Surgical Procedures

& Conditions Treated

At Groin Pain Clinic, all hernia repairs and groin reconstructions are done without the use of hernia mesh.

Groin Reconstruction

The operation involves repair of the Sports Hernia by a tension free tissue repair, re-attaching the conjoint tendon to the pubic bone crest and release of the Adductor longus tendon. Occasionally the obturator, ilio-inguinal and lateral femoral cutaneous nerves are released.

All groin reconstructions are mesh free and performend without the use of hernia mesh.

Hydrocoele

Hydrocoele is caused by too much fluid forming around the testicle and ballooning out the scrotum. This can be treated by aspiration of the fluid with a needle under local anaesthetic, but will almost certainly recur a few times.

A more radical cure can be performed by removing the fluid-containing tissue through an incision in the scrotal skin. This surgical cure usually requires general anaesthetic and overnight hospital administration.

Sports hernias

Sports hernias are recognised as a cause of persistent groin pain without a clinically detectable hernia. The pain of this injury is located deep in the groin area and the discomfort may become severe making it impossible to stride out properly during running or turning quickly. The treatment is by surgical repair to the posterior inguinal wall canal, and the results have been extremely satisfactory.

All hernia repairs are mesh free and performed without the use of hernia mesh.

Women in Sport

Dr Garvey treats a significant population of female athletes in his clinic. Anatomically, the female groin differs from the male groin and Dr Garvey is able to tailor his management and treatment plans accordingly.

Pudendal Neuralgia

Sometimes known as cyclist's syndrome, this pain occurs when sitting and affects the 'saddle' area - the part of the body that would touch a horse if riding.

While pressure on the pudendal nerve may have initially caused the pain, muscle spasms may also develop. Once pain has been present for more than three to six months, there will also be changes to nerve pathways leading to chronic pain.

Adductor tendon release

If no hernia is present there may only be an Adductor tendon injury, the surgery is much less traumatic than reconstruction surgery and can be done as Day-stay only. The recovery period is also shorter, and one should be able to work or return to playing sport 2 to 3 weeks after surgery.

Inguinal (groin) hernia

Inguinal hernia repair is the standard type of hernia repair which is often performed using a tension-free tissue darn or non-absorbable mesh to strengthen the muscle wall of the inguinal canal.

All hernia repairs are done without the use of hernia mesh.

Varicocoele

A varicocoele is formed in the scrotum by dilated veins that drain the testicle (rather like varicose veins that drain the leg). These dilated veins in the scrotum feel like a "bag of worms" and occur more often on the left side. The operation that is performed involves an incision in the groin rather like a groin hernia incision, and then cutting out and tying off a segment of the engorged veins.

Vasectomy

Vasectomy is a simple, safe way of male sterilisation by preventing sperm being able to get to the outside through the penis. A small incision is made in the skin in the upper part of the scrotum and the vas deferens is located, cut and tied. A short piece is removed for examination in the laboratory to be certain the correct tissue has been removed. The same is done on the opposite side. A semen sample is required to be analysed 30 days after this operation to check for sterility.

Post hernia groin pain syndrome

Hernia mesh removal is a surgical treatment offered for mesh inguinodynia - chronic pain that can arise due to the presence of an implanted mesh.

Pain arising from a mesh is multi-factorial. Oral anti-inflammatories are helpful at times. More severely affected patients require injections with local anaesthetics and corticosteroids to reduce neuropathy symptoms. The most severe cases may require surgical intervention.

Other procedures offered include:

  • Breast procedures
  • Circumcision
  • Colonoscopy / gastroscopy
  • Pilonidal sinus excision

Surgical treatment available for:

  • Epididymal cyst
  • Epigastric or ventral hernia
  • Female groin hernia
  • Haemorrhoids (piles)
  • Post hernia repair pain
  • Recurrent hernia
  • Work-related groin injury

This information brochure is based on the National Health and Medical Research Council's Clinical Practice Guideline for the Prevention of Venous Thromboembolism in People Admitted to Australian Hospitals.

Surgery proceeds without complication in almost all cases. However in rare cases, complications can occur, and it is appropriate to mention some of these.

  • There are complications that can take place after any operation under general anaesthetic, but Dr Garvey only uses the best hospitals with the lowest infection rates, and the best anaesthetists to keep any operative complications to the lowest achievable rates.

  • Post-operative urinary retention (full bladder) occurs in about 5 – 10% of male patients. This is usually a complication of the anaesthetic given and the amount of pain-killer used in the first 24 hours after the operation. If this complication occurs, a urinary catheter needs to be inserted and then removed the following morning. If unable to void a second time, then the catheter has to stay in a couple of days longer and a consultation from a Specialist Urologist may need to be arranged.

  • Other possible complications include post-operative haemorrhage or haematoma (bruising) in the wound which may need to be evacuated at a second operation, but usually the body is able to absorb this bruising in the tissues without another operation. The artery to the testicle could also be caused to go into spasm by the mere fact of opening up the groin canal and retracting the spermatic cord out of the way to perform the operation. However, this is a theoretical risk and this has not been encountered in Dr Garvey’s large series of operations.

  • Injury to the nerves in the groin by being entrapped in scar tissue can also occur rarely, and if this happens, the wound has to be opened and the nerves have to be freed from the scar tissue. This is a very late complication and has only very seldom been encountered.

Dr John Garvey

Suite 301, 3rd Floor
BMA House
135 Macquarie Street
SYDNEY NSW 2000
  Free valet parking for patients

Dr John Garvey

Suite 301, 3rd Floor
BMA House
135 Macquarie Street
SYDNEY NSW 2000
  Free valet parking for patients

    contact@groinpainclinic.com.au
FAX  +61 2 9004 1059

8:30 am - 5:30 pm
Monday - Friday

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