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Pain on Hernia Incision

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Had an inquinal hernia. Large internal, no visible signs. Repaired with mesh in Jan 2008.

Great until May 2008, then pain. Got worse and worse over time, not at original site of hernia pain (above leg) but now on the wound itself.

Had MRI, CT, Blood tests, Ultrasound, etc. All normal. Mesh is in place. Can feel a cord (or cord like structure) right on the wound itself, like a raised structure.

Also feel dehydrated sometimes and tired. Pain when I run or walk far. BP drops on exercise a few days later to 90/60 or 100/70 (normal is 110/70)

I
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replied June 20th, 2009
Unfortunately, approximately 3% of patients who undergo inguinal hernia repair will experience chronic pain at the repair site. This is thought to occur due to damage caused to the sensory nerves in this area by the surgery, or by the body's scarring after surgery. If there is no evidence of hernia recurrence, then the initial treatment is usually a trial of anti-inflammatory medications (such as ibuprofen or naproxen), with or without low-dose antidepressant medication (used for chronic pain syndrome, and not for depression). If this treatment does not alleviate the pain, then I sometimes will inject a steroid and anesthetic solution into the scar. This often provides long-lasting (and occasionally permanent) relief. In cases where such injections provide significant relief, but the pain recurs, it may be necessary for a surgeon to go back in and intentionally cut the three nerves that are the likely cause of this pain (this usually results in numbness of the groin and upper thigh areas (but not numbness of the penis or clitoris, thankfully).

Sincerely/ Robert A. Wascher, MD, FACS
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replied June 22nd, 2009
Thanks for the reply. Much appreciated.

I am wondering:

1. Could this be an incisional hernia? I feel some sort of bumps near the wound.

2. Why the drop in BP 2-3 days after exercise?

Doctors reckon I'm very fit but the BP drop worries me.

Iain
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