Post-Surgery Pain Months After Inguinal Hernia Repair: What to Know

Pain sensation months after hernia surgery?

Hello Dr.
Chen,
I underwent inguinal hernia surgery last September and opted for traditional surgery with self-paying absorbable mesh.
Recently, I occasionally experience pain when moving the wound, and if I lean forward too much, I feel a pressure sensation inside the wound.
When I press on the wound, it feels as if the muscle layer has been cut open, which is different from how it felt before when I touched the wound.
I'm wondering if traditional hernia surgery involves suturing the muscle layer.
Thank you, Dr.
Chen.

Xiao Ya, 50~59 year old female. Ask Date: 2020/07/27

Dr. Chen Jiaming reply Surgery

The materials and special designs of synthetic mesh used in modern hernia surgeries vary widely.
Although some claim to be "absorbable," the primary purpose of using synthetic mesh is to create an adhesion effect with the surrounding native tissue upon implantation, thereby forming a robust tissue plate that reduces the likelihood of recurrence.
However, this strong plate did not originally exist in the body, so it requires a period of time to gradually adapt and integrate.
As you described, certain specific positions or pressure may cause abnormal sensations or pain, which are quite common experiences.
The first layer you touch beneath the incision is the fat layer, and it is common to find small defects in the fat layer that have not fully healed postoperatively, with scar tissue underneath that is difficult to smooth out.

Reply Date: 2020/07/27

More Info

After undergoing inguinal hernia repair surgery, it is not uncommon to experience lingering pain or discomfort months after the procedure. This can be particularly true if the surgery involved the use of absorbable mesh, as the body takes time to heal and adapt to the changes made during the operation.
Inguinal hernia repair typically involves the surgeon making an incision in the groin area, where the hernia is located. The surgeon then pushes the protruding tissue back into place and reinforces the abdominal wall, often with mesh. The mesh serves to provide additional support and reduce the risk of recurrence. However, the healing process can vary significantly from person to person, influenced by factors such as age, overall health, and adherence to post-operative care instructions.

The pain you are experiencing, especially when moving or pressing on the area, could be attributed to several factors:
1. Nerve Regeneration: After surgery, nerves that were cut or manipulated during the procedure can take time to heal. This can lead to sensations of pain, tingling, or discomfort as the nerves regenerate. It is not uncommon for patients to experience nerve-related pain for several months post-surgery.

2. Scar Tissue Formation: As the body heals, scar tissue forms at the surgical site. This scar tissue can sometimes adhere to surrounding tissues, leading to discomfort or a sensation of tightness, especially during movement. The presence of scar tissue can also affect the way muscles and tissues function, potentially causing pain when the area is stressed.

3. Muscle Layer Healing: In traditional hernia repair, the surgeon typically sutures the muscle layers back together. If you are feeling a sensation akin to "cutting" or "pulling" in the muscle layer, it may indicate that the muscles are still healing or that there is some tension in the area. It is essential to allow adequate time for the muscles to heal properly.

4. Post-Surgical Complications: While less common, complications such as infection or hernia recurrence can occur. If the pain is severe, persistent, or accompanied by other symptoms such as swelling, redness, or fever, it is crucial to consult your surgeon for an evaluation.

In terms of recovery, it is essential to follow your surgeon's post-operative care instructions closely. This may include avoiding heavy lifting or strenuous activities for a specified period. Gradually increasing your activity level as tolerated can help improve strength and flexibility in the area.

If you find that the pain persists or worsens, it is advisable to schedule a follow-up appointment with your surgeon. They can conduct a physical examination and may order imaging studies if necessary to assess the surgical site and ensure that there are no underlying issues contributing to your discomfort.

In summary, while some discomfort after inguinal hernia repair is normal, especially several months post-surgery, it is essential to monitor your symptoms closely. If you have concerns about the nature or severity of your pain, do not hesitate to reach out to your healthcare provider for further evaluation and guidance.

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