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Surgery Methods dysejaculation |
What about -- Our Hernias?This site is no longer being publicised but we are keeping it available so that interested parties can see what kind of material Leafy Green Web Publishing is capable of producing and publicising. The site was made public from December 2003 to Dec 2005. A hernia information website by the people with hernias for the people with hernias. What about our abdominal hernias, our ventral hernias? What can we do about these wayward organs and tissues, that dare to trespass where they don't belong, and tend to rudely loiter there, where we know they have no business? We can develop inguinal, umbilical, femoral, incisional, and epigastric hernias (alternate plural: herniae). Here is a diagram at Shouldice Hernia Centre that shows where on your body each of these particularly-named malevolent loiterers show up. Inguinal hernias, in males, are the most frequent. Is surgery for such hernias as simple and "routine" as our doctors would seem to want us to believe? Sources of information intended for consumers of medical services, and written by suppliers of medical services -- how much of what they say is straight talk, and how much of what they say is "spin," written more to get us into the operating room without panicking and dashing off in the other direction, than to give us the straight facts? True, hernia surgery appears to be the most frequent kind of surgery that is performed. In that sense, you could say that hernia surgery is "routine." We are talking about over 700,000 ventral hernia repairs in the United States alone. But is hernia surgery simple, easy surgery for a surgeon to perform? Is it routine in that sense? Or is it complicated, tricky, or risky? Just how difficult is it to do, and do without ending up making you worse off after the surgery, than before? And because it is "routine" in the sense that doctors do so many of them, does that mean that it is routine in the sense that the doctor finds that she has to do the same thing over and over, from patient to patient, like a worker on an assembly line does? Is hernia surgery something we would want to rely on a relatively inexperienced surgeon to do? If we need help dealing with a hernia, what help is available from medical professionals? Is surgery the only option? Assuming, for the moment, that surgery is it: what kinds of surgery are available? How much difference is there between different types of surgery? And finally, how much difference in results can you expect, between one surgeon and another? Studies have shown that for some surgeons, 15% or more of their hernia repairs, result in a recurrence of the hernia, within a few years. For the better surgeons, their recurrence rate is less than 1%. Often less than 0.5%. That is quite a difference. For all surgeons, studies show that as high as 30% of patients have significant chronic pain, often lasting years, or indefinitly, and for 15% or more of such patients, the pain interferes with their activities to a substantial degree. Knowing that the outcome of poorly done hernia surgery can be a recurrence of the hernia, and chronic pain, it would seem important to choose a good surgeon. From what I can figure out from my reading, hernia surgery is divided into 2 steps:
Both steps are necessary, but I ask you to take a look at various educational materials, intended for patients, that are provided by doctors and medical professionals, and see what you can find in them about the first step. I think many of these materials gloss over this first step and stress the second step. I hope to eventually make it clear why I mentioned this, and why it may be important to the person with a hernia who is seeking medical-surgical help with their hernia. The second step seems to be, among surgeons, the subject of a bit of debate. There are different schools of thought as to what is the best way to close up the "hole" that had allowed abdominal organs to insinuate their way out of the abdomen. And providers of medical care seem to like to present consumers with a bit of information about the pros and cons of the various methods. However there doesn't seem to be an awful lot of debate in regard to the first step, in regard to returning the abdominal organs to the abdomen and dealing with the sac. Yet it seems to me that this part of the operation requires finesse, if the patient is going to have results they are happy with. Part 2 of hernia surgery seems to be the part determines the likelyhood of a furture "recurrence" of the hernia. But both parts of the operation seems to give rise to the the upsetting, long-term complications that patients complain about. Testicular atrophy, chronic pain, areas of numbness, reduced erectile function, painful ejaculation. I'm not sure which part of the operation, if done with less than maximum finesse, is the part from which more problems arise. But certainly, it seems to me, enough problems arise from part 1, that patients need to know as much about what is involved in that part, as they need to know about what is involved in part 2. For both part 1 and part 2, it seems to be mostly lack of finesse that affects one's recovery, and long-term condition, rather than the method chosen. Nevertheless, there are some variations in doing part one, that may also have an effect. The same thing could be said about part 2 -- however there are a wider variety of methods of doing part 2. Even so -- the particular surgeon that a patient has, seems to have more of an effect upon the outcome of the patient's surgery, than the method of surgery that the patient has. I hope to go into more detail regarding this, at a later date. There are a number of different ways of dealing with a hernia surgically. Mostly these are differences in part 2. There appear to be 2 basic categories of hernia surgery: (1) anterior approaches and (2) posterior approaches, and within each of these 2 categories, there are different methods of dealing with the tissue defect that allowed the hernia to occur. It is interesting to see what the subcategories are, and I will describe them on another page, but, and it seems I am repeating myself: I am convinced that getting a successful result has less to do with what method you choose and more to do with what doctor or medical group you choose. It appears that good surgeons get good results using all the popular methods. Less capable surgeons, using the same methods, get poorer results. The difference can be quite substantial. Lastly, surgeons tell us that abdominal organs find novel ways of insinuating themselves, flowing, out of the abdomen, and surgeons must sometimes, on the spot, devise novel ways of (1) returning the wayward organs to the abdomen, and (2) preventing these same organs from finding a similar way out again, or finding a clever new way out. Gravity and wayward organs are even more persistant than surgeons. Hernia surgery is, in my opinion, not routine surgery, in the sense of being easy or assembly-line repetetive. Because a good repair, that lasts long, and does not result in chronic post-operative pain, requires a great deal of finesse, I would tend to say that getting a hernia specialist to repair your hernia is probably a real good idea. Although there do seem to be a number of general surgeons who do good hernia repairs, even though they don't limit their practice to hernia repairs. I would find out how many hernia repairs they do per year, and suggest that if they don't do more than 100 hernia repairs per year, perhaps you should find another surgeon. Hernia specialists will generally do several hundred per year. This page has been visited web site developed by LeafyGreen Web Publishing article last updated 2005 Jun 16
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