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Incisional Hernia

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Stephen S
Regular Member
Joined : Oct 2019
Posts : 266
Posted 11/10/2020 3:37 PM (GMT -7)
So now about a year post RALP I have developed an incision hernia.

I am visiting a surgeon tomorrow (wednesday).

It feels quite large...on both sides of the incision right above my belly button its at least the size of my hand in total length. I'm not in any pain. Everything works (digestion etc...)

Does anyone have any experience with hernias after a RALP?
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RCS
Veteran Member
Joined : Dec 2009
Posts : 1341
Posted 11/10/2020 4:14 PM (GMT -7)
Yep, for me it was an easy fix. In and out the same day. Reinforced the sutures with mesh. Been good to go for about ten years.
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GoBucks
Veteran Member
Joined : Jan 2018
Posts : 1024
Posted 11/10/2020 6:11 PM (GMT -7)
I have a small one, nowhere near your size. I have had URO, MO and family Doc all feel. All said same thing. Nothing to worry about.
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Steve n Dallas
Veteran Member
Joined : Mar 2008
Posts : 4971
Posted 11/11/2020 2:23 AM (GMT -7)
I had Umbilical Hernia surgery several months Before prostate surgery.... Just don't hang out with any comedians after surgery. Belly Laughing isn't good.
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81GyGuy
Veteran Member
Joined : Oct 2012
Posts : 3130
Posted 11/11/2020 9:03 AM (GMT -7)
We have had in the past a number of discussions about hernias in a prostate surgery setting and what to do about them.

Using the forum search function (upper right on forum index screen) and searching (keeping it general)

hernia prostate

pulls up 499 such discussions (so far), about both "inguinal" and "incisional" hernias.

(BTW, to correct my own ignorance of terminology here, I found this on the Webmd website)

"In an inguinal hernia, the intestine or the bladder protrudes through the abdominal wall or into the inguinal canal in the groin. about 96% of all groin hernias are inguinal, and most occur in men because of a natural weakness in this area ... In an incisional hernia, the intestine pushes through the abdominal wall at the site of previous abdominal surgery. This type is most common in elderly or overweight people who are inactive after abdominal surgery."

After a quick review of the above 499 hits (most had only passing references to the topic) and a little weeding, I thought these three discussions seemed most relevant to the question posed in the OP:

"Hernia Repair After Prostate Surgery"
https://www.healingwell.com/community/default.aspx?f=35&m=3721360#gsc.tab=0

"Inguinal Hernias After radical Prostectomy" (No, not incisional, but some useful information)
https://www.healingwell.com/community/default.aspx?f=35&m=3380994#gsc.tab=0

"Hernia Repair...or not?"
https://www.healingwell.com/community/default.aspx?f=35&m=2777753#gsc.tab=0

Hope these help.

(P.S. I took a special interest in researching an answer for this question because I, too, had inguinal hernia surgery simultaneous with my TURP operation back in 2011)
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GoBucks
Veteran Member
Joined : Jan 2018
Posts : 1024
Posted 11/11/2020 11:21 AM (GMT -7)
Well done 81GyGuy!
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DjinTonic
Veteran Member
Joined : Dec 2019
Posts : 1234
Posted 11/11/2020 12:26 PM (GMT -7)
It's interesting (at least to some of us) that we have the adjective inguinal in English, but groin is used for the noun (inguinopectineal region) rather than the Latin inguina, even in the medical literature.

These are the number of hits hits when I searched in papers at PubMed.

inguinal 43,311
inguina 16
groin 14,129

And the 3 of the 16 papers that used inguina in the title had it in parentheses: "inguinopectineal region (inguina)"

Djin (enquiring minds want to know)
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Paxton
Veteran Member
Joined : Aug 2016
Posts : 1385
Posted 11/11/2020 5:27 PM (GMT -7)
Add me to the hernia club roster — except that mine was after open-heart surgery rather than prostate surgery.

I, too, was one of those imbilical hernias that was in and out the same day. Back to work (office job) in 3 days. Back to the gym (carefully) in a couple of weeks. By now, 7 years later, I can’t even find the scar.

As long as there are no complications in the procedure, the simple ones are easily fixed. If you have a complex hernia, with organ or intestinal involvement, then you need the ace team to do the procedure and you may find yourself with an overnight stay in hospital. These procedures have very low complication rates, and generally much more straightforward recoveries than prostate (or heart) surgeries.
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NewspaperLover
Regular Member
Joined : Sep 2009
Posts : 391
Posted 11/13/2020 9:02 PM (GMT -7)
I had an umbilical hernia in consequence of PCa surgery. Waited a year and a half to have it fixed. Great surgeon on the patch up. No mesh required. Did require general anesthesia. IN and OUT like the burger chain. Was surprisingly sore for a few weeks, but good as new. No complications. Just don’t laugh for a while.
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Stephen S
Regular Member
Joined : Oct 2019
Posts : 266
Posted 11/14/2020 12:42 AM (GMT -7)
I went for a CT scan on Friday. The dr will be calling me on Monday with further instructions.

81GyGuy I did the search as you suggested and I am definitely not alone!

My bulges are quite large....one on each side of the incision but I only feel and see them when I am standing.

So we will see what the surgeon has to say on Monday.
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MG0351
Regular Member
Joined : Jul 2018
Posts : 331
Posted 11/14/2020 10:41 AM (GMT -7)
I have had 3 Hernias....
But not the type mentioned above....
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Mumbo
Veteran Member
Joined : Nov 2018
Posts : 1165
Posted 11/14/2020 2:49 PM (GMT -7)
SS - You would never think I have an inguinal hernia when laying down either. However, once I have been standing for a while, it is clear that the bulge is there as gravity does its work. This is actually good as the hernia is “reducible” by laying down and not stuck in the out position which can be a big problem.

I am awaiting the results of my CT scan on Friday as well although I have studied my images and think I can find the problem area. Hope that is all that they find.
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Stephen S
Regular Member
Joined : Oct 2019
Posts : 266
Posted 11/14/2020 2:58 PM (GMT -7)

Mumbo said...
Hope that is all that they find.

I was thinking the same thing! Tests you cannot study for!

I am also happy to hear the word/condition "reducible" in this context.
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Mumbo
Veteran Member
Joined : Nov 2018
Posts : 1165
Posted 11/14/2020 8:53 PM (GMT -7)
Yeah, my last CT scan report said “by the way, there is some significant calcification in an artery” which led to a cardiologist visit and some additional testing that I really did not need at the time. All turned out fine but just another issue to deal with while dealing with PCa.
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MotownPaul
Regular Member
Joined : Aug 2018
Posts : 78
Posted 11/15/2020 1:17 PM (GMT -7)
I had an Inguinal hernia almost immediately following my surgery. It was the size of a golf ball and hurt like hell. I got it fixed and it’s been fine ever since.
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Stephen S
Regular Member
Joined : Oct 2019
Posts : 266
Posted 11/17/2020 2:29 PM (GMT -7)
So surgery is scheduled for 11/30. I was given a choice between open and robot assisted.

My brother had a hernia years ago and they tried a non-invasive technique. They nicked a hole in his intestine, closed him up, and it nearly killed him. During the discussion today the surgeon mentioned that robotic indeed had that risk but open doesn't. He said the risk with open is infection of the incision.

He said I would be sent home same day regardless of procedure, either way.

I chose open.

Based on my experience recovering from RALP, where those first few days after surgery were awful because I couldn't stack pillows anywhere to get comfortable, I purchased a recliner. Im sitting in it now. It will do nicelyyyyyyyyyyyyy zzzzzzzzz.
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Mumbo
Veteran Member
Joined : Nov 2018
Posts : 1165
Posted 11/17/2020 7:40 PM (GMT -7)
SS - I meet with my surgeon next week so right behind you. I had met with him previously and discussed methods regarding hernia repair on post RALP patients. He said he had done a number of them robotically without any issues. I will ask more questions this time around.

I will probably go robotic as I do not recall any pain from RALP that was attributable to the incisions or muscles cut. It was all the other stuff that made me terribly uncomfortable the days after surgery. I did have conventional umbilical hernia surgery some years ago and I remember that hurting like crazy the next morning for such a small incision. I have had 2 knees and 2 shoulders scoped and repaired without much pain so I am a fan of the little holes and going home. open ACL surgery years ago was the most painful surgery I ever had. RALP is in second place for the discomfort.

I had a friend that had open RP at Mayo and ended up in the local hospital a week later due to surgery complications. You can take all the precautions but stuff just happens sometimes so I try to not worry about that part too much.
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Mumbo
Veteran Member
Joined : Nov 2018
Posts : 1165
Posted 11/17/2020 7:44 PM (GMT -7)
ps: the latest Covid restrictions may make the robotic option more difficult since most of the machines are at hospitals around here and they are starting to limit surgeries. The surgery centers are largely unaffected but I will have to see how this plays out next week.
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GoBucks
Veteran Member
Joined : Jan 2018
Posts : 1024
Posted 11/19/2020 3:49 PM (GMT -7)
Good luck on the surgery. Remember, avoid all comedy and jokes. You can't laugh with that incision. I read something that made me really laugh and I had to bite my hand til I screamed to stop. Pretty sure I can still see the mark.
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Stephen S
Regular Member
Joined : Oct 2019
Posts : 266
Posted 11/19/2020 4:20 PM (GMT -7)

GoBucks said...
Remember, avoid all comedy and jokes.

We would then have to put you on mute for a few weeks! ;)

Thanks for the well wishes.
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GoBucks
Veteran Member
Joined : Jan 2018
Posts : 1024
Posted 11/19/2020 6:03 PM (GMT -7)
LOL. I'll be cool for awhile.
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Stephen S
Regular Member
Joined : Oct 2019
Posts : 266
Posted 12/1/2020 7:13 AM (GMT -7)
Ok its one day after surgery. Here is a brief chronicle of my experience thus far.

One line summary: Compared to RALP, this seemed easier.

As an FYI the hernia developed near the largest incision they created when doing the RALP (the one above my navel). The hernia turned out to be quite large.

1) Covid precautions. I was tested the Wednesday before Thanksgiving, and had my results in the MyChart software that night (i tested negative). Thanksgiving was really muted. Generally speaking life has been really muted as I have only seen like 5 people in the past month because I knew surgery was coming.
2) Surgery went well. Long day. Got there at like 8am and was home by 4. Weird thing....No pillows. They had these foam headrests everywhere. I was not comfortable waiting to be wheeled in to surgery or after in recovery. My wife was not allowed in at all. I felt like they were trying to get me out ASAP. Came home really woozy. I could not walk unassisted at discharge but they really wanted me out.
4) Because the surgery was open I came home with this abdominal girdle which i have to wear for like 4-6 weeks. I dont have to give myself shots to prevent blood clotting like I did with the RALP.
5) Pain level is managed well thus far with three 500 mg tylenols every 6 hours.. Sitting still...no pain. I can now walk around the house. Cannot easily bend. Can slowly do stairs. Can use the bathroom. Interestingly the pad I wear for drips has been completely dry even though I drank a ton of water /juice for the last 18 hours or so plus whatever IV fluids I received. It hurts like crazy to cough or laugh. Until that side effect abates my self quarantine will remain in effect.
6) Very thankful for the recliner...wish I had one for the RALP last year.
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VinceInMT
Regular Member
Joined : Mar 2018
Posts : 431
Posted 12/1/2020 2:31 PM (GMT -7)
Stephen S, thanks for letting us know how it went. It sounds like you are doing well.

You said "I dont have to give myself shots to prevent blood clotting like I did with the RALP."

Yikes!!! I'd almost forgotten about those after my RALP.

BTW, I had an umbilical hernia a few years before PCa. I was out for a 5 mile run and at about the 4 mile mark I felt a pain in that area. I stopped and felt the bulge and knew exactly what it was. I laid down on the sidewalk, arched my back a little, and it went right back inside. Very creepy. I kept pressure on it as I walked the rest of the way home and got into a surgeon within the week. It's been fine every since although he did tell me that it's only about 80% of what it was so don't stress it down there. It's a good excuse for avoiding crunches.
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Skypilot56
Veteran Member
Joined : Mar 2017
Posts : 1426
Posted 12/1/2020 4:09 PM (GMT -7)
Stephen, Good news on the successful surgery. My story was a little like Vince's 6 weeks after RP I was out on a walk about 3 miles from the house when I started to feel a terrible pain around my belly button area turned around and started for the house finally had to stop and take a look wow surprise if my life sticking out of the belly button was a lump the size of a tennis ball I pushed it back in made it home vomitting a couple of times walked in the house told the wife grab your purse and a coat we are heading to Duluth, MN immediately drove the 60 miles to the hospital made the wife kinda scared cause I wasn't wasting any time. Walked into the emergency room after sitting there for two hrs walked crawled back up the desk told the girl to call 911 I was sweating buckets and going in and out of conscious the lump had grown to the size of a baseball next thing I knew I was going for x-ray and then to pre-op had surgery around 3 in the morning. I had to stay the rest of that day and night got out the next day. The manager at work was sure surprised when i called him from the hospital as I had just been back to work 2 days. For me the recovery from the hernia surgery was worse and longer than the RP. I was off from work over 2 months. Hope your recovery goes quick and fast!!!!

Larry
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GoBucks
Veteran Member
Joined : Jan 2018
Posts : 1024
Posted 12/1/2020 7:10 PM (GMT -7)
Glad it went well. Never heard of shots after RALP for blood clots. Stay safe.
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