Surgery Not Always the Answer for Her...

Surgery Not Always the Answer for Hernias

There are 179 comments on the Healthscout.com story from Jan 17, 2006, titled Surgery Not Always the Answer for Hernias. In it, Healthscout.com reports that:

TUESDAY, Jan. 17 -- Men who have a hernia without pain or discomfort may have no need for surgery, a new study concludes.

Join the discussion below, or Read more at Healthscout.com.

Detroit

Dillon, CO

#128 Nov 25, 2013
I (a male, aged 70) treated my reducible inguinal hernia by doing body-core exercises, walking, and numerous body-weight squats--either full or sissy (1/4) squats, among others. The exercising was mostly intended to help lose weight--not primarily for the hernia.

Upon waking up a few weeks ago, I noticed that the hernia was gone, as if there never was one. The hernia reoccurred just one time since, after a three-mile walk a few days later; however, it was barely noticeable then, and I simply pushed it back. The hernia has not reappeared.

For the first couple days after the hernia disappeared I noticed a sensation for a second in my groin when I sneezed or coughed hard. Now, coughing or sneezing has no effects in that regard.

I am glad that I put off having any surgery...
arthur brogard

Australia

#129 Nov 26, 2013
I like the sound of that. Love it. How about some detail on the exercises you did?

Would you give us that?

And perhaps more detail on just what kind of hernia you had that you cured? Direct or Indirect? A mere slight swelling or a distinct lump? Painful or not?

It's all good information.
Detroit

Dillon, CO

#130 Dec 11, 2013
arthur brogard wrote:
I like the sound of that. Love it. How about some detail on the exercises you did?
Would you give us that?
And perhaps more detail on just what kind of hernia you had that you cured? Direct or Indirect? A mere slight swelling or a distinct lump? Painful or not?
It's all good information.
My hernia was a reducible, left-side inguinal hernia that at its worst would enter deeply inside the scrotum. Instead of going to a doctor, who would likely suggest unwanted surgery, I opted for a wait-and-see approach, coupled with exercising the abdominal/hip muscle groups.
Although I can still do ass-on-the-floor full squats with a 280-pound barbell, instead I choose to perform mostly hundreds of very easy 1/4 "sissy" squats, done mostly while watching TV or using my computer. It is simple to do over a dozen such squats per minute, so doing them takes up little time.
The squat is the best overall single exercise for much of the body, as it primarily works the thighs, buttocks, and hip flexors, plus numerous other stabilizing muscle groups. Sedentary people often do very little needed exercise in this regard.
My former hernia never was painful, although I mistook some mildly painful flatulence after drinking sodas pop occasionally for a few minutes now and then while the abdomen was weakening before the intestine was gradually worsening and eventually entered the scrotum.
The location of the hernia was too low in the groin for a truss to work unless a sponge or something similar was inserted. Because I could lived with the hernia without much discomfort, even at its worst, I simply chose to live with it and did pretty much the same as I did before, such as walking a few miles a day three or more days a week, etc.
One night several weeks ago, I pushed the bulge in the scrotum back inside, and after I woke up, the hernia was entirely gone and has not occurred. After the first day, I can cough hard or sneeze and not feel a thing inside my groin.
a brogard

Australia

#131 Dec 11, 2013
Thanks for that.

And I'm very glad your case turned out the way it has.

But your exercises seem to be those that would strengthen the abdominal floor muscles and they don't, I think, have a bearing on this problem.

What I'm referring to is the location of a inguinal hernia between muscles - so that no muscle exercise is going to strength the abdominal wall in that area.

The area is protected by 'aponeuroses' which (apparently, I'm essentially a layman googling all this) are the tendon like extensions of a muscle - that white stringy stuff that joins them to bone.

An inguinal hernia is so named because it occurs specifically in that area which is not a general area at all but quite specific being the area of the inguinal canal, the inguinal ligament being the floor of that, and where the spermatic cord exits the body cavity to make it's way down into the scrotum and the testes.

So it seems what is needed is exercises - or medications - an injection of some substance ?- that will strength the aponeurosis in that area.

I have pictures on the web to illustrate. They are what informed me.

Here: https://plus.google.com/photos/11077559779675...
Detroit

Dillon, CO

#132 Dec 28, 2013
a brogard wrote:
Thanks for that.
And I'm very glad your case turned out the way it has.
But your exercises seem to be those that would strengthen the abdominal floor muscles and they don't, I think, have a bearing on this problem.
What I'm referring to is the location of a inguinal hernia between muscles - so that no muscle exercise is going to strength the abdominal wall in that area.
The area is protected by 'aponeuroses' which (apparently, I'm essentially a layman googling all this) are the tendon like extensions of a muscle - that white stringy stuff that joins them to bone.
An inguinal hernia is so named because it occurs specifically in that area which is not a general area at all but quite specific being the area of the inguinal canal, the inguinal ligament being the floor of that, and where the spermatic cord exits the body cavity to make it's way down into the scrotum and the testes.
So it seems what is needed is exercises - or medications - an injection of some substance ?- that will strength the aponeurosis in that area.
I have pictures on the web to illustrate. They are what informed me.
Here: https://plus.google.com/photos/11077559779675...
I know a bit about inguinal hernias too, especially after I experienced mine...

I also know from web searches that doctors are in disagreement as to the causes of hernias and tend to push surgery over natural, non-medical treatments, which obviously helps them in their bottom line.

Myself, I feel that proper diet and general exercise treated my own advanced hernia inside my scrotum from reoccurring--now for several months already. I suspect, but have no proof, that my own fascia tissues might have had defects in its structure due to issues with insufficient collagen. So, I make sure that I consume at least a minimal amount of protein in my daily diet--and do more exercise in order to make better use of that extra protein.

Until very recently (at age 70) I was very physically active and for that reason likely never had any hernia up to that time. I slacked off some before getting the hernia, but now I do both aerobic and non-aerobic exercise most every day--much as I did before I had the hernia.
Andy G

Raritan, NJ

#133 Dec 29, 2013
Detroit,
If you didn't go to a doctor, how did you know it was a hernia? It could be a cyst or something else.

I think it makes sense that once the fascia is torn, even if the hernia is reducible, the same pressure that caused the hernia in the first place will push the fat, and intestines into the opening. The only way for the fascia to heal and close the opening is if the hernia is reducible and the internal material is no longer under pressure from lifting, straining, etc.

The people who report on the web that they have healed their hernias by doing yoga or other exercises don't explain how this happens physically. Do the muscles get bigger and close the gap? Or possibly they lose so much abdominal fat that the material that was herniating is gone? I guess to be convinced I'd have to hear a doctor or other kind of anatomy expert say that one of these is possible anatomically.
CHARLIE

Hayes, UK

#134 Jan 11, 2014
I Have A Direct Inguinal Hernia And When To The Doctor In 2012 And He Said Don’t Worry About It Be Fine Alone And I Was In Very Bad Pain So I Went Back And He Said The Same Thing I Told Him About The Pain And He Said Come Back If It Hurts Again As Pain Has Stopped So I Left It Until Last May And The Pain Came Back And Now Its A Size Of A Baseball. And I Was Seen By A Nurse And As It Retracted When I Was At The Doctors He Could Do Nothing Now Its January And Its Still There And Bigger But Still Retracts. I Am So Worried And Scared I Am Now Just 19 Help!
Sometime It Makes Me Feel Very Sick Because Of The Pain.
I Am So Scared I Can’t Talk to Anyone Because I a Shy One and I Can’t Because I Am Scared And I’m inbarist
a brogard

Australia

#135 Jan 11, 2014
Andy G wrote:
Detroit,
If you didn't go to a doctor, how did you know it was a hernia? It could be a cyst or something else.
I think it makes sense that once the fascia is torn, even if the hernia is reducible, the same pressure that caused the hernia in the first place will push the fat, and intestines into the opening. The only way for the fascia to heal and close the opening is if the hernia is reducible and the internal material is no longer under pressure from lifting, straining, etc.
The people who report on the web that they have healed their hernias by doing yoga or other exercises don't explain how this happens physically. Do the muscles get bigger and close the gap? Or possibly they lose so much abdominal fat that the material that was herniating is gone? I guess to be convinced I'd have to hear a doctor or other kind of anatomy expert say that one of these is possible anatomically.
Did you look at the pics? https://plus.google.com/photos/11077559779675...

The fascia need not be torn. Look at the operation at desarda.com . The aponeurosis is merely thinned and weaker.

My hope is that appropriate diet and exercise will thicken and strengthen the aponeurosis.

As you can see from the pics the whole problem is the difficult place it is in. No real muscle covering the area. It is to be hoped that exercising what muscles are there will cause them to thicken, to spread laterally, get wider and cause their oponeurosis to strengthen.

The diet should be strong in collagen and whatever else is appropriate to enable collagen to be utilised.

As to exactly what to do to cover these two things: diet and exercise, I must admit I still don't know with any certainty. Gelatin and protein for collagen. Certain vegetables to help utilisation - silver beet my help I think. And Pilates type exercises for the External and Internal Oblique muscles, particularly stretching exercises.

So that's the hope. That's what I'm going for at least.

The medical profession has this as it's most common operation and yet sends you away (me at least) without a word as to how to manage the condition or perhaps improve it and not even a description in my case as to what's really happening - such as in my pics there, I had to find them for myself.

And what appears to be the treatment of choice inasmuch as it seems to have the same statistics for recurrence and residual chronic pain but is done without mesh and therefore without possible complications of removing foreign material if surgery must be done again: Prof. Desarda's technique - they happily profess ignorance of and baldly state, sometimes, they don't want to know!

A clear case of a situation where the citizen must think for him/her self.(Many women get such hernias, too. Childbirth, I think, can cause them.)
a brogard

Australia

#136 Jan 11, 2014
CHARLIE wrote:
I Have A Direct Inguinal Hernia And When To The Doctor In 2012 And He Said Don’t Worry About It Be Fine Alone And I Was In Very Bad Pain So I Went Back And He Said The Same Thing I Told Him About The Pain And He Said Come Back If It Hurts Again As Pain Has Stopped So I Left It Until Last May And The Pain Came Back And Now Its A Size Of A Baseball. And I Was Seen By A Nurse And As It Retracted When I Was At The Doctors He Could Do Nothing Now Its January And Its Still There And Bigger But Still Retracts. I Am So Worried And Scared I Am Now Just 19 Help!
Sometime It Makes Me Feel Very Sick Because Of The Pain.
I Am So Scared I Can’t Talk to Anyone Because I a Shy One and I Can’t Because I Am Scared And I’m inbarist
I've really nothing much to tell you and I'm not a doctor (or even a nurse) and therefore can't give you medical advice.
I'm replying to your post mainly in order to give you a little human attention, feedback, interest in your problem, rather than possibly leave you without any responses and liable to make yourself feel even more unhappy.
You should perhaps read a bit about the hernia - there's many links you can find. I've put my own little set of pics that I hope make it plain what's happening up on the web, you could look at them. The link's up there in a previous post.
This is apparently the most common operation in the western world. So it's not some wild woolly unknown thing. It's pretty routine. That might make you feel better.
You're in the UK so you have good medical help freely available to you. Even if you've got to wait awhile. You will be looked after.
You don't say if you're overweight or do strenuous work or whatever. I've seen it suggested that overweight exacerbates or even gives rise to the condition.
You can find suggestions that we watch our diets but just how to watch them I don't know. Try not to dehydrate seems to be the main thing, so you don't strain at stool. Coffee and lots of liquid would help with that I think.
Myself I do lots of stretching and am going to look at Pilates type exercises. I eat gelatine every day - I find that easy to do :)- and make sure I get some vegetables in my diet.
The hope being that given the materials the body will build strong collagen in the aponeurosis when the aponeurosis is worked, strained, mildly stressed by the appropriate exercise and the cells would respond to that strain by strengthening. Supposedly. Hopefully.
You're young. Your body should be keen to rebuild and strength tissue.
The pain is a worry. Mine is pain free mainly I'm glad to say, so far anyway. Just a little twinge now and then. When that happens I take some Panadol and worry a bit. That's how I can relate to yourself. I worry with my little twinge. I can imagine how you'd worry.
But worrying doesn't help us. Everything seems to be basically okay. It's a well known condition. Shouldn't threaten our lives. The operation to fix it performed by the thousand every year.
So we don't need to worry, really. We need to do. Do something. Diet and exercise. I'm going to try doing again what I used to love doing when I was kid - climbing up the walls with my heels while lying on my back on the bed. Finish up sort of standing on my shoulders.
That should take the weight of all the abdominal contents off the lower abdominal wall completely, shouldn't it? Wouldn't you think?
And then try and find some way of exercising just those muscles that surround the area - the internal and external oblique and the transversus. I don't know how to do that yet. I read just that one thing somewhere about 'stretching' being a good thing.
Like when you push your chest out and the tummy hollows out beneath the rib cage? Like that I think they mean.
You'd have to keep reporting the pain issue to your doctor. And the size change.
Write it all down if you're too shy to talk. Let the doc read it.:)
CHARLIE

Hayes, UK

#137 Jan 11, 2014
Thank you - for you help

what if I do need to go into hospital for an operation I am petrified.

do I have to go in.

::..]

thank you for your advise means a lot thank once again.
hayle

Calhoun, TN

#138 Jan 23, 2014
Hey guys. I have a hernia from previous surgeries and I meet with a surgeon in the morning to see if it needs repaired. I am only 19 and this will be my 4th surgery , being put to sleep each time. Any advice?
arthur brogard

Australia

#139 Jan 24, 2014
Charlie: I'd say your main need is for some support, someone to help you, just be around, perhaps go with you to the doc or be there to talk to afterwards (and before), don't you think?

And perhaps more understanding of your own condition..

And Hayle... I've got no advice, sorry. I'm not the right person. Not qualified.

If I was in your situation I'd be looking for as much information as I could get - you can perhaps tell that from my posts up there, what sort of person I am.

And I'd get a complete and detailed description of my current condition complete with complete and detailed descriptions of my prior operations, what was done, how, by whom.

Get any ultra sounds I could and any x-rays that have been done, anything, everything.

And I could take all that stuff to other people. Surgeons of my choice. Doctors I trust to help me. That kind of thing.

I'd want to know just what's going on....

Once I had a clear, simple description of what my situation was I think I'd probably try to put it in front of Prof Desarda or Doctor Thomas ( is it? Who is doing the operation in the States somewhere?) and ask them if they thought it was a situation they could fix and if so how? When? And how much money?

:)
Andy G

Raritan, NJ

#140 Jan 24, 2014
@ Arthur - I wonder if a surgeon could tell you in what percent of inguinal hernia patients the fascia is torn. I have never seen this information published. In any case, that information would provide a clue as to the likelihood that self-treatment programs would succeed. Before having surgery I reviewed the various videos and posts from individuals who claimed they healed their inguinal hernias themselves and I tried some of the exercises for a while. I concluded that since these men said it took many months of exercise for hours every day, that it was not practical for me to continue.
lobster

Harrisburg, PA

#141 Jan 27, 2014
arthur brogard wrote:
Charlie: I'd say your main need is for some support, someone to help you, just be around, perhaps go with you to the doc or be there to talk to afterwards (and before), don't you think?
And perhaps more understanding of your own condition..
And Hayle... I've got no advice, sorry. I'm not the right person. Not qualified.
If I was in your situation I'd be looking for as much information as I could get - you can perhaps tell that from my posts up there, what sort of person I am.
And I'd get a complete and detailed description of my current condition complete with complete and detailed descriptions of my prior operations, what was done, how, by whom.
Get any ultra sounds I could and any x-rays that have been done, anything, everything.
And I could take all that stuff to other people. Surgeons of my choice. Doctors I trust to help me. That kind of thing.
I'd want to know just what's going on....
Once I had a clear, simple description of what my situation was I think I'd probably try to put it in front of Prof Desarda or Doctor Thomas ( is it? Who is doing the operation in the States somewhere?) and ask them if they thought it was a situation they could fix and if so how? When? And how much money?
:)
dr tomas is in fort Meyers fl and his web page is ufirsthealth. He had an internet price of about 3500$ but I believe his regular price is 4500. He does do the Desarda method and is mentioned as such in dr desardas web site. Good luck to you all
arthur brogard

Australia

#142 Jan 27, 2014
Thanks for the info on Dr Thomas, lobster.

I don't know the stats on torn fascia, Andy. I'd like to. If I can find out I will. Prof Desarda doesn't seem to mention it, does he?

Have you see these pages about fascia:

http://www.anatomytrains.com/fascia/

Very interesting. They seem to think the whole system is to be viewed as one whole, so that improving the collagen in the fascia in the area of an inguinal hernia would be achieved by improving the the whole system, I suppose.

And it is to be viewed as system in tension, responding to tension. That puzzles me.

On the one hand it seems to suggest if we can find exercises to tension the aponeurosis then we'll be promoting the strengthening of it. The closing of the hernia.

But on the other hand it begs the question why didn't the hernia heal itself via the same mechanism when the abdominal contents are continually tensioning the aponeurosis?

Where all the doctors seem to say that it inevitably gets larger - i.e. the apo is getting weaker.

I wonder if that that's true. We never see reports, studies about those who've seen hernias come and go, reduce, repair, all of their own, presumably through precisely that mechanism.

But perhaps it is happening all the time?

And it seems to be there should be at least a possibility that an injection of an appropriate substance in the area of the weakening could cause a strengthening of the tissues there.

Maybe that's nuts. Maybe there's no such known substances. But then again, maybe there are.

And what about scar tissue? Isn't that stronger and less elastic than normal tissue? Then why not simply scarify the aponeurosis in that area, keep the strain off it for a day or two or whatever while the scar tissue grows?

How'd your operation go, Andy?
Awais

Lahore, Pakistan

#143 Mar 3, 2014
My mother have heart condition and heart doctor suggest that anesthesia cannot be given to patient as patient may not awake up after that... i m so confuse because hernia doctor said that operation is must.. need help!!
Andy G

Raritan, NJ

#144 Mar 3, 2014
@ Arthur, So far the surgery is working fine. I have pain sometimes but nothing too bad.

@Awais, There are different kinds of anesthesia. Ask the hernia surgeon if your mother can have a lighter anesthesia that is less risky.
Actorgirl

Nelson, Canada

#145 Mar 10, 2014
Hank wrote:
Always better to get a hernia repaired. As has been said they can only get worse. Always better to have surgery when you are younger rather rthan older. Just had mesh installed for an incisional hernia. Only 10 days have passed and I am ready to climb mountains (I am not a mountain climber). Feel great and it was the right decision.
What is an incisional hernia? Mine happened because i have a large scar on abdomen due to huge operation after car accident. Mine wall is so weak. Now the docs won't fix hernia because of all the scar tissue. I am pretty worried. Seems to be getting even more uncomfortable. It is femoral.
arthur brogard

Australia

#146 Mar 10, 2014
an 'incisional hernia' is a hernia through an incompletely healed incision from a previous operation.

That's obviously different to a hernia pushing through an abdominal wall that remains intact.

It would seem like a good candidate for a mesh repair to me - a layman.

My concern for myself is to avoid mesh repair in order to diminish the small chance of later complications, small as it is.

In this kind of inguinal hernia there's apparently a weakening of the tissues of the abdominal wall and the contents push through that weak area - causing a 'sac' to develop, a bulge of weakened tissue.

You can see this being cut off in one of Prof Desarda's videos of his technique, I think. I've seen it in some Youtube video.

This interests me. This is the root cause of the majority of hernias (I've read that too much physical strain has been discredited as a cause) and yet there's no discussion I can find anywhere on WHY these tissues in this area becomes weakened.

You know, it could turn out in the end to be something as simple as a bacteria. There could be a secretion from the intestine in that area or a secretion associated with the intestine, that causes a weakening.

Might be in a better position if we knew. I search for documents about biopsies and pathology reports of inguinal hernia tissue but I don't find any as yet. If anyone does know of some perhaps they'd let me know?

Not operating because of scar tissue surprises me. I would have thought scar tissue to be stronger than usual and therefore good strong tissue to cut through, do what you have to do and then rejoin.

Shows how much I know. Not very much. That's the whole problem. Trying to learn. More info available now than ever before in the world but still not enough: witness my problem there and the overall problem of simply finding a surgeon in my country that'll contemplate Prof Desarda's operation.

Scar tissue seems to be capable of cutting and joining for surely that's what's done in 'scar revision' surgery where they change and improve scars? http://www.nlm.nih.gov/medlineplus/ency/artic...

Femoral hernias come in a range of styles but they all seem to be fairly fraught with danger, seems to me (ignoramus that I am), because of the nature of them. http://en.wikipedia.org/wiki/Femoral_hernia

I'd think your doctors would want to get onto it as soon as they can. It is reducible I'd guess?(Means it goes back in, you know?)

Don't know about anyone else but I try to get my bottom end up higher than my top end whenever I can (and feel like putting out the effort - which is a surprising amount really).

Like standing on my shoulders, against the wall, legs up the wall. Or some much easier variation of that - like calves on a chair, bum on a couple of cushions, shoulders on the floor...

Hoping that relieving the pressure of the abdominal contents on the weak area will at least slow down the continued deterioration of the condition and praying that perhaps there might even be some attempt by the tissues to revert back to where they should be.

It's a bugger, the whole thing, eh?

Keep your money. Just give me health.

:)
Jubjub Bird

Wilbraham, MA

#148 May 15, 2014
I'll admit I'm scared to get the surgery done on an inguinal hernia that I have.

Anyway. I've been lifting weights rather carefully the past few months and I've noticed that none of them seem to put any pressure on my hernia. What does put pressure on it is sneezing, coughing, gas... maybe a big shit that needs to come out.

They recommend not lifting heavy, but I don't understand why. If you are lifting carefully... you aren't holding your breath in, a squat doesn't put pressure in the groin area, farmer walks you can do with a relaxed stomach, and while it's true that in the push up position gravity seems to be pushing the hernia slightly (I think), most of the strain/pressure is on the upper body of course. Anyway, I'm saying that none of the exercises I do even put pressure on it in the way that a sneeze does...

I do get some pain sometimes, but it always seems to be connected to a bowel movement or gas. I never get it when lifting. So I think the recommendation to not lift heavy (heavy being something like above 20 lbs I think), is a strange one. If anything, it should be recommended perhaps that you try not to sneeze or cough as much.

Actually I almost forgot to say, I got this hernia a few months ago during an illness where I was coughing very hard. And the point of all I am saying is that it doesn't seem to me that heavy weight lifting is bad for an inguinal hernia.

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