Which suture surgeon to choose?

[medquestion007]

I have reviewed patient testimonies, FDA recalls, and medical literature about mesh, and I have decided I am going to absolutely avoid it.  I am 28 years old with what is likely a sports hernia.  There is no noticeable bulge or hernia, and the pain has become unbearable and will confine me to a bed for a week or two at a time.  The pain originally manifested in my testicles, but recently I feel pressure in my groin area, resulting in a pinched feeling in my femoral nerves.

I've consulted both Dr. Krischkan in Ohio and Dr. Petersen in Nevada, and both do a modified Shouldice (i.e., 2 layers vs. the traditional 4).  Dr. Krischkan will also add a Goretex patch, but will abstain if the patient requests.  Both doctors impressed me over the phone, and both have done thousands of these repairs.

I've had this for about 6 or 7 years and I just lived with it.  The episodes have gotten more intense in the last year, and I've get ~2-3 episodes a year.  However, no doctor even suggested "hernia" to me, ever.  I finally got sick of it, looked online, and thought wow this might be an inguinal hernia.  Since there is no bulge, I later concluded I might have a sports hernia.  Dr. Petersen in Las Vegas reviewed my symptoms and concurred.  

Are there other conditions which could cause pain over such a long time, consistent with a hernia?
Are there other suture doctors I should consider, besides the Shouldice Clinic in Canada (no passport)?
Is there any way to manage or repair a hernia without surgery?

Thanks.

[Paderla Anitha, DNB]

Hello and hope you are doing well.

Understand your predicament. But if at present you do not have any symptoms, I would advise you to wait and watch. As hernia is a clinical diagnosis, and as a definitive diagnosis has not been made, it may not be there. Check to rule out urinary tract infections.

Hope this helped and do keep us posted.

[medquestion007]

Hi,
Thank you for your response.

It's been about a month since the latest, and by far most severe, flare-up.  I've been to 2 general surgeons, a urologist, a GP, phone call with hernia specialist, and 2 ER doctors (I was worried about strangulation).  So far, I've heard quite a variety of things:

1.  Weakness of inguinal canal
2.  Epidimidis.  (prescribed antibiotics)
3.  Inflamed prostate (prescribed antibiotics)
4.  Nothing wrong
5.  Very small inguinal hernia
6.  Sports hernia (consistent with #1)

There seems to be a lot of variation in the diagnosis.  From what I gather, groin pain is extraordinarily difficult to diagnose without obvious symptoms.  I am worried about confirmation bias by my self-diagnosing, but I'm frustrated with the half dozen or so doctors not having anything for me to go on.  I am at a dead end and don't know what to do.  They say imaging won't work.  I'm worried I might get an unnecessary, high-risk surgery that may not fix anything.  

Is there a better approach here?  Should I see a different type of doctor, perhaps a sports medicine guy?  It seems that people diagnose within their specialty...the urologist said I had an inflamed prostate (but didn't actually check) and the general surgeon said I had a weak inguinal ring.  There isn't much consilience about groin pain.  I am at a dead end and would appreciate any advice about how to proceed.

[Paderla Anitha, DNB]

Hello and hope you are doing well.

With an inguinal hernia, usually there is a bulge visible. This usually increases on coughing and reduces on lying down. You need to be examined by your primary care physician for a diagnosis to be made. Surgery is the only treatment and cure for inguinal hernias.The surgery is best performed as an elective surgery with all the adequate precautions, to prevent recurrence. As we do not maintain a directory of doctors in this forum, we cannot recommend any specialists.

Hope this helped and do keep us posted.