Spinner Giles has yet to set a comeback date

The Warwickshire star, who has already ruled himself out of this season, fears he may not be able to recover fully without suffering lasting damage.

The 34-year-old said: "The underlying thing is that you never know how much long-term damage you are doing.

"I've never thought it is not worth it, but I have to start thinking about it."

Giles fought back from a year out to play in the first two Tests of last winter's Ashes series but returned home early from Australia following a serious illness to his wife Stine.

He then suffered an injury setback and underwent his third operation just before the start of the season.

It's more difficult than last time around because it's my third operation Ashley Giles

The left-arm slow bowler believes it will be at least another four weeks before he can attempt running again and another two months after that before he will be fit enough to consider playing cricket again.

He added: "I certainly don't want to look at hip replacements. It is a difficult time because cricket is what I do and cricket is what I have done for 20 years, but I do have to start thinking about the implications.

"It is great to keep going and saying to yourself, 'I will be fine', but the chances of recurrence are very high and I can't keep going through operations.

"I've had some dark days because if cricket ended tomorrow for me I'm not sure what I would do, but at the same time I would also be happy with my lot.

"I've loved every minute of it, even the bad times and tough times because I've learned something through all of them.

"It's more difficult than last time around because it's my third operation. Last year I had a light at the end of the tunnel to aim for which was the Ashes and I don't have that this time, so it's become a lot harder to battle on through.