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post radical nephrectomy developed a flank bulge
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Apr 03, 2012 - 1:34 am
My husband had a radical nephrectomy from Stage 1 kidney cancer this past August. He almost immediately started developing a huge bulge - NOT a hernia. After a CT scan in October it was determined he has a denervation, flank bulge due to the nerves not regenerating from the flank incision. The muscle wall has thinned out and cannot hold back the 'gut'. The bulge is the size of a soccer ball at present. It literally is his 'guts' sticking out of his right side. Has anyone else had this 'side effect' for which we were NEVER warned about? We are not finding any help. One doctor said that a mesh can be used and they attach it to his ribs and pelvis (sometimes the spine) to support the side. But it restricts your movement and it feels like a brick is in your side and can cause more pain. The doctor also said that most docs stopped doing this procedure due to its poor outcome. Has anyone else had this happen? I'm sorry that some of you will be frightened by this and I'm sorry but I'm looking for answers. |
Joined: Nov 2011
I'm sorry but not surprised that you haven't received an answer here so far. I believe the reason is that, so far as I am aware, no-one here will have encountered this problem manifesting in this way.
It sounds to be a very unusual and most unfortunate outcome. Unless they have experienced it themselves, contributors here will not want to venture into an area they know nothing about and will probably, like me have concluded that it's a question that has to be put to the specialists in this field. If I were in your position, I would be seeking several additional opinions and only from acknowledged experts with the relevant experience. Your doctors should be able to refer you to those best equipped to help.
Joined: Mar 2012
I have been carrying my side bulge for several months now and today it is particularly swollen and uncomfortable.... I have never heard of the problem stemming from the insides pushing out but I certainly can say it feels that way. I have had a sonogram and there is no issues in there but I do have some problems with the nerves that were cut. Good luck
Joined: Apr 2012
I have exactly what you describe. I had a radical nephectomy over 2 years ago and still have the bulge even after a mesh repair. The flaccid muscle just could not hold back anymore and hernias developed after six months post nephrectomy. The mesh repair helps but the bulge and future hernias are possible. The repair was worse for me than the nephrectomy. I use a 6 inch surgical binder to hold things in and it does make getting around much easier. Absolutely keep asking surgeons about what can be done. Ct and mri scans can identify a hernia/s. You do not want some organ falling thru and get strangled. Also there is a simple hands on exam/test to see if the incesion or muscle has ruptured. When I asked the surgeon is this common with a nephrectomy, he said he has only seen it a few times. Now this guys was in his 60s so my gut feeling is he was holding back on the honesty. With such a long incesion and cutting thru so many layers of muscles surely nerves will be severed. Keep an eye on it and have that repair surgery plan near at hand. Good luck!
Joined: Apr 2012
Thank you for your honest response. My husband will have a surgery to repair his flank bulge May 31. It's very sad that you had this surgery and you still have problems. It's so hot where we live, wearing a binder is just miserable. He has no hernias that we know of so the strangulation issue isn't a problem. I'll keep you updated on the outcome. It's a trade-off to have it or not have it.
Joined: Apr 2012
Just want to update you on my husbands recent surgery. His 8 inch incision has now turned into a 15 1/2 inch incision and his volleyball sized bulge is gone. Our surgeon was Dr. Guy Voeller in Memphis, TN. We have found he is the top surgeon in the regional and is known nationwide for his specialization on hernias but what my husband had is not considered a hernia but is treated like one. They did not attach mesh to his ribs or pelvic bone. They cut away the denervated muscle, found viable muscle and sewed the mesh to an overlapped muscle. So far so good. The doc actually said that it will take 6 months before we will know for sure if it is truly successful. My husband will need to slowly get back to a normal lifestyle with attention to keeping his weight down and exercising. We are so grateful to the Lord for finding this surgeon! There is hope!!
Joined: Nov 2011
That's great news. Good luck to you both and I hope you'll make sure he gives the procedure best poss chance of long-term results by doing as he's been told and keeping his weight down and exercise up. He'll feel a lot better if he does.
Joined: Nov 2011
But, needless to say, I guess, building up the exercise work slowly and carefully in the way the experts will have told him to.
Joined: Mar 2013
I just read your post about your husband's flank bulge and surgical correction by Dr. Guy Voeller. I have the same problem on my left side. I wondered how your husband has healed and if he is pleased with the results. I am desperate to get an answer to this problem.
Joined: Mar 2013
Hi Vross!
I have the same problem as you. I would like to find some solution to it. Please let me know what you find.
Do send me a message so we can talk in more detail.
Rmore
Joined: Aug 2012
I had a laparoscopic nephrectomy in September 2012 that has left me with a large grapefruit sized "hernia". My family doctor sent me to a general surgeon who said he could "try" to fix it but that there were no guarantees. Due to the location, there would be nowhere to attach the mesh. I then went to the Shouldice Clinic in Toronto for a second opinion. The Shouldice Clinic is renowned for hernia repair. That's all they do, hernia repair. They poked and prodded my bulge and indicate that it was not a true hernia, but "denervated abdominal wall". The surgery I had in September destroyed the nerve(s) running through that part of my abdominal wall, causing the muscle to be flaccid. The damage is permanent. They indicated that the would NOT repair this for me. They indicated that due to the nature of this beast, chances are that the bulge would return. The "Shouldice" way of repairing hernias does not include using mesh. While they could use mesh to repair this, they indicating that it would probably make it worse. They said the risks far outweighed any benefit that could be had from the surgery, so again they indicated that I could not have this repaired at their clinic. I appreciated their candor and honesty and trust their advice as they are the hernia experts. I am now trying to accept that I will have the bulge forever. Luckily, I have no pain associated with the bulge, just discomfort and the fact that I have to wear really large tops to cover the bulge. They recommended that I lose weight in order to possibly make the bulge smaller, or at the very least prevent it from getting larger. I currently wear abdominal support to help me not have such an unsightly bulge. I hope the weight loss will help.
Joined: Oct 2011
a physiatrist. Let them do a nerve conduction study. They will be able to tell if the damage is permanant, getting better or getting worse. Without an electromyelgram, they can't tell you that the muscles are denervated.
Joined: May 2013
I am going to have a rad nepr in three weeks and the doctor showed me where he was going to make the incision, cutting the two nerves, remove a rib bone and that I would have a bulge forever on my right side.....As long as I can take care of myself , I can deal with the bulge.....What else can I expect after the hospital stay, I am an outside person and I hate down time, but a guy gotta do the healing thing...
Joined: May 2013
Gary,
I just had a open partial in Feb, so its been 12 weeks. As an ironman athlete, avid skier, etc I was concerned as you are. I ended up having lots of complications and turned my stay into 12 days. Again at 12 weeks, I am now biking at moderte intensities and doing a run/walk mix. My surgical side still feels a bit off (still some swelling and numbness - no pain) but I am exercising and getting more active each week.
The key is the first 3-4 weeks at home, focus on healing. Start walking. But take it easy and you will be as active as ever within a few months.