference to your quality of life while you are living with a hernia. Most people report that they have much less discomfort and more energy. Some men also report that their hernia is healing on its own, especially if they also improve their diet and strengthen their abdominal muscles with exercises.
The type of truss is also important. Some trusses have hard, rounded pads which can dig into a hernia and possibly enlarge it. This can cause scar tissue to form around the edges of the hernia and prevent your hernia from healing itself, as scarred hernia edges cannot knit back together again.
My hernia is so small, do I really need to wear a support?
Most of the men who have reported curing their own hernia have worn a support. A good support keeps the intestine inside, where it belongs. If intestines continue to protrude through a tear or rupture in the abdominal wall, they prevent that tear or rupture from healing itself. It’s like trying to heal a cut while keeping your finger permanently in it.
To be effective, your hernia support or truss must have pads that remain in contact with your hernia at all times. Most trusses cannot follow body movement and so fail to do this. That is one reason why they are not often prescribed. You should try to find a support that has flat pads which move with the body and slide together in such a way that the hernia area is supported at all times, even while running, cycling or swimming.