Inguinal Hernia And Urinary Retention

The reason that I had to live with a catheter for so many months was initially to relieve the acute urinary retention (AUR) – meaning I could no longer go wee-wee – being caused by a urethral stricture (see the post My Stricture of the Urethra for more on what that means).

In the weeks leading up to that day I woke up with no ability to pee at all, my stream was very weak, and when I went to the bathroom, my bladder would try to push against the blockage. The caused painful contractions – involuntary contractions – that were difficult to prevent. Thankfully, once the catheter was placed, this was no longer an issue.

So after a few days of having the catheter, with its inflated balloon sitting inside my bladder, I noticed a little bulge at the bottom of my abdomen (on the right side). I remember telling my wife that it must be the catheter balloon causing it. There was no pain from it, so I just forgot about it.

Flash forward 6 months, to a point several weeks after I had the catheter removed (this was post-urethroplasty surgery). I noticed that the bulge in my abdomen was still there. Odd. Clearly it was not being caused by a balloon in my bladder. It hadn’t been causing any pain. What was it then?

At my appointment for the uroflowmetry test, I asked my urologist to take a look. He pushed and palpated the bulge and said, “yeah, you have a hernia.” What? Isn’t that bad?

It turns out that it is an inguinal hernia (https://digestive.niddk.nih.gov/ddiseases/pubs/inguinalhernia/). After doing some research into this type of hernia, it turns out that some folks may be in danger with an inguinal hernia – if a bit of intestine becomes “strangulated,” for instance. That can even be life-threatening. But other folks, especially the ones for whom the bulge causes no pain and seems to disappear when they lie down, may actually not even need to have the hernia repaired at all! But let a doctor make that call!

I have a consult for General Surgery to look at my hernia in a few weeks. For the present at least, mine is not considered dangerous. But if I start to feel nauseated, have any fever, or notice the bulge turning red or purple, I’ll be going to the emergency room.

So how did I GET an inguinal hernia in the first place? Well, that is hard to say with certainty. But remember when I mentioned the abdominal contractions I was getting when I tried to pee before I got the catheter? My urologist thinks the repeated straining caused by those contractions were to blame. But just that alone would not normally be enough. There has to be some sort of defect or weakness in the abdominal wall. In guys, this is usually caused by a congenital problem where the entrance to the inguinal does not close properly when you’re a baby. That’s probably what happened to me, combined with the intense “bearing down” in the area during the weeks of AUR I went through before the catheter was put in.

So that’s something I didn’t know. So if you notice a bulge down just below your pubic bone, it might be worth having checked out to see if it is an inguinal hernia.

[Update – Nov 3rd]

I had my consult with General Surgery a couple of weeks ago, and they determined that the inguinal hernia required surgery. It was scheduled for January 14th, 2014. But they had a cancellation for November 5th. So they are going to do open surgery (as opposed to laparoscopic) on that day. When I was having my pre-op meeting with General Surgery, I told them I’d been experiencing pain in my testicle and scrotum ever since my urethroplasty 14 weeks earlier. Based on that, they decided to send me for an ultrasound of my scrotum. I underwent that test last night. Tomorrow I have a meeting with my surgeon (the one whose going to perform my hernia repair), and I am hoping that the ultrasound turns something up that will shed some light on why I’ve been having all the pain. Then I hope he tells me the surgery will fix everything. Aren’t I the optimistic one?

I’ll update this post tomorrow after my meeting with the doc.