In the last post I discussed the importance of getting hernias checked. This is really serious as the effect of the hernia on nerves can cause a lot of what might seem to be unrelated pain. Meaning, you can have pelvic pain as a result of hernias at your abdominal or inguinal areas. Like I said before, I only truly opened my eyes to this a few years ago thanks to my detective patients.
Before jumping into surgery to repair a hernia, it’s important to understand what can happen as a result of hernia repair. Let me preface this with one statement. I have not had any patients start with pelvic pain and then get a hernia repair to end up with more pelvic pain. I say this because of the next statement.
Hernia repairs can cause pelvic pain.
Let me repeat much of what I just said, but in a different way.
Hernias can cause pelvic pain. I’ve had patients get a hernia repair in order to reduce/eliminate their pelvic pain. I have never had a patient get a hernia repair in order to reduce/eliminate their pelvic pain and end up in more pelvic pain.
Hernia repairs can cause pelvic pain. Depending on where the hernia is located, it is very possible to develop pelvic pain as a result of the repair.
Here is why:
- During the incisions, it is possible to nick, damage or irritate a nerve that extends down to the pelvis. This can happen with any incision at any part of the body. It also happens with Cesarean scars when women deliver. A small (or large) nerve gets a little more action than it was meant to have and that nerve gets pissed. It can develop a reactionary neuroma which is like a little flower bud along the nerve now that is constantly and unnecessarily sending signals to all the remaining highways of that nerve – potentially the clitoris, penis, scrotum, testicles, close to the sit bones and anus. It just depends on which nerve gets mad. It could be the ilioinguinal, iliohypogastric or genitofemoral nerve.
- When mesh is placed, scar tissue can develop over the mesh and the surrounding nerves that can extend down to the pelvis. Scarring of the nerves reduces their oxygen intake, blood flow and their mobility. Without enough oxygen and blood the nerve has essentially become ischemic. This means the blood supply (and oxygen carried in the blood) is cut off from the nerve. This is really bad for the health of the nerve. Nerves are a small percentage of the human body, but they require an oxygen supply that is proportionately quite hefty. Without this and without proper mobility, you are going to feel pain in the pelvis.
- When mesh is placed, it can roll up a bit and irritate nerves that extend down to the pelvis. This causes all the same symptoms as reasons 1 and 2 because of the same reasons as reasons 1 and 2.
Essentially, you could have a variety of different pelvic pain symptoms resulting from a hernia repair. Person A and Person B could have drastically different symptoms depending on which nerve is mad and what part of that nerve is mad, but it’s possible that their symptoms are all a result of an imperfect hernia repair.
There are options for those dealing with pelvic pain from hernia repair and those will be discussed in the next post.
If you have any questions or comments, please leave them anonymously in the comment section below or email me at [email protected]