Pain lasting more than 3 months after hernia surgery is abnormal. You do not have to live with it.
Mesh hernia surgery is complicated by abnormal chronic pain in 20% of patients. Life changing pain occurs in 5% of patients.
The surgical community at large is heavily biased in favor of using mesh for routine hernia repairs when hernias can easily be repaired without mesh with excellent results. Unfortunately a generation of surgeons have been weakened by their dependence on mesh and no longer have the confidence to repair a hernia without it.
This investment in mesh has lead to institutional denial with negative consequences for patients:
Patients who come to us with mesh pain typically have suffered all of this. They have been made to believe that it is all in their heads and that nothing can be done.
If you have pain where your mesh was placed lasting more than 3 months we can assure you that:
Our experience with hernia mesh removal for pain has been that roughly 80% of patients are cured or significantly improved. April 2015 Dr. Petersen presented his hernia mesh removal for pain results to the 1st World Conference on Abdominal Wall Hernia Surgery in Milan, Italy. The presentation was well received and Dr. Petersen had an opportunity to discuss his results and exchange ideas with several internationally prominent hernia surgeons.
The average pain score of our patients before mesh removal is 8.4/10. After mesh removal it is 2.6/10.
Patients are confused by their doctor's resistance to acknowledging their pain and the fact that it is coming from their mesh. Patients have an innate awareness that their pain is coming from their mesh and thus are deeply confused by their doctors. Patients need to know why no one understands their problem and why no one will help them by removing the mesh. I have tried to explain this to hundreds of patients but my explanation is a harsh criticism of a profession that is generally held in high esteem. Maybe I can't explain it. Maybe that will be up to the doctors themselves when some day they realize that they were wrong. In any case this is what I see.
There are very few surgeons in the world who will remove hernia mesh for pain. We know of fewer than a half dozen and most of them are outside of the United States. Most any surgeon will remove mesh for infection.
The problem is that medicine has become bureaucratized. Doctors are no longer managing their own profession. Doctors are told how to practice medicine by the government, insurance companies and hospitals. Device manufactures and pharmaceutical companies are spending billions of dollars on advertising successfully defining standards of care and controlling patient expectations.
A generation ago doctors were expected to be "The Experts" in the practice of medicine. Medical education was heavily based on the basic sciences of anatomy, histology, pathology, microbiology, physiology and pharmacology. After the basic sciences we were immersed in clinical experience and taught clinical tradition. We were taught to be critical thinking clinicians. At the end of our training we were all quite capable of thinking for ourselves and solving unique clinical problems. We were expected to be able to solve problems that we had never seen before.
Modern doctors now are discouraged from thinking for themselves and challenging the status quo. They now have to walk in lock step following practice guidelines, evidence based medicine and standards of care. These titles sound good but all that the really are is declarations of authority coming from the bureaucrats who want to control doctors.
Challenging mesh as the standard of care is disruptive to the system. There are very few doctors who are willing to be disruptive to the system, even for the sake of their patients. The power and the influence is all on the side of the mesh manufacturers. This is why mesh pain patients have such a hard time, IMHO.
I remove hernia mesh because it relieves pain in properly selected patients. If it did not I would not be doing it. I have almost no support from my colleagues. But I have the support of many grateful patients and that is all that I need to keep doing this kind of work.
A recent publication in a very well respected surgery medical journal says "The value of open inguinal herniorrhaphy without mesh is being lost. Mesh herniorrhaphy 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
"Milan—Chronic groin pain after hernia surgery is now considered the most important issue facing inguinal hernia surgeons and their patients. Yet, there is still much uncertainty surrounding what causes the pain and how to prevent it." - Victoria Stern, General Surgery News
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