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Your Guide to Understanding Sports Hernias and the
 Medical Treatment of
 Sports Hernias
by William Brown, MD
Advanced Medical Treatment for Sports Related Hernias

Your Important Questions Answered

I understand you have questions and concerns about the sports hernia surgical procedure.  Please click on a topic of interest below to learn more.  And if your question is not addressed, please contact me.

Do I have to be asleep for the operation?

There are two excellent options by which the operation can be performed:

One is local anesthesia with sedation, during which time the anesthesiologist uses intravenous medication to calm the patient. Then local anesthetic is injected into the operative site. The local anesthetic does burn initially, but it becomes effective within several seconds and then the operation can be proceed. The advantage of local anesthesia with sedation is that the patient feels no nausea or other side effects. After surgery the patient can leave the surgery center almost immediately. The local anesthetic blocks any pain for about eight hours.

Two is general anesthesia. General anesthesia involves going to sleep. The anesthesiologist gives medicine through the IV and then a tube is put in the airway to support breathing during the operation. Local anesthetic is still injected into the operative site to control postoperative pain. General anesthesia is best for patients who are very anxious and do not want to be aware of anything. There may be some feeling of being drugged after the operation.

Both general anesthesia and local and local anesthesia with sedation are very effective; both choices are good. For a redo operation general anesthesia is probably the best.

Will I be 100% after surgery?

About 90% of athletes are able to return to their original sport with minimal or no pain.

About 5% of patients are significantly better but still have a moderate amount of pain with sports.

A few patients still have pain that limits their ability to play sports.  This can be a difficult problem.  But I will continue to work with you until we have a satisfactory solution.

I wish I could give you guarantees but I cannot.

How long does the operation take?

The operation takes about forty minutes.

Do I have to be shaved?

Some pubic hair has to be removed to provide adequate exposure. Shaving is kept to a minimum.

Do the sutures dissolve?

The deep sutures are usually permanent. The sutures used to close the skin are buried underneath the skin and dissolve within a few weeks. They do not need to be removed. These suture are not visible.

Will there be swelling after the surgery?

For a few days the area will be swollen because the of operation itself. Swelling can be kept to a minimum by using ice. After about a week the body will start laying down healing tissue. This will feel like a firm lump underneath the incision. This is called the “healing ridge.” The “healing ridge” will be mildly tender and will persist for about four weeks until it is reabsorbed.

Will there be bruising?

Even a small amount of blood can cause a large bruise. The bruising is usually just in the groin area, but can extend into the scrotum or onto the thigh. It resolves in a few weeks.

Is infection a concern?

Infections are extremely rare.

What does the round ligament do?

In women the round ligament travels through the operative field. The round ligament supports the uterus. It can be left in place or divided. If it is divided then it should be sewn to the abdominal wall so that the uterus does not lose this important suspensory ligament

How soon before I can resume sexual activities?

Sexual activities can start any time after surgery. Try to limit sex to once a day until you feel stronger.

How soon before I can resume normal housekeeping duties?

Women can start housekeeping right away. Men should avoid dishwashing or vacuuming for at least six weeks after surgery. 🙂

What is mesh and do you use it?

Mesh is a synthetic material that looks like very fine fishing net. It can add strength to the groin after surgery. But the mesh can also cause significant problems. The most common problem is pain. The pain is the result of a nerve becoming adhered to the mesh or the result of the mesh become stiff from fibrosis. Thus, unless absolutely required, I do not advise the use of mesh.

What are the possibilities of complications from the surgery?

Complications are rare.

Can a groin injury recur?

Athletes by their nature want to continue to participate in sports.  And thus athletes are prone to injure themselves.  The strength of my repair will not be better than what God gave you originally.  The chance that you will develop a recurrent injury at the same site that requires surgery is about 4%.

Thinking of having a vasectomy?

The vas deferens travels through the operative field and can be easily divided during groin reconstruction. It does not increase the postoperative pain, and does not increase significantly the operative time. If you are considering a vasectomy, this is a good time to have it done.

How do I find a local surgeon?

Your best chance to find a local surgeon familiar with the treatment of a sports hernia is to contact your local professional soccer or hockey team and ask them who they use.  Other experts in the field are Dr. William Meyers in Philadelphia,  Mr. Simon Marsh at the Gilmore clinic in London, and Dr. Ulrike Muschaweck in Munich.

If I come to California, how long do I have to stay?

Athletes who come to see Dr. Brown are examined and evaluated on the first day. Surgery is scheduled for the second day. The athlete returns home on the third day.

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