Inguinal Hernias, Groin Pain, Nerve Blocks, and Finding Relief

Eric H. Williams MD
Specializing in reconstructive surgery and pain relief in the Greater Baltimore area.

Surgery is frequently seen as a means of solving a problem, but it can come with risks.

When a doctor cuts into a patient, it is a form of trauma. It is very careful and controlled, but still trauma, nevertheless. The benefits intended with a surgery must always outweigh the risks that are involved in the procedure, but sometimes it can still leave a patient with negative results.

One such result can happen with patients who have had surgery for an inguinal hernia. This condition occurs when a soft tissue—usually part of the intestine—has protruded through an area of weakness in the abdominal muscles. This creates a painful spot that can significantly impede one’s life and, in some cases, create a life-threatening complication.

There are many recommendations to surgically repair an inguinal hernia, and the doctors who make these decisions are doing so based off very good information! In some cases, however, hernia repair surgery can result in groin pain that lasts more than 6 months following the procedure. Most research has demonstrated that at least 5-30% of patients will have significant post-surgical pain in the groin after hernia repair.

This type of pain can manifest in different ways and in different locations, including:

  • Pain that is radiating, sharp, or “electric” in the groin or lower abdomen radiating into the pubic region and groin crease, sometimes into the upper thigh
  • A burning sensation where the surgery was conducted.
  • A feeling as though something strange or foreign is in the body.
  • Pain in the testicle in men or labia in women.
  • Pain while walking, sitting, changing position, or squatting.
  • Pain felt during sex.

The cause of this pain is often nerve-related. More specifically, it is likely damage to a nerve or nerves caused during the surgery or because of scarring after the surgery.

If the culprit is not nerve damage, it might be a negative reaction to the mesh that was used for the hernia repair. It might be causing irritation, or your body might be recognizing it as an invader.

It should be noted that, in the vast majority of cases, this damage should not be blamed on the surgeon who operated. Our bodies contain such intricate and complex systems of nerves that sometimes, no matter how careful a doctor can be, some nerve damage might result. That is why there is never a non-zero risk with surgery.

If you do experience lasting groin pain following hernia repair surgery, and it is nerve-related, we may be able to help you find relief or manage it in a significant way.

What to Do About Post-Hernia Surgery Pain

To determine the best course of action for lasting pain following inguinal hernia repair, we must get our bearings on the underlying cause of the problem.

If it has been less than 6 months following surgery, some natural pain from the procedure may still be expected. Within this window, it is often best to focus on conservative treatments and see whether they do a sufficient job of managing the discomfort. Such treatments might include steroid treatment, physical therapy, and referral to pain specialists.

If pain persists, however, it is time to move on to deeper evaluation and more advanced treatments.

First, we must determine whether nerve injury or damage is at the root of the problem. Was a nerve cut or stretched during surgery, or is mesh aggravating a nerve in some way, or has the nerve been sucked into dense scar tissue? 

An important tool in making this determination is a nerve block. This is merely an injection of local anesthetic made near a targeted cluster of nerves.

If a nerve block has a significant temporary effect on your pain, that provides us solid evidence that the targeted nerves are part of the problem. Odds are high—about 85 percent—that we will be able to significantly relieve your pain. If the nerve block doesn’t work, there may still be options we can take; the chances of success are unfortunately lower, though.

Once we have performed a full evaluation, we will discuss with you the best options available for finding relief. If this involves surgery, and we both conclude that this is the way we wish to proceed, we will arrange for a procedure.

The procedure is typically outpatient and will take 1-2 hours per side that needs work. In many cases, we can reuse the same incision previously made for your hernia repair.

The nerves affected are often removed, and it is important to note that this frequently replaces the pain with numbness in the area. This numbness tends to improve over time, however, and in the majority of cases the numbness is much preferred to the pain that existed beforehand.  The nerve blocks help the patient determine if the numbness is tolerable and preferable over the original pain.

You will be permitted to go home following the surgery (barring any complications), and will be able to slowly increase your level of activity over the following days. The nerve removal procedure will usually take a shorter period to recover from than the original hernia repair.

But What About… Performance?

When it comes to matters of groin pain and nerve removal, there is naturally some question about whether it will affect sexual performance.

There is good news on this front: the nerves that are likely causing your pain are not the same ones responsible for your sexual organs.  Their sensations should not be affected, and not having your pain anymore should be a significant mood-booster as well!

We’ll Help Your Pain However We Can

We have had years working with persistent groin pain caused by nerve damage and have seen many happy patients as a result of it. You can see some of their testimonials here, if you wish.

We wish we could guarantee full relief and recovery for all patients, but that is simply never the case. What we can promise is to do all we can within reason to provide as much relief and comfort as possible.

You don’t have to deal with your post-surgical pain on your own. Call our Towson office at (410) 709-3868 to schedule an appointment with Dr. Williams, or use our online form to reach us electronically.

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