Implant First or Hernia

[AST2123]

I am consider implant, the process was put on hold before due to issues with my previous insurance. I had an inguinal hernia repair on the left side by mesh, and now I am seeing a little swelling on the right side. My surgeon stated that I need to have it done with a mesh as well.
I do not think the hernia is an urgent issue for me, but I am concerned about doing hernia repair after prothesis implant.
I would appreciate your valuable opinions on this issue. If I get the implant, the reservoir will be located in the middle of the scrotum, I think. So, I am trying to decide on which one I have to go for first. I would love to have the implant first, as it takes a couple of months to heal completely.

[hopeful_future]

I'm not a doctor, and this isn't intended to be professional medical advice. However, my husband has had meshes put in on both sides, and I just got an implant a couple of days ago. I think my recommendation would be to go for the hernia first. The reason I'd say this is just that any surgery is going to involve some strain around urinating and passing stool, especially depending on what pain meds work best for you. I don't think the reservoir placement would be an issue, but your doctor would know more about that.

Again, just my opinion, but I'd ask myself "could I go 5 years without this surgery and still be healthy?" Between the two, I think the hernia surgery just takes higher priority health-wise. If there's anything time-sensitive (doctor availability, finances, etc), that could change my opinion on it, but all things being equal, that's what I would go with.

And of course, ask both of your doctors, they may have better information than us internet citizens.

[AST2123]

I'm not a doctor, and this isn't intended to be professional medical advice. However, my husband has had meshes put in on both sides, and I just got an implant a couple of days ago. I think my recommendation would be to go for the hernia first. The reason I'd say this is just that any surgery is going to involve some strain around urinating and passing stool, especially depending on what pain meds work best for you. I don't think the reservoir placement would be an issue, but your doctor would know more about that.

Again, just my opinion, but I'd ask myself "could I go 5 years without this surgery and still be healthy?" Between the two, I think the hernia surgery just takes higher priority health-wise. If there's anything time-sensitive (doctor availability, finances, etc), that could change my opinion on it, but all things being equal, that's what I would go with.

And of course, ask both of your doctors, they may have better information than us internet citizens.

Thanks hopeful_future for your reply.

[Txagq8]

i would do the hernia.

if one isnt bothering you its eady enough to ignore a hernia. until it strangulates. then it isn’t possible to ignore, nor is it as easy to fix as it would be beforehand.

A strangulated hernia that goes gangrenous can kill you. By comparison ED is a minor inconvenience.

they won’t do both surgeries on the table at the same time. I know. I asked.

Therefore I had hernia done 17 Dec 2019 and implant installed 31 Dec 2019. Two weeks apart. Piece of cake.

[Lost Sheep]

I think the reservoir of a 3-piece implant cannot be placed in the scrotum under any circumstances. (There is one model where the reservoir is part of the inflatable and the pump and valve are in the scrotum, but that is not often used absent complicating factors.)

Normally the inflatable tubes are in the penis, the pump bulb and valve unit is in the scrotum and the reservoir placed somewhere in the abdomen.

Placement of the reservoir is sometimes complicated by anatomy or prior surgeries but there are various locations that can be used.

FOR SURE, let your surgeon doing the hernia repair know that you will be having an inflatable penile implant in the near future and request that he make allowances in how that surgery is performed (incision location, repair technique, etc).

Ask about doing both at the same time. Txagq8's surgeon may be more conservative/cautious than yours. Sure, doing both is more complicated and a bit riskier, but doing two surgeries in succession carries added risk, too. In my case, I had an implant and vasectomy done at the same time. Some people advised against that for various reasons, but my surgeon had no problem with it, doing the implant first and then (as he said, if there is no contraindication) finishing up with the vasectomy. My case was different than yours, as my case still only involved a single incision in the scrotum and your case will likely involve two incisions in different locations. Your surgeon(s) will know best for your particular case.

[AST2123]

Thanks Txagq8 and Lost Sheep for your responses.
Of course doing both in one session, will be the best option for me, but hard to find a top transplant surgeon accepting it, or performing both.

[Echegollen]

I had the exact same question as AST2123 and I was about to post it right now but then I came across this thread. What a coincidence.

I know I wouldn't be comfortable doing both at the same time, not necessarily because it would involve a higher number of incisions done at the same time, but more because I would want to have the best of the best surgeon for each surgery. From what I understood, an inguinal surgery is not a walk in the park and can go extremely wrong. I doubt I could find a surgeon who is amongst the best of the best in penile implant surgeries who is also one of the best in inguinal hernia surgeries.

I don't think top surgeons for penile implants such as Dr. Eid and Dr. Perito would do hernia surgeries. They are the best at what they do because they focus on very specific surgeries.

[oldbeek]

I had a hernia repair after my implant in the same university hospital. I had concerns that the hernia surgeon lacked information on the whereabouts of the reservoir. I didn't want to get my reservoir nicked by a scalpel. The hernia surgeon had my implant surgeon assist her with the operation.

[AST2123]

I had the exact same question as AST2123 and I was about to post it right now but then I came across this thread. What a coincidence.

I know I wouldn't be comfortable doing both at the same time, not necessarily because it would involve a higher number of incisions done at the same time, but more because I would want to have the best of the best surgeon for each surgery. From what I understood, an inguinal surgery is not a walk in the park and can go extremely wrong. I doubt I could find a surgeon who is amongst the best of the best in penile implant surgeries who is also one of the best in inguinal hernia surgeries.

I don't think top surgeons for penile implants such as Dr. Eid and Dr. Perito would do hernia surgeries. They are the best at what they do because they focus on very specific surgeries.

You are absolutely correct! A top implant surgeon can't be a top Hernia repair surgeon, and vise versa. I was thinking Hernia repair is less complicated than implant, but yes, they both need good skills.

[AST2123]

I had a hernia repair after my implant in the same university hospital. I had concerns that the hernia surgeon lacked information on the whereabouts of the reservoir. I didn't want to get my reservoir nicked by a scalpel. The hernia surgeon had my implant surgeon assist her with the operation.

Comparing the 2 feelings when you are going for these surgeries, I would love to have the implant asap. Pain is killed by the thoughts about you will be achieving after the surgery. At the same time, hernia is inevitable, and become worse.