Post-Operative Concerns After Open Plug/Mesh Inguinal Hernia Surgery

Open mesh repair for inguinal hernia surgery?

Hello, doctor.
May I ask you a few questions? After an open mesh inguinal hernia repair surgery: 1) Ten days post-surgery, the white blood cell count (10.99) has increased, and the neutrophil (88.4%)/lymphocyte (7.7%) ratio (11.48) is still high.
How long will it take for these levels to start decreasing? (Before the surgery, my annual WBC was stable, with white blood cells at 6.5, neutrophils at 60%, and lymphocytes at 30%.) 2) The surgical incision has not been painful since the operation? 3) The area affected by the surgery has experienced an increase in neuropathic stabbing pain in both range and intensity compared to pre-surgery, and it is persistent throughout the day.
Is taking pain medication the only option? It seems to have little effect.
4) Is it still possible to remove the plug/mesh? The discomfort from the nerve pain is significantly greater than before the surgery and has lasted longer.
5) My testosterone level was 600 pre-surgery and dropped to 169 ten days post-surgery.
This should not be a concern, right? (All tests were done at a lab since the hospital is too far away.) Thank you.

qoo, 40~49 year old female. Ask Date: 2023/02/27

Dr. Chen Jiaming reply Surgery

It is advisable to consult the original surgeon regarding postoperative clinical issues.
Each individual's recovery after surgery varies, and there is no absolute standard.

Reply Date: 2023/02/27

More Info

After undergoing open plug/mesh inguinal hernia surgery, it is common for patients to have a range of post-operative concerns, including changes in white blood cell counts, pain levels, and recovery experiences. Let’s address each of your questions based on medical knowledge and typical post-operative expectations.

1. Increased White Blood Cell Count: It is not unusual for white blood cell (WBC) counts to be elevated after surgery, as this can be a response to surgical stress, inflammation, or infection. A WBC count of 10.99 is slightly elevated compared to your baseline of 6.5. The neutrophil percentage is also elevated, which can indicate an acute inflammatory response. Typically, WBC counts begin to normalize within a few days to weeks post-surgery, depending on the individual’s healing process and any underlying conditions. If there are no signs of infection (such as fever, increased pain, or discharge from the surgical site), this elevation may be a normal part of your recovery.

2. Absence of Pain at the Surgical Site: The fact that you do not experience pain at the surgical site can be a positive sign of healing. However, it is essential to monitor for any changes, such as the onset of pain, redness, or swelling, which could indicate complications. Pain levels can vary significantly among individuals, and some may experience minimal discomfort while others may have more pronounced pain.

3. Neuropathic Pain: The increased intensity and frequency of neuropathic pain you are experiencing post-surgery can be concerning. This type of pain may arise from nerve irritation or damage during the surgical procedure. While pain medications can help, they may not always be effective for neuropathic pain. It is advisable to discuss this with your surgeon, as they may consider prescribing medications specifically for nerve pain, such as gabapentin or pregabalin, which can be more effective than standard analgesics.

4. Removal of Plug/Mesh: If you are experiencing significant discomfort or pain that you believe is related to the mesh or plug, it is crucial to consult your surgeon. While it is technically possible to remove the mesh, this decision should be made carefully, considering the risks and benefits. Mesh removal can lead to complications such as recurrence of the hernia or additional surgical risks. Your surgeon will evaluate your symptoms and may recommend imaging studies to assess the situation before making a decision.

5. Testosterone Levels: A drop in testosterone levels from 600 to 169 post-surgery can be concerning, but it is essential to consider the context. Surgical stress, pain, and recovery can temporarily affect hormone levels. If you are not experiencing symptoms of low testosterone (such as fatigue, depression, or decreased libido), this may not be an immediate concern. However, it would be wise to follow up with your healthcare provider for further evaluation and monitoring of your hormone levels.

In summary, post-operative recovery can be complex, and individual experiences may vary widely. It is essential to maintain open communication with your healthcare provider regarding any concerns or symptoms you experience. Regular follow-up appointments can help ensure that your recovery is on track and that any complications are addressed promptly. Always prioritize your health and well-being, and do not hesitate to seek medical advice when needed.

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