hernia repair experience

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Galileo
Veteran Member


Date Joined Nov 2008
Total Posts : 697
   Posted 5/6/2010 7:08 PM (GMT -6)   
Thought I'd say something about my hernia operation Tuesday. It was to repair an incisional hernia that had emerged slowly over the past few years from my main prostatectomy scar, in my navel.

I checked in at 8:00 AM, got into into the gown, put a little sticker near the hernia that said "Surgical Site" (a nicer way of saying "Cut HERE"), and got an IV going. Just before the OR nurse came to get me, an antibiotic was added to my IV. When she arrived, she also injected something (maybe Versed) which relaxed me as we wheeled back to the OR. I remember the oxygen mask, and then the next thing I know I was sipping some cold juice and eating crackers in recovery. The whole procedure took about 30 minutes from the time I was wheeled back until the surgeon spoke to my wife.
He put in a piece of mesh and sutured my navel back into its original shape.

While in recovery, the nurse gave me a few small doses of fentanyl right into the IV, which gave me immediate pain relief, and gave me a percocet tab to swallow just before leaving. By 11:30 we were on our way home.

The next 48 hours were a little uncomfortable but manageable with sporadic doses of percocet. It has been hard to sleep, even with pillows under my knees, but it's getting better. Today I felt a lot better than yesterday. I was able to remove the dressing from the incision and take a shower today. Even with the sutures, I can tell the area is going to look a lot better than it did. The old prostatectomy scar looks better all along its length (not very long--I had a Da Vinci).

The sutures are self-dissolving.

So that's my experience so far. I'm going back to work in a week, after a followup.

I regret not having taken care of this sooner.

Best wishes to anyone with this procedure coming up.
Galileo

Dx Feb 2006, PSA 9 @age 43
RRP Apr 2006 - Gleason 3+4, T2c, NX MX, pos margins
PSA 5/06 <0.1, 8/06 0.2, 12/06 0.6, 1/07 0.7.
Salvage radiation (IMRT) total dose 70.2 Gy, Jan-Mar 2007@ age 44
PSA 6/07 0.1, 9/07 and thereafter <0.1
http://pcabefore50.blogspot.com


goodlife
Veteran Member


Date Joined May 2009
Total Posts : 2691
   Posted 5/6/2010 7:12 PM (GMT -6)   
It will make you look fine in the swim suit this summer.
Goodlife
 
Age 58, PSA 4.47 Biopsy - 2/12 cores , Gleason 4 + 5 = 9
Da Vinci, Cleveland Clinic  4/14/09   Nerves spared, but carved up a little.
0/23 lymph nodes involved  pT3a NO MX
Catheter and 2 stints in ureters for 2 weeks .
Neg Margins, bladder neck negative
Living the Good Life, cancer free  6 week PSA  <.03
3 month PSA <.01 (different lab)
5 month PSA <.03 (undetectable)
6 Month PSA <.01
1 pad a day, no progress on ED.  Trimix injection
No pads, 1/1/10,  9 month PSA < .01
1 year psa (364 days) .01


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 5/6/2010 7:18 PM (GMT -6)   
Glad you got through it ok, and you are on the mend. Interesting story, wasn't sure how they fixed things like that. Good healing to you.

David in SC
Age: 57, 56 dx, PSA: 7/07 5.8, 7/08 12.3, 9/08 14.5, 10/08 16.3
3rd Biopsy: 9/08 - 7/7 Positive, 40-90% Cancer, Gleason 4+3
Open RP: 11/08, Rht nerves saved, 4 days in hospt, on catheters for 63 days, 5th one out 1/09
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos margin
Incontinence:  1 Month     ED:  Non issue at any point post surgery, no problem post SRT
Post Surgery  PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA: 1/10 .12, 4/8 .04, next one:  July
Latest: 7/9 met 2 rad. oncl, 7/9 cath #6 - blockage, 8/9 2nd corr surgery, 8/9 cath #7 out 38 days, 9/9 - met 3rd rad. oncl., mapped  9/9, 10/1 - 3rd corr. surgery - SP cath/hard dialation, 10/5 - 11/27 IMRT SRT 39 sess/72 gys ,cath #8 33 days, Cath #9 35 days, 12/7 - Cath #10 43 days, 1/19 - Corr Surgery #4,  Caths #11 and #12  same time, 2/8-Cath #11 out - 21 days, 3/2- Cath #12 out - 41 days, 3/2- Corr Surgery #5, 3/6 Cath #13 out - 4 days, Cath #14- 27 days, Cath #15 - 26 days, Cath #16 - 4/23 put in


JB71
Regular Member


Date Joined Nov 2009
Total Posts : 206
   Posted 5/7/2010 7:17 AM (GMT -6)   
I'm thinking of having my belly button hernia repaired because it's really starting to bulg and looking nasty.

Wondering how long I should wait though because the scar from the open prostate surgery back in January is rather close to the belly button.

Jerry in Canada.
.
Age, only 71.
July 2009, PSA 9.1, free ratio 0.16
September GLEASON 4+4=8, T2A
Prostate 44cc.
Calcium: 2.46  (range: 2.20 - 2.65 mmol/L)
25 Hydroxy Vitamin D: 102 (range: sufficiency:
76 - 250 nmol/L)
Bone Scan: Negative
CT Scan scheduled for Dec. 1st. Negative.
Started Casodex 50mg. on Nov. 6, first pill of 30.
Got Lupron 22.5mg ( 90 day ) on  November 19.
No real side effects as of Dec. 15 except dry skin and hair but getting quite 'porky' in the belt area even though now I go to the gym, three times a week. Also I dont have a need to shave anymore so now I can save my 'shaving' allowance and direct it to my stash of Depends !
 
Christmas Day got my first hot flashes. Thanks Santa!
 
Open surgery done on Jan. 20th. by Dr. J. Chin at London's University Hospital.
 
Cath removel scheduled for Feb. 8th. Yes, I know,
that will be 19 days. Dr. is out of country until then.
====================================
Pathology Report:
 
Gleason Score: cannot be determined due to hormone therapy effects. ???????
Extraprostatic Extension:
present, left radial, multifocal
present, left basal, multifocal
Resection Margins:
Apical: involved by invasive carcinoma, multifocal
Bladder Neck: involved by invasive carcinoma, unifocal on left side.Other: non-tumoural prostatic present at resection margin.
Perineural Invasion: present.
Seminal Vesicle Invasion: absent
Lymphovascular Invasion: absent
Lymph Node Status: no malignancy in regional lymph nodes
Additional path. findings:
high grade prostatic intraepithelial neoplasia
 
Pathology Stage: yp T3a NO MX
==================================
Radialogist appointment was on Friday Feb. 26 with Dr. Glenn Bauman in London.
Got another Lupron 90 day shot today and he wants to start IMRT soon. CT Scan plus measure scheduled in about 3 weeks. ( march 15)
 
First PSA test since surgery on March 18th.
with the results of <0.03 !!!
 
Started a Facebook page for bikers with prostate issues at:
 
IMRT to start on May 10.
 
.


Steve n Dallas
Veteran Member


Date Joined Mar 2008
Total Posts : 4829
   Posted 5/7/2010 8:17 AM (GMT -6)   
I lived with my half a golf ball size buldge for a good 5 years. One big ol bump it into something and it Hurt Real Bad for a week motivated me to get it taken care of.
 
JB - you'll have to ask the surgeon, but odds are you can do it anytime.
Age 55   - 5'11"   215lbs
Overall Heath Condition - Good
PSA - July 2007 & Jan 2008 -> 1.3
Biopsy - 03/04/08 -> Gleason 6 
06/25/08 - Da Vinci robotic laparoscopy
05/14/09  - 4th Quarter PSA -> less then .01
11/20/09 - 18 Month PSA -> less then .01
Surgeon - Keith A. Waguespack, M.D.


laxacharlie
New Member


Date Joined Apr 2010
Total Posts : 16
   Posted 5/7/2010 10:04 AM (GMT -6)   
Great thread for me, I just got online and was about to ask a question about navel hernia repair after robotic prostatectomy. Had my procedure 4/12, and have just noticed a growing bulge, now about the size of a small grape, at my navel incision. I understand that these are not rare, and that the fix is fairly uncomplicated. Some questions for those with experience with incisional hernias: (1) I assume a surgical remedy is the only fix? (2) I am a bit fed up with limiting exercise to walking, does this surgery put serious exercise on hold for yet another 4-6 weeks? (3) Any advantage to jumping on the fix right away vs. waiting? If one does wait, does vigorous exercise exacerbate the hernia? (4) I assume that this can be done as day surgery. Is a general needed, or can this be done with a local? (5) Does the uro. who performed the surgery normally do the fix? (6) How long is a person out of commission after surgery?

I do see my uro next Wed. about this, but any insight to the above questions would be most helpful. Thanks!

Galileo
Veteran Member


Date Joined Nov 2008
Total Posts : 697
   Posted 5/7/2010 10:40 AM (GMT -6)   
Laxacharlie, my surgeon told me I didn't have to fix it, but eventually it might cause serious problems. Definitely no rush.
Surgery is the only fix as far as I know, although you can wear some kind of device (there was a Saturday Night Live skit with Dan Ackroyd about this) to hold it in. Surgery has a fairly high failure rate, my doctor warned me. The trick is to do the surgery so that the repair is not under tension. That was his goal.

Yes, I am limited in exercise for a while. I am able to move around the house pretty well now, 3 days later, but I am now having to remind myself not to lift. I look forward to riding my bike and hiking again, as well as being able to do some of the more strenuous things around the house, like mowing the lawn. I imagine I will get advice from the surgeon about those things when I meet with him, but I'm guessing the timeline will be to take it pretty easy for several weeks, then gradually get back into normal activities.

I was exercising pretty vigorously before surgery and it didn't seem to exacerbate the problem, aside from a little soreness. Not sure if that applies universally, though.

I had the procedure done under general, but from browsing the web it looks like it is also often done under a combination of light sedation and local anesthetic.

The doc who did my repair is a general surgeon who does a lot of hernia repairs. I would not have considered my urologist for this since it has nothing to do with my genitourinary system. Plus, I have a sneaky suspicion that my urologist saw that this was coming, and said nothing. Hmmm...

He told me to take a couple of weeks off work. It depends on how strenuous your job is (my is not physically strenuous). I could be back at work now, except that I still need to take a pain pill during the day. Also, my bowel is still soundly asleep from the anesthesia. I'm taking a laxative today to see if I can get things moving. I wouldn't want to be at work for that... :)
Galileo

Dx Feb 2006, PSA 9 @age 43
RRP Apr 2006 - Gleason 3+4, T2c, NX MX, pos margins
PSA 5/06 <0.1, 8/06 0.2, 12/06 0.6, 1/07 0.7.
Salvage radiation (IMRT) total dose 70.2 Gy, Jan-Mar 2007@ age 44
PSA 6/07 0.1, 9/07 and thereafter <0.1
http://pcabefore50.blogspot.com


Steve n Dallas
Veteran Member


Date Joined Mar 2008
Total Posts : 4829
   Posted 5/7/2010 12:09 PM (GMT -6)   
Charlie - see my post above about bumping the buldge nono
 
AND, it's rare - but your "guts" can buldge and get caught and turn gangrene. I was told you'll know if it happens cause it takes a few days and hurts more as time passes. Just keep it in mind.

RCS
Veteran Member


Date Joined Dec 2009
Total Posts : 1247
   Posted 5/7/2010 4:40 PM (GMT -6)   
laxacharlie
 
Mine was about the size of a peach and did not hurt at all .... but when I would sit down it felt like I had a tennis ball stuck in my stomach.  It didn't hurt, just felt funny. 
 
Surgery and recovery went fine no problems (had it done about two months ago).
 
It looks anf feels great.
 
Surgeon didn't want me to do much of anything strenuous for 4 weeks .... and didn't want me lifting more than 10 pounds for 6 weeks.  I'm currently lifting up to 20 pounds.
PSA 2007 - 2.8
PSA 11/24/2008 - 7.6
Pc Dx 2/11/09; age at Dx 62
RLP 4/20/09
Biopsy - Invasive moderately differentiated prostatic andenocarconoma; G 3+3=6; PT2C; No evidence of Seminal Vesicle or Extraprostatic Involvement; Margins clear; Tumor identified in sections from prostatic apex.
Immediately continent after removal of cath.
ED - Trimix works well; viagra @ 60%
PSA - 7/31/09 <0.06
PSA - 12/1/09 <0.06
PSA - 3/29/10 <0.06
 
 
 


RCS
Veteran Member


Date Joined Dec 2009
Total Posts : 1247
   Posted 5/7/2010 4:52 PM (GMT -6)   
laxacharlie
 
Sorry I missed some of your questions ...
 
(4) I assume that this can be done as day surgery. Is a general needed, or can this be done with a local?
I had same day ... took about an hour ... out of the hospitalin three.  I had a general, butr he said he could do a local.
 
(5) Does the uro. who performed the surgery normally do the fix?
My uro sent me to a general surgeon who had done a bunch of hernia repairs ... this was my fourth (3 ingunal)
 
(6) How long is a person out of commission after surgery?
I'm two months out and am pretty much back to normal ... but watching what I lift.  I'm guessing you should curtail your strrenous exercise for 4 to six weeks ... push it and you could pop an internal stitch ... seems like the older I get the longer it takes to recover from a hernia repair.
PSA 2007 - 2.8
PSA 11/24/2008 - 7.6
Pc Dx 2/11/09; age at Dx 62
RLP 4/20/09
Biopsy - Invasive moderately differentiated prostatic andenocarconoma; G 3+3=6; PT2C; No evidence of Seminal Vesicle or Extraprostatic Involvement; Margins clear; Tumor identified in sections from prostatic apex.
Immediately continent after removal of cath.
ED - Trimix works well; viagra @ 60%
PSA - 7/31/09 <0.06
PSA - 12/1/09 <0.06
PSA - 3/29/10 <0.06
 
 
 


laxacharlie
New Member


Date Joined Apr 2010
Total Posts : 16
   Posted 5/10/2010 2:27 PM (GMT -6)   
A follow up question on hernia repair to those who have experienced an incisional (ventral) hernia post RALP. I do have what appears to be a small hernia on my navel incision. Did you have open or laparoscopic? I assume that most used the "tension free" method with mesh. As is typcal of any medical procedure, there seem to be many options, with no clear choice. Also, has anyone on this form had incisional bumps or swelling which were not hernias? I am off to see some docs this week, and am hoping not to have another surgery so soon after my RALP, which was done on 4/12. Thanks!

Sleepless09
Veteran Member


Date Joined Jul 2009
Total Posts : 1267
   Posted 5/10/2010 2:37 PM (GMT -6)   
Galileo, thanks for the report. It's always good to know what may be lying ahead.

Good luck with the recovery. Watch some movies, read some books, and be assured a nice rum and coke before supper does a world of good.

Sheldon AKA Sleepless
Age 67 in Apil '09 at news of 4 of 12 cores positive T2B and Gleason 3 + 3 and 5% to 25% PSA 1.5
Re-read of slides in June said Gleason 3 + 4 same four cores 5% to 15%
June 29 daVinci prostatectomy, Dr. Eric Estey, at Royal Alexandra Hospital Edmonton one night stay
From "knock out" to wake up in recovery less than two hours.  Actual surgery 70 minutes
Flew home to Winnipeg on July 3 after 5 nights in Ramada Inn  ---  perfect recovery spot!
Catheter out July 9
Final pathology is 3 + 4 Gleason 7, clear margins, clear nodes, T2C, sugeron says report is "excellent"
 
Oct 1st 09 -- dry at night, during day some stress issues.
Oct 31st padless 24/7 
 
First post op PSA Sept 09  less than 0.02
PSA on Oct 23 test again less than 0.02
PSA on Jan 8 less than 0.02
PSA on April 9 less than 0.02 
 
  


goodlife
Veteran Member


Date Joined May 2009
Total Posts : 2691
   Posted 5/10/2010 3:42 PM (GMT -6)   
Laxacharlie,

It is open. It is only going under the skin and fatty layers. Laparascopic is only good for when you go down inside the gut.
Goodlife
 
Age 58, PSA 4.47 Biopsy - 2/12 cores , Gleason 4 + 5 = 9
Da Vinci, Cleveland Clinic  4/14/09   Nerves spared, but carved up a little.
0/23 lymph nodes involved  pT3a NO MX
Catheter and 2 stints in ureters for 2 weeks .
Neg Margins, bladder neck negative
Living the Good Life, cancer free  6 week PSA  <.03
3 month PSA <.01 (different lab)
5 month PSA <.03 (undetectable)
6 Month PSA <.01
1 pad a day, no progress on ED.  Trimix injection
No pads, 1/1/10,  9 month PSA < .01
1 year psa (364 days) .01


Galileo
Veteran Member


Date Joined Nov 2008
Total Posts : 697
   Posted 5/10/2010 3:53 PM (GMT -6)   
I had the tension-free mesh method done as an open procedure.
Galileo

Dx Feb 2006, PSA 9 @age 43
RRP Apr 2006 - Gleason 3+4, T2c, NX MX, pos margins
PSA 5/06 <0.1, 8/06 0.2, 12/06 0.6, 1/07 0.7.
Salvage radiation (IMRT) total dose 70.2 Gy, Jan-Mar 2007@ age 44
PSA 6/07 0.1, 9/07 and thereafter <0.1
http://pcabefore50.blogspot.com


laxacharlie
New Member


Date Joined Apr 2010
Total Posts : 16
   Posted 5/10/2010 5:08 PM (GMT -6)   
Hi, Goodlife
Thanks for your response. However there seem to be many hernia specialists (including some at Mayo) who do offer laparoscopic surgery for hernia repair, and there is some disagreement (surprise surprise) as to the "best" method. It gets confusing at times.

goodlife
Veteran Member


Date Joined May 2009
Total Posts : 2691
   Posted 5/10/2010 5:14 PM (GMT -6)   
I stand corrected . Seems like a lot of effort for such a simple procedure.
Goodlife
 
Age 58, PSA 4.47 Biopsy - 2/12 cores , Gleason 4 + 5 = 9
Da Vinci, Cleveland Clinic  4/14/09   Nerves spared, but carved up a little.
0/23 lymph nodes involved  pT3a NO MX
Catheter and 2 stints in ureters for 2 weeks .
Neg Margins, bladder neck negative
Living the Good Life, cancer free  6 week PSA  <.03
3 month PSA <.01 (different lab)
5 month PSA <.03 (undetectable)
6 Month PSA <.01
1 pad a day, no progress on ED.  Trimix injection
No pads, 1/1/10,  9 month PSA < .01
1 year psa (364 days) .01

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