Post-Hernia Surgery Pain: Is It Normal or a Sign of Complications?

Q: Post-Hernia Surgery Pain: Is It Normal or a Sign of Complications?

Confused Medical Student： Hello, after general surgery, it typically takes about six months for the wound to regain approximately 90% of its original tensile strength. <br>As for the fibrotic response, it generally depends on the individual's constitution; some people may take a

Hernia?

Dear Dr.
Hsu,
I would like to seek your professional advice again.
My original question: I underwent hernia repair surgery (inguinal hernia) in mid-February of this year, without the use of a synthetic mesh.
It has been nearly four months since the surgery, but the surgical site still experiences a dull pain.
This pain is not from the incision itself but rather a sharp sensation from the internal tissues.
Sometimes, when sitting for a long time or wearing jeans, the pain intensifies.
I am unsure why this is happening after such a long time.
Is this normal, or is there a possibility of recurrence?
From what I have read, it is advised to avoid heavy abdominal exertion for six months post-surgery.
However, to be honest, I only adhered to this advice for the first one to two months after the operation; since then, I have been playing badminton and doing regular push-ups.
Could this activity have contributed to a potential recurrence, given that I still experience internal sharp pain?
You mentioned: (1) Besides the visible external sutures, there are also some non-absorbable sutures within the tissue.
Initially, these sutures can provoke an immune response, leading to tissue swelling and fibrosis.
I understand that there may be some fibrosis because the area feels hard to the touch, but it has improved significantly since then.
(2) After two months? Generally, it is recommended to take care for six months...
No, it has been almost four months, and I am still experiencing internal sharp pain, which makes me anxious.

I am concerned if this is a normal phenomenon.
To be honest, I only limited my activity for the first one to two months after the surgery, and then I resumed exercising.
I wonder if the sharp pain could be due to the internal membrane being stretched or not healing properly.
Should I return to the clinic for a check-up? Given that it has been nearly four months and I still feel this internal sharp pain, it doesn't seem right.
I would appreciate hearing your thoughts on this matter.
Thank you.

Yihuo de yixuesheng, 20~29 year old female. Ask Date: 2009/06/02

Dr. Xu Weikai reply Urology

Confused Medical Student: Hello, after general surgery, it typically takes about six months for the wound to regain approximately 90% of its original tensile strength.
As for the fibrotic response, it generally depends on the individual's constitution; some people may take a long time to soften.
Of course, the local heat application I previously recommended can accelerate the recovery process.
What you refer to as the inner membrane is likely the fascia or myofascia, which is less prone to tearing in younger individuals.
Regarding the localized tingling sensation, it may sometimes be due to heightened sensitivity in younger people, where the presence of foreign material causes discomfort.
The prior heat application should help alleviate this.
Additionally, if the pain worsens after heat application, it may be necessary to consider the possibility of a wound infection or an allergic reaction to the sutures, which could complicate recovery and prolong the healing time.
Occasionally, administering antihistamines can help reduce allergic reactions.
If there are any unclear points, feel free to ask again so we can further discuss and research together.
Department of Urology, Taitung Hospital, Ministry of Health and Welfare, Dr.
Hsu Wei-Kai.

Reply Date: 2009/06/02

More Info

Post-hernia surgery pain can be a complex issue, and it is understandable that you are concerned about the persistent discomfort you are experiencing nearly four months after your inguinal hernia repair. It is important to differentiate between normal post-operative pain and pain that may indicate complications or recurrence of the hernia.

Firstly, it is common for patients to experience some level of discomfort or pain after hernia surgery, especially within the first few months. This pain can be attributed to several factors, including the healing process of the tissues, the presence of sutures (both absorbable and non-absorbable), and the body’s inflammatory response to the surgery. The internal structures may take time to heal completely, and during this period, sensations such as sharp or stabbing pain can occur as nerves regenerate and scar tissue forms.

You mentioned that the pain you are experiencing is not at the incision site but rather a deeper, internal pain. This could be due to several reasons:
1. Nerve Regeneration: After surgery, nerves that were cut or manipulated during the procedure may take time to heal. This can lead to sensations of pain, tingling, or numbness in the area, which can sometimes feel like a deep, internal pain.

2. Scar Tissue Formation: As the body heals, scar tissue forms, which can sometimes adhere to surrounding tissues or organs. This can lead to discomfort, especially if the scar tissue is pulling on nearby structures.

3. Muscle Strain: Engaging in physical activities such as playing badminton or doing push-ups before the recommended recovery period can potentially strain the abdominal muscles. This strain can lead to pain, especially if the muscles are not fully healed.

4. Recurrence of Hernia: While it is less common, there is a possibility of hernia recurrence, especially if physical activities are resumed too soon. If the pain is localized to the area of the previous hernia, it may warrant further investigation.

Given that you have been active after the initial recovery period, it is crucial to listen to your body. If the pain persists or worsens, it is advisable to consult your surgeon or a healthcare professional. They may perform a physical examination and possibly imaging studies, such as an ultrasound or CT scan, to assess for any complications, including recurrence of the hernia or other underlying issues.

In terms of management, here are some recommendations:
- Rest and Activity Modification: It is essential to allow your body adequate time to heal. If certain activities exacerbate your pain, consider modifying or temporarily avoiding them until you have fully recovered.

- Pain Management: Over-the-counter pain relievers, such as ibuprofen or acetaminophen, can help alleviate discomfort. However, consult your doctor before taking any medication.

- Physical Therapy: If pain persists, a physical therapist can provide exercises to strengthen the abdominal muscles safely and improve flexibility, which may help alleviate pain.

- Follow-Up Appointments: Regular follow-ups with your surgeon are important to monitor your recovery. If you have concerns about the pain or any new symptoms, do not hesitate to reach out for medical advice.

In conclusion, while some level of discomfort can be expected after hernia surgery, persistent or worsening pain should not be ignored. It is always better to err on the side of caution and seek medical advice to ensure that your recovery is on track and to rule out any complications.

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