Right groin pain, or Left groin pain or both - yes Femoral Hernia - NO OBVIOUS LUMP

This is Part 2 for Right Groin Pain...................................................

Diagnosis:

It can be very frustrating if once you realise you may have a femoral hernia you cannot get it diagnosed either by your GP or by a Consultant.My GP did diagnose a femoral hernia but my path onwards did not go smoothly.

My GP then referred me for an ultrasound, one to make sure that my female bits were fine (transvaginal/internal) and a second one to locate a possible hernia(right groin US/external), due to the long wait for these and the fact that I was not well I decided to pay privately. I probably did this in the wrong order and should have seen a consultant first but at the time I had no idea how the private sector worked.

You are able to choose a Radiologist privately and view their CV and date of registration (years of experience) etc. As it happened I chose the earliest date available at the private hospital but I was lucky as my Radiologist had many years of experience. Firstly he confirmed that my female bits were fine, secondly he proceeded to locate the hernia. I made it quite clear to him that I thought I had a hernia near my femoral canal/inguinal canal. Before I attended the US I did make sure that my bowels and bladder were empty as this aids the examination by having a very squishy abdomen (I had read the bowels part online). The radiologist pushed the camera very deeply into my abdomen and even turned it on its side, while in my abdomen I had had a few US while pregnant but this was a much deeper exploratory examination externally. He found a bulge on my femoral canal on top of the bulge was a hole (no idea how big as presumably it is magnified on the Xray - nothing mind you was poking through (intestine I mean). I was given a copy of the findings on xray and I could see clearly the bulge (not big) and hole. (normal practice with private - I understand.

I then was referred to a Consultant, armed with my findings I expected everything to go smoothly. My Consultant unfortunately did not know the Radiologist and was not happy accepting his findings (I understand this is common practice). I was examined but there is a special procedure that is performed (clinical examination - this is described in the Hernia leaflet on this website), he hadnt carried this out (or should I say I dont believe he did). I was obviously not happy that he wouldnt accept the radiologists findings. He suggested an MRI. As I had read that an MRI would be unlikely to show a hernia (without intestines poking through) I was very relucant. I agreed eventually. Had MRI and there was no hernia. It did show that other than a Cyst, which I certainly didnt have in my first US scan everything was fine, so of some use I suppose.I believe the cyst was very close to my femoral hernia and was in some way caused by it, I'll be positive - (maybe to help? maybe the fluid contains healing qualities!) Remember its an open wound but internal. A cyst from what I gather is a "boil" or "sac filled with fluid". I did put this information to the Consultant but he didnt answer.

To try and gather more information for my Consultant I attended the NHS US that had been arranged. I found that during the US, even though the technician knew it was to locate a hernia (GP wrote) they appeared to be looking for a bulge/lump. He skimmed my abdomen and very gently pushed on my abdomen, in no way did they delve as deeply as the first Radiologist. As I thought nothing was found. Had I known then what I know now and its only with hindsight I would have asked why they dont go much deeper but at the time I was unaware. I think it can only be their lack of knowledge ie femoral hernias often dont have lumps or the equipment? (hopefully not) or just the very technique, he had never had to find one, he had only been asked if he could find one?????? so he/she was none the wiser.

I had one more US to locate the hernia but once again nothing was found. The reason was the same as above, but again its only with hindsight that I know that now.

I did have a CT scan at the very beginning of my problems but that was to locate kidney stones so wouldnt have covered the area of a hernia (I dont think so anyway). All clear on CT scan.

I have also had quite a few blood tests, nothing showed (completely normal for hernias - I understand).

The articles above are well worth reading as I realise I havent written this very well. Within the articles it does mention other diagnosises that can be confused with a hernia and visa versa.

I have no hard feelings towards the medical staff that I came into contact with, I genuinely believe they bent over backwards to try and help me, their efforts were their best. They honestly wanted to help.

If anyone would like to add their story, diagnosis, advice, comment on my discussion please feel free, its here to help all. If Doctor Sarah Jarvis has anything to add I would be interested to read it????

Wow, I've provided a nickname 'Wackystwinsister' because last year I showed my Consultant the same articles you posted here after close to two years' of excruciating pain, which continues to date.

My problems started with a trip to A & E 2 years ago for upper right hand side abdo pain, where the doctor laughed and said 'it's just constipation'. Fell on hip in January 2011, and a scan first suggested 'hip fracture', repeat scan suggested 'nothing wrong with hip'. In April, went to A & E with right-hand back pain, doctor suggests it's my '8th rib'. Then the real pain began! Lower and Upper GI scan revealed twisted and enlarged colon, and colonoscope unable to get through to right side of colon due to incomplete 'movement' if you know what I mean!

Fast forward to extensive prep, still unable to see right side of colon so after a barium enema and CT scan, consultant suggests it's a gynae issue. Laparoscopy booked for last September, but went into hospital in August due to unbearable pain; scan suggested 'pelvic DVT', so spent 9 days trying to 'dissolve' the 'clot' and then having other scans to prepare me for my laparoscopy.

10th day scan suggests 'clot' has dissolved, but apparently 'left-side' colon twisted (despite never having left sided pain in my life). Scan also suggested cyst on ovary and fluid in right-sided fallopian tube (previous pregnancy scan in 2005 had suggested cyst, plus during intra-abdo scan in January 2011).

Laparoscopy scheduled for day 13 of stay to remove tube, potentially ovary, and even agreed to a full hysterectomy if necessary as I have a hand - full of kids, i(.e literally a hand full in numbers). Went under the anaesthesia so optimistic that my pain was coming to an end, only to wake up to be told my ovaries and tubes were as good as new so nothing was removed!!! Horror, despair, revulsion all rolled into one was what I felt.

Discharged myself in the same chronic pain as when I went in, and a lipoma appeared a week later on the neck right sided again - with acute pain on right abdo continuing. To date, I've been diagnosed by the same Trust with pelvic congestion, advised to just take an injection in the groin to numb the pain, or to simply stay on painkillers which stupefy me and constipate even further.

Sent the links you've posted to my Consultant at the end of last year, who literally laughed at the prospect of a hernia, and instead has chosen to rely on scans taken much earlier in the year when they weren't looking for a hernia. A transit scan this year indicated there's a severe blockage somewhere as hardly any of the markers ingested passed through my system, the pain has now settled in my groin area and right leg, yet no solution. An appeal to the NHS to refer me out of borough for treatment has failed, and I'm simply living each day in agony.

Hello twinsister, you sound far far worse than I am, and you've also had some unnecessary operations which cant give you any confidence in your doctors.

My severe groin pain has not returned since my visit to A&E but I can always feel a stinging in my right groin area, like an open wound. I dont take it easy and even if I dont feel well I do whatever needs to be done which cant help.

My nightmare is still continuing like yours. I have the ability to pay for my consultations and tests required whether I agree with these tests or not, this obviously speeds things up.

My first consultant said categorically that I did not have a femoral or inguinal hernia and wrote this in no uncertain terms to myself and my GP. He mentioned the 3 ultrasounds I had had even though one said "slight bulge on femoral canal" and my MRI and CT, nothing found so no hernia. If you look through the mountains of information online and on this website it says "diagnosis by clinical examination", US, MRI and CT scans quite often show no evidence. Obviously symptoms are relevant but I have discovered General Surgeons appear to know very little about femoral hernia symptoms in women.

I then decided to see what I considered should be a top General Surgeon at a well known London clinic where recently a footballer went to. I had to wait quite a while to see him but I thought the wait would be worth it. His main speciality was not hernias. He examined me, asked my symptoms, took my pulse which was higher than normal and then diagnosed me with an overactive thyroid, probably not helped by the fact I had to label the fact I did lift heavy items. I had the test it was normal.

So finally, I have gone to a hernia specialist, he has his own hernia clinic in London and seems to be well spoken of in other hernia blogs. I knew this was a main speciality of his. He did a test on my right leg toes didnt curl on that leg when he ran key up the sole of my foot, my thigh is still slightly numb and has agreed if I have an MRI on my lumbar spine (nerve in right leg might be trapped in my spine even though I have no pain in my back at all) he will do an exploratory in the femoral canal area and find out if I have one or not. So finally someone will have a look. Whether he definitely thinks I have a femoral hernia or not doesnt interest me I just want him to have a look in the groin/femoral area. This is an exploratory operation.

My A&E consultant out of the blue organised a gallstones US which I had done but that was negative.

So I have had quite a few tests but not one has shown anything. I was lucky in that my first US showed a slight bulge on my femoral canal so I always felt I was not going bonkers by saying I had one when my first and second consultant said I didnt or it was unlikely.

There is a Consultant in London who covers hernias and gyne problems, as far as I know there is only one and I think shes called a gyne/oncologist I didnt see her but I have been told she covers both areas, maybe she is a urogynecologist???? not sure.

When they opened you up did they look anywhere near your femoral canal, groin area? What reasons has your doctor given you to say you definitely dont have a hernia. Did you see him face to face to discuss it. Doctors dont like articles from the internet but it seems as if you had exhausted all other avenues. You could contact Embarrassing bodies, see if they might help you????? Especially as you are still undiagnosed - tell me what you think.

Hiya! When they opened me up they didn't look anywhere near the canal or groin area, just at the ovaries and fallopian tube which they said are 'perfect' despite the scans they had said showed they weren't perfect.

I'll contact embarrassing bodies though I was looking last night to see if I could find hernia 'research' clinics I could contact to try and get someone to 'take a look in the groin femoral area' like you've managed to do as part of a research programme or something similar.

I've twice received a letter from my Trust, suggesting they want to give me a nerve block (second one received today), to my 'left obturator' despite my pain having been in my right hand side all this while!

The pain is excruciating, to say the least, and considering I've had many kids and worked till the last day of pregnancy, I can say I've got a high pain threshold, but this pain is really on another level!

Most consultants will not do an exploratory operation unless they are 99% sure. Operations can be risky. They dont want to be sued. Years ago it was different, they didnt have all these scans availabe then so had to take a more risky approach.

Why dont you post on patient co uk your symptoms and the type of pain you are getting and where it is located. See if anyone has any ideas?? You have to be quite specific ie do you feel sick with the pain, have you been sick with the pain? What type of pain do you get in your back. See what other people say.

One very clever question my doctor asked me was "when you were in A&E what was your behaviour like", on the three occasions I was in A&E two of those occasions I was unable to sit or lie on the trolley, I was up, pacing the floor, trying desparately to find different positions to help relieve the pain, I didnt find any positions but it managed to annoy most of the A&E staff as all the other patients were on their trolleys. I just couldnt keep still. I did have codine but even then the pain was bad. The other occasion in A&E I had gas and air and I had no pain whatsoever so I sat on the trolley without a problem, that night they kept me in for four days. I have not felt sick with the pain.I was writhing around on the floor.

Has there ever been a lump? I also had shooting pains down my pubic area as well but my leg was far worse so never bothered to mention it.

I would definitely try Embarrassing bodies it has just started a new series and last night they were asking for people to contact them. They do seem to have very good consultants to advise the people who ring in and they normally are much better afterwards. It sounds as if you have been suffering really bad pain for a long time and to keep taking strong pain killers is not the answer. You have been through a needless operation as well, all good points to get on E.B. I realise you may not want to tell the UK your problems but if they managed to find out what is really wrong then it would be worth it. I think you have a really good case for them to help with. It doesnt always have to be embarrassing.

Just had the results of the MRI on my lumbar spine, they say I have a prolapsed disc. But I have no pain whatsoever in my back, or down my spine and I am still lifting very heavy objects with no pain. I hope this doesnt mean I cant have my exploratory, I would be disappointed.

Thanks so much and I've never had a lump, just severe pain including down that right thigh and in the pubic area. Interestingly, when I got admitted via A & E, it was because they saw a 'blood clot' in the pelvis, whereas although they had me on injections for the 13 days I was in, they didn't talk about any follow-up for the clot or any warfarin or stuff like that. I'm just wondering if the 'clot' was really a cyst or something else - whatever the case, still in so much pain.

I'll go onto embarrassing bodies and see if I can get help there and I understand your point about surgeons not wanting to get sued nowadays. When I asked the gynae chap why he hadn't at least removed the ovary which has repeatedly shown a cyst on it in scans, since I'd signed up for him to remove as a minimum my tube and ovary, and if necessary a hysterectomy, he said it was because once he'd got a good view inside, he 'felt' the ovary didn't need to be removed! I think one huge problem is there aren't enough female consultants, so you get male consultants who don't fully understand how the female body is meant to work (outside of what they've learnt in books) - and there's a difference between theory and reality, that's what many midwives say once they've actually had a baby themself! Off to embarrassing bodies again, and thanks so much for your time.

Hi ladies.

Not sure where to start, but here is my contribution to this discussion.First I think it is worth me setting the scene to get to where I am now. For the last couple of years I have had periods that doctors would say are regular but to me are irregular because I seem to remember them being very regular. My periods range from every 24 days to every 28 days. In addition to this I think I am quite sensitive to hormone flucatations, which in turn make me feel as though I am in a constant menstrual cycle. Which of course we all are (women of course) but most people are only aware of the obvious signs of the menstrual cycle.Ovulation is a process in itself for me, I can feel the complete process. Visits to the doctor are met with it is normal and I should feel fortunate that I know my body so well. I could have antidepressants to help dilute the feelings of anxiety. Quite honestly as grim as it is I would much rather know what is going on in my body.

I also have bowel/wind trouble which is further troubled by my cycle.

Moving on................... last October I started training for the London Marathon. At times following long runs my abdomen area would feel inflammed and uncomfortable. The thought of going to the doctor explaining this well what can I say... Anyway I completed the marathon, but I have to say I felt restricted by the abdomen stuff, so I run to accommodate it. Anyway feeling relatively normal one week a month was becoming part of me.

Early May 2012, had an episode of severe inflamation across my abdomen. This coincided with ovulation so I started to think possible endometroisis. I have though PCOS also. You know you become desperate and google become you medical advisor. Warning going down this route, you can adopt the most sinister illnesses. This accompanied by anixiety is not a good combination.I booked an appointment to see my doctor (14 June) to discuss the above and I also booked an appointment with the gynacologist(21 June) who has a slot at the local family planning clinic, no not to discuss for family planning but, an opportunity to discuss my stuff. I am fed up of feeling like rubbish.

2 June, getting dressed and noticed a lump in my groin area. Instead of feeling worried I felt relieved as I had a feeling this was somehow related to how I have been feeling and indeed still feel. Anyway I visited the walk in centre who confirmed that it was a hernia and I need to see my doctor to be referred for surgery. Back to google and I believe from research that it is a femoral hernia. Thanks to wacky I further researched your suggested sites and felt relief on the findings I beleive I have had this for a coulple of years and the running perhaps aggravated it. Went to see the doctor who said he thought it was a femoral hernia. I have been referred for surgery on 2 July, this may help as the surgeon may have a better undertanding of what symtoms can present with this hernia.

Attended doctor appointment on 14 June explained how I had been feeling, I did ask whether she thought the hernia was related to how I had been feeling. Of course she said they were not, but I was expecting that response. Anyway my doctor suspects from some of my symtoms, one I may have PMT (I agree with that) and two I may have coeliac disesese. I have had test for this and I understand they take three weeks to come back. Another symtoms that has developed is a lot of gas, so burping (not ladylike I know) it feel like I have had a fizzy drink.

Hope I haven't waffled too much, but just wanted to give an idea of the possible side effects from a femoral hernia. Will keep you updated .

Thanks Sanga for posting this, very very useful information. I would be interested to know how they are going to fix it, are they going to mesh it or stitch it???? If its something you would rather not think about dont worry.

I also have trapped gas/air and my stomach is much larger than normal and I havent put any weight on. I have so many symptoms relating to this hernia that I only mention the most problematic ones.

I too am trying to accommodate my hernia by eating very very carefully, only fresh fruit and raw salads, as much fibre as I can eat. If I eat what I did before the A&E admission I end up having to take a laxative.

My last consultant wanted me to have an MRI of my lumbar spine as he wasnt sure why I had a numbness on the top of my right leg, as I have no back pain I was very suprised to learn that I had a "mild prolapsed disc with no never entrapment". I lift very heavy items and am forever bending in awkward positions and have never had any problems with my back. I was then sent to a back surgeon. Firstly this surgeon/consultant was very very pushy and told me that if I had a steroid injection in my back it would cure all my bladder problems, constipation, groin stinging and slight thigh numbness. He also pushed for me to have a private prescription for anti-inflammatory drugs. At the beginning of the consultation I told him that I suffered no back problems and that I was very fit. He didnt examine me or ask to see where the numbness in my thigh was. He was only interested in giving me a steriod injection. He works at a private hospital in harrow that is quite large!!!! Anyway I certainly wont have any injection in my back or take anti-inflammatory drugs. The back consultant told me that a prolapsed disc mends on its own with rest but I have been resting because I dont feel well.

I can only think that the mild prolapse is due to my bowels pressing on it. My constipation is so bad that I should take a laxative everyday but I dont want the problems the following morning.

I am going to one more hernia consultant but I am beginning to think that I will never get it diagnosed and will be left like you in trying to cope with it. I went to the gym today and am trying to get it to burst out as it seems to be the only way I am going to get it sorted. In one of the articles above it says that the men get sent to the lumbar department. These would be men that also dont get a lump, it does happen to men as well.

My periods are now relatively regular but the pain is different it hurts but in a strange way and seems to last forever. My thrush is also playing me up but I am not resorting yoghurt as I am not sure if it is a good idea to constantly use caneston.

My GP diagnosed a femoral hernia twice when I visited her after A&E but that was because I was pointing at the area where you would get one, not because of my symptoms that she was confused about.

Is there anyone in this country that knows about femoral hernia, I am beginning to wonder.

Is it more painful now you have a lump? If so how are you coping. Do you know how big your lump is.

Just interested really.

thanks again Sanga your a star.

Hi Wacky.

Not sure how they will repair it, but will let you know. I understand I will have to have around 2 weeks off work. I think what will happen with you is one day you will stretch or pick something up and out it will pop out in following weeks. I remember one day stretching and feeling a sharp pain down my left side, but the hernia only presented a couple of weeks later. The lump is the size of a grape. I have to say I haven't really had constiaption, but pretty much loose stools.

I have felt quite out of sorts really.

My blood test showed enlarged red blood cells and increased white cells, but I have had increased white cells a few times so doctor not concerned as still within normal range. In fact my doctor has increased white cell count. I think the enlarged red cell cout is possible symtom of coeliac. My doctor has asked me to go back (not urgently) to have a further blood test to check my B12 and follate levels. Anyway my doctor assured me there is nothing sinister to worry about, but you know ones mind does start to wander. Whether this is related to the hernia I am not sure but would not rule it out to be honest.

Agreed, it maybe connected it may not. It is obvious that the symtoms for a femoral hernia are different from person to person, also maybe age and pregnancies or other earlier medical problems show slightly different symtoms.

Also you may not get constipation because you eat a particular diet.

Please tell us how you get on.

Wacky - havent the faintest idea why I called myself that I am not that wacky.

Just updating anyone who is interested. I am still wating to see what the back surgeon says about my prolapsed disc, whether he will take full responsibility for my bladder infections, constipation, trapped gas, stinging groin etc. He was extremely pushy. I have no hope of this particular hernia consultant doing an exploratory now as the back surgeon, from what he told me, will suggest a steroid injection to cure me so this will put more doubts in my Hernia Consultants mind.

Meanwhile I have visited another hernia consultant (normally general surgeons) who many months ago was recommended by my GP's practice and is well known to the surgery. I saw him yesterday and he suggested an exploratoryoperation, but the repair to the hernia, if they find one (its still open for debate) will be repaired and entered from another part of my body. This will mean two operations but I am happy that an exploratory will be done as this consultant did say "the only way of truely knowing is to have a look inside".

I asked this consultant if he would stitch it and he said "no" he would use mesh. The previous hernia consultant said he would stitch it - maybe it depends on what is found at the time, the size of the rupture, and maybe how close other organs are........I do know I have a large bladder so will definitely tell the latest hernia surgeon that.

Anyway, still no diagnosis until I have myself opened up so you never know they could find nothing.......

I did ask about herniography which Patient Co UK mention in their leaflet, the consultant said that it was a test that was considered out of date and not something they would recommend anymore.

Any other ladies/men who want to put their stories forward, please do, it can only help.

I will get back when my exploratory has been done and the results of whether or not I have a femoral hernia have been confirmed.

Had a laparoscopy yesterday. the doctor put a camera down my belly button and looked at my femoral and inguinal canals. After the operation the doctor said that he didnt find any hernias in either my femoral or inguinal, left or right area. He saw no infection. Before they put a camera down I think they blow you up so that they have more space. After the operation I felt ok, when he told me the diagnosis I obviously wasnt happy. But today, I feel very good, maybe its the anaesthetic but I feel much more lively than I have in a long time. Also the stinging in my groin/femoral area has disappeared, maybe when he blew me up he dislodged something that occurred in January and that has helped. This is very early days so will not know for a month if my symtoms (bladder) have improved. It hasnt helped that I did read that they dont always find them when they do a laparoscopy but I am relieved that the area is not full of infection. If I continue to feel better and my symptoms do disappear then it will have been worth it. It doesnt explain the right pain in groin in January but I shall have to live with that.

Keep getting in touch if you have information.

Hi

Thanks for the update., I don't have a femoral hernia the surgeon said it is a saphreno varix (kind of varicose vein). Also blood test came back low iron and low b12. Explains why I feel rubbish. Doctor now exploring

What it could be. I think it is possibly gastritits. Oh yes and I haven't got coeliac.

What can I can say.....

Hi, sorry to hear you are still wondering what you have - just like me. I am still not well. Felt fantastic yesterday after the surgery but I have another bladder infection so am back on antibiotics. What was the lump, was that the vein, did he go inside you and look at it?

I am still convinced I have ruptured myself - somewhere, I do go completely over the top with exercise and lifting heavy weights. When I saw the consultants two of them did say something about my vein, which is near the canal.

As my bladder infection has come back I shall have to think about my next move.