hernia or strain?

I'm a 31 year old man in in good physical health and physically fit.  I had a mesh inguinal hernia repair (left side) about 10 years ago.  Two weeks ago I went heavy in the gym and everything seemed fine.  However, later that night while getting off the couch I felt a sharp pain on my right side ( it felt all too familiar.)  The next day I had a rather large bulge in my right lower abdomen area (like an egg size in diameter, but only slightly noticable.)  I went to the doctor he said no obvious hernia was present (nothing was pushing through.)  Symptoms got worse the next day and included constipation, bloating and pain in right testical.  I returned to my doctor and he presecibed a stool softener and suggested an X-ray and ultra sound, but neither revealed anything abnormal.  I went back to doctor and he prescribed ibuprofin for the pain and possible swelling.  I felt better after about 1 week, but the bulge is still there.  So, yesterday I went for a short hike and today my right testicle is really hurting and I can feel a cord pulling from my stomach all the way down.

Any ideas on what I could have done?  Is it possible to strain a testicle but not have a hernia?  If so, what’s the recommended time to not exercise?  Also, what could cause the bulge?  ...I live on an island and quality medical attention is hard to come by.  I appreciate any help.

[Kevin Pho, MD]

Indeed, the possibilities include a repeat hernia or muscle strain.  Normally, this can be determined through a physical exam.

However, if the case is unclear, I agree with the ultrasound and/or a CT scan which can give a more definitive diagnosis.  

So, yes it is possible to have a strain and not a hernia.  I cannot give specific recommendations as for treatment over the internet, but it seems like imaging would be your next step here.

This option can be discussed with your personal physician.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin Pho, M.D.

KevinMD.com
Twitter.com/kevinmd