The Herniabible Blog

advice from people who have had an inguinal hernia

Loss of Orgasm After Groin Hernia Surgery

This report comes from one of our survey respondents

It’s now 365 days since my right inguinal hernia repair, open using mesh. From the morning after surgery there has been complete loss of orgasm and all erogenous/erotic feeling. The doctors are in total denial. This happens more often than they care to admit. Apparently we need all the sensory nerves in order for the brain to produce the sexual high and orgasm. Pudendal and perineal nerves often yanked in removing hernia sac… pull a nerve 15% and it never comes back, except as pain. Iliohypogastric and ilioinguinal also contribute to sex feelings, especially if you are circumcised. If only I had known.

More details

During open inguinal hernia repair, the pubic tubercle is the bone landmark which surgeons use to tell how far to cut. Two centimeters in from this point is where the spermatic cord changes course and a finger is used to separate it from the floor. The hernia sac is a part of the interior lining enclosing the bowel that is forced out through the inguinal canal. Typically it adheres to the cord and must be cut free. The surgeon can only go those two centimeters before encountering the suspensory ligament of the penis.

This is a wide band that circles and encloses the penis very much like a ‘marital aid’ or constriction band. It is firmly attached to the pubic bone and is what makes an erection point up and supports it for sex. It also helps the veins close off to maintain the erection.

The penile dorsal nerves lie under this sheath and are also exposed in the area inside before the penis enters the encircling ligament. If the surgeon pokes through this area in any of the three steps (exposing the cord, dissecting the sac, or suturing the mesh to the pubic tubercle) you can end up neutered like I was. If the suture ties into the ligament you can get the often-described-but-never-explained loss of firm erections, or often described ejaculatory or erection pain.

In my State medical malpractice claims have been legislated out of existance in the name of tort reform. I cannot be fixed, there is no way to protect yourself from incompetent surgery, and no way to make the doctor pay. Lack of informed consent likewise does not exist as a legal barrier.

If you had inguinal hernia surgery more than a year ago, please consider filling in our anonymous online survey.

June 16, 2009 Posted by | Case reports, Surgery issues | , , , , , , , | 11 Comments

Think carefully before you opt for hernia surgery

KPS’s Story
2 Oct 2008
Had my inguinal hernia repaired by open surgery six weeks ago today. Worse off now than I was before I had the repair. All was ok for the first week, and then the pain and discomfort started to increase. I visited my GP who said all was well and not to worry and prescribed a course of antibiotics to counter any swelling. This achieved nothing and the discomfort increased although the bruising went away to be replaced with numbness down the side of my groin and the top of my leg. As well as this I now started having pins and needles in my right hand and loss of feeling at various times. Having endured two more GP visits with little progress I was told to wait a couple of weeks to see if things settled down. I have only this week started driving to work, as I still find it difficult to lift my leg. I cannot continue to do my job as a heavy vehicle engineer and am working in the office until further notice. Each day when I get home it feels like I have a heavy bag of potatoes pulling at my groin and I am ready for bed at 8 pm.

7 Oct 2008
Been to the GP again today and saw a different doctor. He recognised my problems straight away and suggested an injection of cortisone mixed with an anaesthetic to lessen the pain. He admitted that the tissue was still swollen and that I had suffered nerve damage during the surgery. At the moment it feels strange as it’s only one hour after the injection. Back to the doc in three weeks to see how it went, also identified the problem with my numb hand. It turns out that the radial nerve in my elbow was crushed while I was on the operating table. I have to wait three weeks to see if it improves before getting any treatment.

28 Oct 2008
Got my cortisone injection which hurt like hell. Everything calmed down for a couple of days before the pain returned. Explained this to the doc and he checked me out again and this time found the spot where the pain was coming from. After I peeled myself off the ceiling he tried a test with a needle to see if I could feel anything in the area that’s numb from the incision down the side of my groin and into my leg. I did not feel anything. I’m now going to try some nerve blockers (Amitriptyline Hydrochloride) to take the pain away and make me more mobile, to see if the nerve tension decreases. The side effects are a bit worrying.

18 Nov 2008
Have tried Amitriptyline and found little improvement, so went back to the GP. Am now waiting for an appointment to see the surgeon who originally did my surgery. Will be interested in his comments.

17 Feb 2009
I have just been to see the surgeon at the hospital and he has agreed that there is a problem. The area down the right of my groin is swollen and puffy and there is still discomfort and pain there as well as around the scar. So I am now waiting to have the groin and the scar scanned to try and see what the problem is. It’s only taken 6 months to get this far. The story continues.

GDSM’s Story
GDSM had surgery with a mesh implant for a left inguinal hernia. Due to persistent post-operative pain he returned for many follow-up visits, to be told that everything was “normal”. Then after one year the surgeon decided that he may have stitched up the nerves in the groin and recommended re-operating. GDSM sought a second opinion and was told the symptoms did indicate a trapped nerve. The second surgeon subsequently cut the nerve (he could not remove the mesh implant without causing further damage). GDSM remained in very bad pain and could barely stand up straight. Many visits later the surgeon said he could do no more and referred GDSM for pain management. After 60 nerve block treatments and many types of anti-depressants and pain medications including oxycodone, tramadol and morphine, the pain still persisted. GDSM went from one surgeon to another until he finally found one who was prepared to remove the mesh implant. This brought some improvement but the nerves in GDSM’s groin are now so severely damaged that he is diagnosed as having RSD (Reflex Sympathetic Dystrophy, also known as Complex Regional Pain Syndrome) – “a whole new fight”. The primary symptom of RSD is intense, continuous pain. Improvement is beginning but is slow.

MCB’s Story
7 Sep 2007

I certainly wish i had done some research and found the Herniabible website before electing for surgical repair. I first noticed a small lump in my left groin in 2004, I suspected it was a hernia caused by weight training (I am a 38 year old male) but chose to do nothing about it as it was causing me no symptoms of any kind, no discomfort, I was only aware of it when showering etc.

in 2006 a chance, informal conversation with a doctor caused me to seek medical advice. Subsequently, my GP referred me to a consultant, who suggested surgical repair. No mention was made of post-operative complications. The option of leaving the hernia until it was causing symptoms/pain was not discussed.

I had surgical repair carried out in March this year on the National Health Service. It was not the original consultant surgeon, but a registrar who performed the surgery.

Prior to going into hospital I was a fit, healthy and happy young man. Since the day of the surgery I have experienced constant pain and tightness in my groin. I walk with a limp, cannot exercise, find it difficult to experience pleasure in life due to the discomfort and have become very depressed.

It now transpires that the registrar made his incision the wrong way, which has caused scar tissue to form around the cord that feeds blood to my testicles. This pulls my penis to one side, causing discomfort, and an erection is impossible to sustain due to the pain. There is almost certainly nerve damage which will subside over the years but never full heal.

The consultant has offered to attempt to remove the mesh and free up the cord, but due to the original scar being in the wrong place will have to cut further out. The repair is not simple and I could lose my left testicle.

I am hopeful that things will improve after this repair, however, am worried that they may get worse.

The reason I am writing this post is to advise anyone thinking about having surgical repair for a hernia to carefully consider your options. If I had followed the advice on the Herniabible website I could have had 20 symptom-free years with my hernia. Now I am facing 20 painful, unfulfilled, unhappy years.

28 Jun 2008
In December 07 I went in for further surgery to have the mesh removed (by the professor this time). After the surgery he told me that he had removed a nerve as well as the mesh. I wasn’t entirely happy with this as I had clearly expressed the desire to have only the mesh removed and no other form of treatment. However, I felt relatively well after the operation, and went home trying to be positive.

After about two weeks I started to realise that all was not well. He had gone in through the same scar, so the tightness of the scar tissue pulling my penis to the left returned. I am now left with a penis which is painfully pulled to the left for the rest of my life.

It soon became clear that the surgeon’s decision to remove a nerve had been the main problem. After the removal of the mesh, the tightness between my abdomen and my left leg was less. But after about a month, when the scar had healed, the pain in my groin was actually increasing. I am now in considerably more pain than I was after the original operation, and this is constant pain, every minute of every day. Physical activity obviously makes it worse. Every step while walking produces pain and discomfort.

It’s easy for me to get negative while writing on this subject. Suffice to say, my feelings on surgical repair for inguinal hernia are obvious. I’m told that in three years the pain may start to subside. It certainly has not abated in the last six months. I’m also led to believe that damge to large nerves does not heal well.

There is also the problem that came from limping for so long after the original operation due to the mesh being so tight. Removal of the mesh has helped, but when I try to exercise on my rowing machine, my hip now clicks due to the effect of walking with a limp for so long.

Anyway, the reason that I am writing another post is to warn anyone due to have surgery for a hernia, that things may go well, however, they may also go badly, and once the damage is done, there is no returning to your pre-operative condition.

25 Feb 2009
Hello to everyone reading this post. I am pleased to see that the post is still active and that it has been viewed many times. I hope the admin won’t mind me adding another reply. It has been two years since my original op and 15 months since the 2nd op. I still experience considerable pain and numbness and suffer sexual dysfunction. It is interesting to note the article by O’Dwyer on watchful waiting as he was my consultant. I was an ideal candidate for watchful waiting, I was young, healthy, physically fit, with a small hernia which was asymptomatic (I had no pain or discomfort, it did not affect my life at all) and which had not grown in three years. During the consultation he did not mention watchful waiting or any alternatives to surgery.

It is hard to quantify how badly the pain, numbness and sexual dysfunction has affected my life. Suffice to say that I now understand the term ‘Over the Hill’. My days as a healthy, physically and sexually active young man are behind me. Psychologically it is very difficult to accept. I have been depressed since the first operation. My message is simply this, if you are in a similar position to the one I was in and you are reading this website, then you are in a position to avoid the pain that I have suffered. Remember when consulting doctors (GPs or surgeons) that it is only their opinion and that there are alternatives views on what to do when you have a hernia.

Yes, there are cases of hernia repair surgery which have gone well. However, mine is a genuine case where the surgery was unnecessary and the outcome significantly damaged the quality of my life. Due to there being no follow-up visit to the consultant, I imagine that my case has been statistically classed as a success. How many other outcomes similar to mine will be classed as successful? It is common for people in the UK to assume that the medical establishment ‘knows best’. However, I truly believe that if I had never visited my GP with a lump in my groin, I would be happily living with my hernia in blissful ignorance. As you are reading this website, then you have access to information which will mean that you could live with your hernia for many years or even heal it without surgery. Please invest the time to understand the alternatives to surgery for an inguinal hernia.

It seems incredible to me that there are tens of thousands of surgical repairs carried out on inguinal hernias each year when they can be healed with a £50 flat pad support. If I had known about them before my operation and if I had known how badly surgery would have affected my life, I would have gladly paid £5000 for such a product.
I would urge anyone reading this to seriously consider this account of my experience of surgery, and to search the internet for more accounts of post-operative pain and complications. I can assure you that I am not unique in my experience.

Message from Herniabible staff: The above three cases are sadly not unusual. Here is what the researchers say.

“Watchful waiting can be recommended as an alternative to surgery for men with inguinal hernias. Emergency surgery is needed only rarely, and a substantial minority of patients have persistent discomfort for at least several years after hernia repair surgery.”
O’Dwyer and colleagues, Annals of Surgery, 2006

“In a survey taken one year after surgery, 29% of patients still suffered persistent post-operative pain. Younger patients were worst affected. The problem equally affected all types of hernia and surgical technique”
Bay-Nielsen and colleagues, Danish Hernia Database, 2001

“After surgical mesh repair, 15% or more hernia cases are reported to have a recurrence, and postoperative pain and disability are frequent, especially after a second repair operation.”
Neumayer and colleagues, New England Journal of Medicine, 2004

One year after hernia repair surgery, 3 to 6% of hernia patients will have severe pain, and more than 30% will have mild pain. This pain persists for many years and affects everyday activities.
Page and colleagues, British Journal of Surgery, 2002.

If you had inguiinal hernia repair surgery more than a year ago, please take part in our online survey

Click here to access links to these and other medical articles on our main site.

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April 8, 2009 Posted by | Case reports, Surgery issues | , , , , | 4 Comments