Hernia Mesh Removal for Pain
Pain is a common problem after mesh hernia surgery
20% of patients develop chronic groin pain after having mesh inguinal hernia surgery. Most of these patients will go undiagnosed and untreated sufferig their pain in silence, confusion and dissappointment in their doctors.
Significant pain lasting 3 months after hernia surgery is abnormal. Period. When other likely causes of pain have been ruled out then it is almost certainly the mesh.
Patients who come to see us for mesh removal have had injections, nerve blocks and nerve removals with no relief. There are studies that say that these treatments help and there are studies that say that they don't. It is our impression from the patients that we see that these treatments do not help.
With the more positive results that we experience our patient selection critereon for mesh removal becomes less restrictive. At one time we recommended waiting at least 6 months from the original time of mesh hernia surgery before the mesh can be removed. We have learned that there are exceptions to this rule.
Our experience with mesh removal has been that roughly 80% of patients are cured or significantly improved. These results are good enough to recommend the surgery to patients who have exhausted other treatments and who still have significant pain. We tell patients that if they can manage the pain by other means they should not have the mesh removed.
20% of patient who have removal of mesh for pain do not have significant improvement of their of pain. We hypothesize that the patients who continue to have pain continue to produce scar tissue no matter what you do. Also, many patients with chronic severe pain from hernia mesh develop PTSD (post traumatic stress disorder) which can be difficult to recover from.
The reason that we are restrictive in selection of patients for mesh removal is because we do not want any patient to have worse pain after mesh removal. Our experience with this has been very good. We are aware of only one patient who says that they have worse pain out of many hundreds of successful cases of mesh removal for pain.
Our mesh removal patients have a variety of symptoms and complaints that they relate to their mesh. "I never had this problem until after I got my mesh" is a very common statement that we hear. Our experience removing mesh is that many of these symptoms resolve for reasons that we cannot explain and therefore we cannot advise patients to expect as a result. But our expereince has lead us to not discount any symptom that a patient relates to their mesh.
What happens when mesh is in the human body for twenty years and more. Nobody knows? But we are going to find out! Who wants to be part of this experiment?
A recent publication in a very well repected surgery medical journal says "The value of open inguinal herniorraphy without mesh is being lost. Mesh herniorraphy is being inappropriately used as the standard of care. The complication of inguinodynia is occurring at inappropriately high rates. Ilioinguinal neurectomy is not a simple solution."Am J Surg. 2012 Apr;203(4):550. Epub 2008 Sep 11. Inguinodynia and ilioinguinal neurectomy. Danto LA
Ask Us Now!
Enter your question in the search box below and we will show you where the answers are on our website.