Twofer or not twofer

[Jonnyjuan]

I have decided to proceed with an implant. I have consulted with Dr Eid and have no problem traveling for the procedure ( I live in MN). My dilemma is that I also have an inguinal hernia on the left side, right side was repaired 20 years ago. So, I was wondering if I should just get both things done at the same time to get it over with. Dr Eid can’t do it so I consulted with Dr Kohler at the Mayo Clinic and he said he could arrange to have a surgeon repair the hernia while I am under for the implant. He says he has done this twofer about 20 times. Has anyone done it this way? Just wondering if the recovery would be brutal.

[Txagq8]

I had a hernia done 2 weeks before I got my implant.

I suggested doing them simultaneously. Both general surgeon (hernia) and urological surgeon (implant) told me not only no, but hell no.

I thought maybe the hospital just wants to charge me more, but their reasoning made sense.

Any time they cut you open to do surgery, infection is a risk.

There is typically less of a problem with a hernia since all they’re doing is sewing up a rupture in the abdominal wall and maybe reinforcing it with some mesh. If you end up with an infection it’ll probably be cleared up with IV antibiotics.

The implant is more problematic. It’s staying inside you. Any infection is likely to colonize the capsule that forms around the cylinders, tubing, pump, or reservoir. If that gets infected, you’re probably looking at removal and try again down the road, after the infection becomes ancient history.

It’s a given in medicine that the less time they have you open, the lower the likelihood of an infection. I read some scholarly articles where doctors who do lots and lots of implants (sometimes implants only)) have a open-to-close time averaging 34 minutes and less than 1% infection rate whereas an implant from a surgeon not considered “high volume” had an open-to-close time over an hour and a 3.4% infection rate for first time implantees.

Based on my experience-I bruised bad as shit, was sore, had no significant pain, and was pretty much functioning normally the day after surgery-I like to think they steered me in the right direction.

If it were me, despite my love of all things efficient, I’d get this done in two stages. A quick job by a guy who does lots and lots of implants (thereby knowing what he’s doing) will go a long way to lowering the post surgical stress level.

[Gt1956]

I've never had a twofer nor had a hernia. But my wife did a gall bladder removal & a tummy tuck at the same time. I/we thought it worked out good. This was before laprascoptic surgery was available. Saved on the hospital part of the bill because insurance picked it up for the gall bladder surgery.

If you can work out all the logistics & get the drs all on board its worth it. Case in point. My IPP dr only operates one day a week and it is in the morning. So it can be a hassle to set it up.

Good luck.

[nuance]

Is this infection risk true for other implants (breast or say hip/knee replacement)? Is the penile implant for some reason the most risky. I thought they come with some antibiotic layer to reduce risk. Also what makes it more likely for a diabetic?

[Rider1400]

Just my opinion!!! I would get them done together as the down time would compliment each other. In my case it would be much less time off work and less time off my feet. I personally think the infection risk would be more separate as not likely spreading from one to the other would seem likely. Just my 2 cents. I did have a bad accident 3 weeks before my implant surgery scheduled and ripped my left shoulder out breaking my arm and three ribs and completely separated my biceps muscle. I had a 3 plus hour surgery on shoulder and exactly a week later had my ipp surgery so the ill was healed up long before my shoulder. Didn’t have to deal with trying to go back to work for 10 weeks this way.

[FinallyBionic]

I also had inguinal hernia on both sides. I had one on the right side done about 20 years before my implant. The left one I had it with a mesh one year before implant. Before going to the implant, they did ultrasound for these hernia locations. The one with the mesh was good, but there was a small opening on the right. My implant surgeon stated that this doesn't need to be repaired.
The question was on which side the reservoir is to be placed. Considering that I might have a future repair on the right side, the surgeon decided to put the reservoir on the left side. All is good now.
Your case is little different. If you need to get the hernia repaired, better to do it first, or let dr. Eid decide, because he is one who is taking the responsibility of the implant. He might accept the twofer and put the reservoir on the right side, so that it won't herniate the left.
It is not an easy decision, but it is 100% your implant surgeon call.