Extreme weight gain!

Hey everyone!

I was hoping I could get some advice from you all regarding an inguinal hernia I've been dealing with for about 14 years now... honestly, for the longest time, I didn't have any symptoms at all—no pain, no burning, nothing—it was completely asymptomatic. It was just a medium-sized hernia on my right side, and since it wasn't causing me any actual trouble, I always figured there was no real reason to go through with surgery...

But then, about four years ago, a portion of the hernia started descending into the scrotum. That part was roughly the size of a walnut, but again, it didn't hurt or burn, so I just kept living my life as usual... however, about six months ago, that area started growing, and now it's more like the size of a tennis ball. I've also started noticing some symptoms lately, like this stinging sensation in my groin, a bit of pain, and just a general sense of discomfort in the scrotum...

On top of that, I’m feeling some pressure and occasional cramping deep within my abdomen...
I was wondering if those cramps could be directly related to the hernia itself, or if it might be something else entirely...

I’ve been thinking about traveling over to Germany to see Dr. Koch, because I've heard from a few people that he's a major specialist when it comes to inguinal hernias...

So, there are a few things I'm curious about:
1. Has anyone here actually gone to him for surgery, and if so, what was your experience like?

2. He mentioned that he performs Neurolysis during the procedure, and I was wondering if anyone knows what that actually entails and whether it's generally recommended...

3. It seems a little strange to me that he sends his patients to a nearby hotel after the operation, much like how Dr. Muschaweck does... I mean, shouldn't a patient ideally have medical staff close by right after surgery, just in case there's vomiting, intense pain, a fever, or something else popping up...

It feels like you can only really get proper, full care in a hospital setting rather than staying in a hotel...

Hey there,
1. I’m assuming you’re talking about Dr. Andreas Koch? Back in 2016 and 2017, Focus actually named him their Top Physician of the Year for his work in pelvic hernia surgery. While I haven't sat in his exam room personally, he certainly seems to have a stellar reputation in the field.
2. As far as I understand, Neurolysis involves clearing away scar tissue from the nerves. That buildup can be a real nightmare when it comes to chronic pain, so if you're dealing with discomfort, it makes total sense why the doctor would bring up neurolysis as an option.
3. In my experience, procedures of that complexity aren't typically handled at an outpatient center.

stormyhound13 said:Hey everyone.

I'm looking for some advice regarding an inguinal hernia I've been dealing with for about 14 years now. Honestly, it was never an issue—no pain, no burning, nothing. It was just this medium-sized bulge on my right side. I figured, why bother with surgery if it isn't actually bothering me?

But then, four years ago, part of the hernia started descending into the scrotum. That bit was about the size of a walnut. Still no pain, no discomfort, so I just ignored it. Fast forward to about six months ago, and that swelling has grown to the size of a tennis ball. Now I'm starting to feel things—a stinging sensation in the groin, some soreness, and this nagging discomfort in the scrotum.

On top of that, I’m feeling pressure and occasional cramping deep in my abdomen.
Could that cramping be caused by the hernia itself, or am I looking at something else entirely?

I was thinking about heading over to see Dr. Koch in Germany. Some people say he’s a massive specialist when it comes to inguinal hernias.

So, here’s what I’m wondering:
1. Has anyone here actually gone to him for surgery? What was the experience like?

2. He mentioned performing Neurolysis during the procedure. What does that even mean, and is it actually something you want done?

3. It seems a little weird to me that he sends his patients to a nearby hotel after surgery, similar to how Dr. Muschaweck operates. Shouldn't a patient have medical staff within arm's reach after an operation? You know, in case of vomiting, intense pain, fever, or whatever?

I mean, you can get proper care in a hospital, but you aren't getting full nursing care in some hotel room.

My husband had his hernia repaired recently. Not with your doctor, but also in Germany since we live here. Over here, they treat it as an outpatient procedure, so you head home just a few hours after the surgery. Someone has to physically pick the patient up, assuming they can walk—they might be a bit groggy, obviously, which is why they don't drive themselves. For pain, they give you Ibuprofen, and you're given heparin shots to administer yourself. Then you just follow up with your regular family doctor.

So, he’s saying all of this happens at his own private clinic or outpatient surgery center... which honestly makes me a little nervous, because I was really hoping to have my procedure done at a major hospital like Mayo Clinic rather than somewhere smaller...

Yeah, so this is actually about Andreas Koch...

I was just wondering how you all define "outpatient" in this context... I’m still trying to wrap my head around some of these medical terms because they feel a little fuzzy to me...

I think I’m starting to get the full picture now, though it does raise a bit of a dilemma since I don't actually live in Germany... so if I follow what he's saying, I’d have to spend about three or four days staying at some hotel nearby, and he would just check in on me once a day, and then if everything seems to be going smoothly after those few days, I could finally head back home...

I'm curious to hear what you all think about that kind of arrangement?

Outpatient means you show up in the morning, get the procedure done, and then head home or back to your hotel just a few hours later. It’s probably a good idea to have someone drive you. Most major hospitals or medical centers have their own dedicated Outpatient Surgery Center for these kinds of minor things.

Basically, you’re getting the same level of care an American patient would get living here. The only difference is that back home, your primary care doctor handles the follow-ups, whereas once the surgeon finishes the procedure, they pretty much wash their hands of you. Since you're coming from out of town, you don't have a local GP to lean on, so your surgeon ends up playing both roles. Just keep in mind, even after those first three or four days, you aren't going to be sprinting around. You'll still be limited when it comes to walking long distances or lugging heavy suitcases. It all really depends on how you were planning to travel.

When it comes to the travel aspect, I’m not really sweating it because my brother is coming along to look after me and keep a close eye on things...🙂

The main reason I settled on Dr. Koch is simply because he doesn't use mesh.
Where I live, everyone seems to go with the mesh approach, but I've been reading up on it and apparently, it can cause some pretty significant issues down the road. There is also Dr. Muschaweck, but traveling that far feels like a bit much for me, and I have a feeling her fees might be higher than his anyway...

I guess I'm still kind of in that undecided phase regarding whether I should actually pull the trigger on the surgery or not. To be honest, I don't deal with debilitating pain; I sleep fine, I move around without much trouble, and I can still get my walks in, but lately, I've started noticing this slight discomfort, just these occasional stinging sensations and mild aches... I've had this hernia for about 14 years now, but over the last four years, it has gradually migrated down toward the scrotum, and it's roughly the size of a tennis ball now, which is probably why those symptoms are finally starting to creep in.

I was just wondering, did your husband have his surgery done under local anesthesia or did they go with general...?

stormyhound13 said:Did your husband have the surgery under local or general anesthesia?

under general anesthesia

If you don't mind me asking, I was just wondering how you were feeling once the surgery was all over... did you deal with any nausea or maybe run a bit of a fever or anything like that?

None of that. He just popped three 400 mg Advil tablets. He’s never been much of a pill person anyway. He was feeling a little loopy that first day, sure, but by day four? He was back behind the wheel driving his car fine enough.

If you wouldn't mind, I was also wondering about three more things:
1. Did he deal with any pain leading up to the surgery?
2. Was the hernia just in the groin area, or did it extend down into the scrotum like mine has...
3. And did they perform the repair without a mesh, or did they use one?

Best regards!

He didn't even feel any pain. Just this weird sensation whenever he’d cough or anything. The hernia was strictly in the groin area, so they just went in and installed a mesh. Good luck with everything!

I was wondering if anyone here could give me some insight into how common chronic pain actually is following an inguinal hernia repair... does anyone know what kind of percentage of patients end up dealing with long-term discomfort after the surgery is over?

I think I read somewhere once that maybe around 20% of people develop chronic pain...

Chronic pain? In my case, it’s basically at 0%. You might feel a little thickening here and there because of where they implanted the mesh—it’s just an old habit of mine to poke at it to make sure everything is still sitting right where it belongs. But honestly, one thing you absolutely have to do is stick to nothing but cold showers. It’s non-negotiable if you want to stay on track.
Good luck out there.

Have any of you guys gone through surgery here in the States, or did you end up traveling abroad for it?

And if you don't mind me asking one more thing... do you think it's actually a smart move to go under the knife when dealing with back pain?
The pain in my lower back is just getting to be too much, specifically right down at the base of my spine, near the tailbone area...

Rebro
2. honestly, it’s up to the anesthesiologist to make that call at this point.

I honestly don't get why anyone would bother dealing with the hassle of traveling to Germany just to pay out-of-pocket for a surgery that’s basically routine—it's such a straightforward procedure. I had mine done about eight years ago at a local hospital back in the States, and man, the recovery was lightning fast... plus, I haven't dealt with any pain since.

Hi there. I happened to stumble upon this thread and I have a question. What kind of issues can the mesh actually cause?...