Is Your Surgeon Recommending the One Best For You?
Once your hernia is diagnosed, the conversation turns to how is it going to be repaired. There are several methods to repair a hernia and your surgeon should be skilled in and familiar with them all.
There is no right hernia repair technique that applies across the board. The right method depends on several factors, including the type of hernia you have, your unique anatomy, and the extent of the hernia.
In general to repair an indirect inguinal hernia, the Marcy technique is a good option that gives excellent results and minimal postoperative pain.
For direct inguinal hernias, your surgeon might recommend the Bassini, the Shouldice or the Desarda techniques.
The Bassini method is a good option if your inguinal canal is weak, but not completely torn. Expect a little more tension and pain with this repair compared to other methods.…
What Roles Nerves Play in Your Hernia Repair Surgery
Your nerves are what give you sensation. During surgery it is important not to damage the nerves. Here’s what you need to know about the three major nerves in the inguinal area before you head into surgery for hernia repair:
What are the Three Major Nerves?
- Iliohypogastric nerve: provides sensation to the pubic hair area and the upper part of the scrotum or Mons.
- Ilioinguinal nerve: provides sensation along the inguinal ligament, on the inside of the upper thigh, and on the outside of the scrotum or Mons.
- Genital nerve: provides innervation to the cremasteric muscles and sensation to the testicle or labia majora.
Some Hernia Repair Surgeons Advise Cutting the Nerve
Some surgeons routinely cut the nerves during a hernia repair with the thought that it decreases pain after the operations. Yes, cutting the nerves eliminates some pain, but also…
Hi Dr. Brown,
My surgeries turned out incredible; I’m able to run full speed with no pain.
You’re the man!!
In April 2017 I began experiencing lower abdominal pain and testicular pain which became progressively worse over the following months. I live in the New York city area and sought help from various highly regarded doctors, orthopedists, urologists and physical therapists but none were been able to diagnose or resolve my issues. As a fairly competitive athlete (long-distance runner) and highly active person (rock climbing and mountaineering) this was extremely frustrating and disappointing for me. In conducting my own research online of my symptoms, I kept on coming back to Dr. Brown’s wonderfully informative and comprehensive website. The description of a sports hernia fit precisely with my condition. I contacted Dr. Brown in November 2017 to seek his thoughts and I was immediately impressed with his responsiveness, thoughtfulness, knowledge and willingness to give me advice. In December 2017 I finally decided to make travel to California to see Dr. Brown…
What Happens to the Cremasteric Muscle During Non-Mesh Hernia Repair Surgery?
Perhaps your surgeon mentioned the cremasteric muscle when discussing your hernia repair surgery. The cremaster muscle surrounds the spermatic cord and runs from the internal inguinal ring to the testicle. The cremasteric muscle has two important jobs:
- It pulls the testicles closer to the body when they are exposed to cold.
- It brings the testicles closer to the body during sexual intercourse.
However, since it is a muscle, it has the potential to add volume around the spermatic cord and thereby make it more difficult to get a tight hernia repair.
Options for Addressing the Cremasteric Muscle
Removing it: There are surgeons who routinely remove the cremasteric muscle during hernia repair surgery, which results in a tighter repair. However, removing this muscle means it can no longer do its job of pulling the testicles closer to the body in…
I know I haven’t been great about checking in, so I wanted to drop you a quick note.
Overall all, things have been really good. I still have some numbness and sensitivity around the incision, and what I would call “tenderness,” but most days I more or less forget that anything happened.
The other reason for reaching out is that I wanted to say thank you for the excellent quality of care I have experienced throughout this entire process. I really don’t think I’ve said that enough.