NIS

Advice to patients with chronic pain after mesh hernia surgery

You are going to be okay. There are some pitfalls that I want to warn you about but I want to reassure that there is treatment for hernia mesh pain and most patients getting the right treatment recover.

I have found that patients with hernia mesh pain are very aware that the cause of their pain is their mesh. This is in spite of what their doctors are telling them. The simple fact is that 20% of patients with hernia mesh go on to develop chronic pain. Hernia recurrence is only a 2% risk. So a patient with hernia mesh and chronic pain chances are that their mesh is the cause of the pain. So the first bit of advice that I have for hernia mesh pain patients is do not let anybody tell you that it is not the mesh.

The reason that mesh causes pain is because it is recognized by your body as foreign and your body responds by mounting chronic inflammation. Chronic inflammation causes pain. Period. It is not an error in surgical technique. It is not because the mesh has moved. And the odds are against a hernia recurrence.

Imaging studies such as CT scan, MRI and ultrasound are for the most part worthless for evaluating a patient with hernia mesh pain. There are rare cases of hip disease and kidney stones that can be confused with mesh pain but these diagnoses should be clinically evident. Imaging studies typically show nothing wrong with the mesh if in fact the mesh is visualized. On most imaging studies the mesh is invisible. Unless an alternate diagnosis is suspected imaging studies are a waste of time and money.

Be very wary of a surgeon telling you he thinks you may have a small hernia recurrence causing your pain. The last thing that you want to do is submit to exploratory surgery. At surgery there is nothing to be found. Pain is not caused by a single nerve entrapment, a broken stitch or an invisible hernia. The only reason to go to surgery is to remove the mesh. The worst cases that I have seen are patients who go back to surgery and get more mesh placed for a nothing hernia recurrence.

If you get sent to pain management that means that your surgeon has given up on you. They will give you pain medication to cover up your pain or they will do nerve procedures to temporarily block your pain. None of this will cure your pain. I no longer require patients go through a trial of pain management before mesh removal.

Patients with chronic pain after mesh hernia surgery need to know who are the doctors who have experience taking care of this condition. I am one of them. A list can be found at www.meshmedicaldevicenewsdesk.com.

- Kevin C. Petersen, M.D.