“As far as we know, there haven’t really been any good studies … to quantify the sexual dysfunction that you get with hernias,” says Shirwin Towfigh, MD, surgeon and president of Beverly Hills Hernia Center in California, adding that there is no link between male sexual organs and hernias. “The nerves are totally different. The anatomy is actually separate.” A hernia occurs when part of an organ protrudes through an abnormal opening in an abnormal way. An inguinal (groin) hernia occurs when part of the intestine bulges through a weak spot in the abdominal wall at the inguinal canal, which is the passageway through the abdominal wall near the groin, according to an article published by Harvard Medical School. About 1 in 4 men develop an inguinal hernia in their lifetime and about 1 in 7 will have a hernia that will need surgery, says Dr. Towfigh. RELATED: The Ultimate Guide to Healthy Sex
How Can Hernias Affect Your Sex Life?
Hernias are mainly asymptomatic. The majority of people don’t have pain from their hernia. Instead, they might have discomfort, a dull ache, or no noticeable symptoms except for the bulging from the hernia itself. But people who do experience pain are more likely to experience sexual problems, says Towfigh. A study published in the International Journal of Urology, which included 210 men and 14 women, revealed that 23.2 percent of patients complained about preoperative sexual dysfunction, and 16 percent of patients complained about postoperative sexual dysfunctions. “They may have pain with orgasm, pain with erection, or they may not be able to achieve or maintain an erection,” says Towfigh, adding that hernia removal surgery normally fixes these problems. Inguinal hernia operations are the most common surgery for hernias. “Surgery by an experienced and dedicated hernia surgeon is the safest way to repair a hernia, and using a flat mesh implant, minimally invasively or open by Lichtenstein technique, is still the most accepted way to perform this procedure,” says Brian P. Jacob, MD, an expert hernia surgeon at Hernia Repair in New York City.
Does Inguinal Hernia Repair Cause Sexual Dysfunction?
Although hernias do not appear to have a direct link to sexual dysfunction, pain after surgery may cause sexual dysfunction in some patients, but it is a complicated issue, says Towfigh. According to the Cleveland Clinic, pain after surgery may be associated with the mesh used in hernia repair. The body may recognize the mesh as a foreign object, causing inflammation or irritation. Chronic pain may also result from a nerve being caught in the mesh. In this case, patients my opt for mesh removal, nerve ablation, or anesthetic injections to relieve the pain. “Specifically, sometimes the cremaster muscles or the spermatic cord can become adherent to scar tissue or a mesh implant and therefore potentially be indirectly related to sexual dysfunction complaints,” says Dr. Jacob. “I believe that it is very important to teach the patient who is complaining of sexual dysfunction that it is unlikely for sexual dysfunction and inguinal hernia repair to be directly related unless there is a significant problem with the location of the mesh after its implant.” A study published in June 2016 in the Central European Journal of Urology found that having an inguinal hernia and undergoing hernia surgery may impact sexual activity. This study also revealed that implanted mesh can lead to long-term tissue induration, which can impact sexual function. Another study, published in March 2018 in the journal Frontiers of Surgery, found that sexual dysfunction due to groin pain after hernia surgery is surprisingly common. There is still limited research on this topic, says Towfigh. “I recognize that, in rare cases, the two (hernia repair surgery and sexual dysfunction) may be related, and therefore it is important to separate out the cases where they are potentially related from the majority where the two are not related. For the cases where sexual dysfunction is not related to the hernia repair, we must send these patients to physicians who specialize in sexual dysfunction,” says Jacob.
How Soon Can I Resume Sexual Activity After Surgery?
The Hernia Surgery center in Los Angeles advises patients to discuss sexual intercourse with their doctor, as hernia repair recovery times may vary. The good news is that they are no medical or physical restrictions on activity after surgery, but patients should let pain be their guide, as sex may be uncomfortable at first, according to the Cleveland Medical Center. So if it is painful, give it some more time. Bruising and swelling of the scrotum and the base of the penis and the testicles can also occur in some patients after open or laparoscopic surgery, but these symptoms should gradually fade on their own, according to the Society of American Gastrointestinal and Endoscopic Surgeons.
