Dr. Balentine received his undergraduate degree from McDaniel College in Westminster, Maryland. He attended medical school at the Philadelphia College of Osteopathic Medicine graduating in1983. He completed his internship at St. Joseph's Hospital in Philadelphia and his Emergency Medicine residency at Lincoln Medical and Mental Health Center in the Bronx, where he served as chief resident.
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
Epigastric, umbilical, incisional, lumbar, internal, and Spigelian hernias all occur at different sites over the abdomen in areas
that are prone to anatomical or structural weakness. With the exception of internal hernias (within the abdomen), these hernias are
commonly recognized as a lump or swelling and are often associated with pain or discomfort at the site. Internal hernias can be
extremely difficult to diagnose until the intestine (bowel) has become trapped and obstructed because there is usually no external
evidence of a lump.
How is a hernia repaired?
A hernia repair requires surgery. There are several different procedures that can be used for fixing any specific type of hernia. In the open surgical approach, following appropriate anesthesia and sterilization of the surgical site, an incision is made over the area of the hernia and carried down carefully through the sequential tissue layers. The goal is to separate away all the normal tissue and define
the margins of the hole or weakness. Once this has been achieved, the hole is then closed, usually by some combination of suture and a
plastic mesh. When a repair is done by suture alone, the edges of the defect are pulled together, much like sewing a hole together in a
piece of cloth. One of the possible complications of this approach is that it can put excessive strain on the surrounding tissues through which the
sutures are passed. Over time, with normal bodily exertion, this strain can lead to the tearing of these stressed tissues and the
formation of another hernia. The frequency of such recurrent hernias, especially in the groin region, has led to the development of
many different methods of suturing the deep tissue layers in an attempt to provide better results.
In order to provide a secure repair and avoid the stress on the adjacent tissue caused by pulling the hole closed, an alternative
technique was developed which bridges the hole or weakness with a piece of plastic-like mesh or screen material. The mesh is a
permanent material and, when sewn to the margins of the defect, it allows the body's normal healing process to incorporate it into
the local structures. Hernia repair with mesh has proved to be a very effective means of repair.
After the hernia repair is completed, the overlying tissues and skin are surgically closed, usually with absorbable sutures. More and more of hernia repairs are now being done using laparoscopic techniques (see below).
Abdominal pain is pain in the belly and can be acute or chronic. Causes include inflammation, distention of an organ, and loss of the blood supply to an organ. Abdominal pain can reflect a major problem with one of the organs in the abdomen such as the appendix, gallbladder, large and small intestine, pancreas, liver, colon, duodenum, and spleen.
Marfan syndrome is hereditary condition affecting connective tissue. A person with Marfan syndrome may exhibit the following symptoms and characteristics: dislocation of one or both lenses of the eye; a protruding or indented breastbone; scoliosis; flat feet; aortic dilatation; dural ectasia; stretch marks; hernia; and lung collapse. Though there is no cure for Marfan syndrome, there are treatments that can minimize and sometimes prevent some complications.
Testicular pain, or pain in the testicle or testicles are caused by a variety of diseases or conditions such as testicular trauma, testicular torsion, testicular cancer, epididymitis, and orchitis. Common symptoms of pain in the testicle or testicles are abdominal pain, urinary pain or incontinence, fever, nausea, vomiting, and pain in the scrotum or testicle. Treatment depends on the cause of the testicular pain or pain in the testicles.
Testicular cancer symptoms include a painless lump or swelling in a testicle, testicle or scrotum pain, a dull ache in the abdomen, back, or groin, and a feeling of heaviness in the scrotum. Treatment for cancer of the testicles depends on the type of cancer (seminoma or nonseminoma), the stage of the cancer, and the patient's age and health.
Hydrocele is a collection of clear fluid in a thin walled sack that also contains the testicle. Hydroceles are more common in males than females. There are two types of hydroceles: 1) communicating and 2)non-communicating. Hydroceles present at birth may resolve on their own. Hydroceles that appear in the teen or adult years may require surgery.
Regular physical activity can reduce the risk of disease. Regular exercise can also reduce the symptoms of stress and anxiety. There are fitness programs that fit any age or lifestyle.
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