Maarten Vasbinder lives in Isaan for 1½ years. His profession is general practitioner, a profession that he mainly practiced in Spain. On Thailandblog he answers questions from readers and writes about medical facts.
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Dear Martin,
For a year and a half I have had a bubble the size of a small egg on the right side just above my penis. When I lie in bed the bubble disappears but when I sit or stand it comes out again. I suspect it is a small hernia.
I am a 65 year old man and have been living in Chiangmai for a few years and have my own non-Dutch basic health insurance.
My question is whether there is a simple and relatively risk-free keyhole surgery for this ailment and what costs should I expect?
Many thanks in advance for your answer.
Yours faithfully,
B.
*******
Dear B.,
That does look like an inguinal hernia.
If it doesn't bother you further (pain), you can wait. There is, however, a small risk of constriction. Constriction is an emergency, because, for example, an intestinal loop can be closed.
Initially, in such a painful case, it is best to lie down and put ice on it, trying to push the bulge back. If that doesn't work, go straight to the hospital.
There are several surgical techniques for hernias. With and without laparoscope (keyhole surgery). Usually a mat (mesh) is placed, so that the abdominal contents can no longer escape. Mats seem to be more resistant to recurrence of the hernia, but have the disadvantage that they can cause pain. They are also very expensive. In India they use a piece of sterilized mosquito netting. That works just as well and only costs a few cents.
A plastic can also be made. The inguinal canal is made narrower. That's the old-fashioned method of surgery. There are various methods for this, which the surgeon can explain to you. I think the end result is better, but many surgeons have little experience with this method.
A third possibility is a fracture band. That is a kind of pants that pushes the bulge inward. Available at orthopedic stores and major pharmacies.
I can't tell you what an operation costs. You have to ask at the hospital.
Sincerely,
Maarten
I don't quite understand the answer.
“Mats seem more resistant to repetition(…)” Better than what?
French,
With mats there seems to be less chance that the hernia will come back, but that has never been properly investigated.
Surgeons prefer to work with those mats. That is easier and the operation takes less time.
Regards,
Maarten
About 3 years ago I had the same problem,
until after about 1 year the fracture broke through and I had to go to the hospital.
The operation included 2 nights and 2 days of hospitalization costs
Military Hospital at Sattahip approx 24.000 bath.
Albert, you mean the Sirikit Hospital in Ban Kilo Sip? A very bad hospital. Had me operated there on a hernia (hernia) and got it back after about 6 weeks. Had become such a big hole that my intestines came out and I had to put my hand on it while walking. After waiting for a doctor at Sirikit Hospital, from 0730 to 1400, the surgeon said, 'I won't do that, find another hospital'. I was then taken by Thai neighbors to the Government Hospital Si Racha where I was immediately admitted and operated at night during a 3-hour operation. 2 days hospital and costs Baht 11000- (eleven thousand) That is now 3, three, years ago. Me and several Thais have very bad experiences with this “Military Hospital”.
In the Netherlands, after placing a mat, someone experienced severe pain after a long period of time. Matje had grown together and could no longer be removed. This man committed euthanasia at one point.
http://www.pressreader.com/netherlands/de-telegraaf/20160723/282123520865403.
I had it done here 1 1/2 years ago at Loei ram hospital. They don't have a laparoscope here yet so 9 of those metal staples went in to close things up. Been there for 3 days and the total cost was 54.000 Baht.
2 years ago I also had the same symptoms. A swelling (of about 5 centimeters) right above the genitals. When I lay down the swelling went away, but when I stood up or sat down it came back.
In the end I had surgery, a 'mesh' was placed on me.
The choice of hospital is a different story.
The private hospitals (Lanna, McCormick, Rajavej) in Chiang Mai wanted to charge between 45.000 and 70.000 baht for this procedure.
Inguinal hernia surgery is the most commonly performed operation of all procedures.
Suan Dok, the large state hospital was able to perform the operation for 12.000 baht, but there was a waiting period of 2 weeks.
In the end I was operated on in a state hospital in Lamphun, for 14.000 baht, including 2 nights in a private room.
The procedure went smoothly, performed by a Thai doctor who could speak English fluently. Of course, the hospital staff only spoke Thai.
After the recovery period, I haven't had any discomfort since.
Am 68 years old and had surgery on July 27, 2016 at state hospital in Ubon ratchanthani surgery performed by a female doctor who spoke good English.
Had to stay in my private room for a week because of the hot weather, as I'm already sweating. Everything is done to your satisfaction without any costs. My wife has a government position and as a man you are free of costs.
success with the operation.
The reactions are actually quite “witty”…..The procedure with the mats is applied millions of times…and nothing ever happens…and here is only about negative things…and yes, the Dutchman's most important subject….what the costs its..humor really humour
I am 68 years old. because I also have an inguinal hernia on the right side just above my penis since 8 months ago. I inquired at the memorial hospital in Pattaya to have it operated on. and what the operation costs would be. They informed me that I had to stay in the hospital for 2 days and the price was 160000 baht? 2 weeks later I drove to Satahip to ask what it would cost me for the operation. and there it was still a good 60000baht? and was advised to wait a little longer as it was a risk??? I don't understand it anymore... so I bought myself a rupture band.
See my response to Albert. I would like to add that the “Military Hospital” in Sattahip refuses to perform operations on people over 70 years old. I was 76 years old at the time and was also one of the reasons I was sent away. To an equally old Thai with also an inguinal hernia, who works at the Amphur and sometimes comes to my house, it was simply said "you're too old, we won't do that". My Thai neighbor who died 1 years ago, who was dying in the “Military Hospital” Sattahip, was told “get out of here, go home but don't die here”. So whatever he did. Nice hospital. Have more stories about this “Hospital”.