Should mesh be replaced when it is being removed because of pain?
This answer is intended for any hernia surgeon who might be reading this. Removing mesh is the right thing to do for mesh causing inguinodynia. But if you have to replace the mesh, even with "better mesh" or gortex, your surgery has already failed. You are better off risking a recurrence and doing an external oblique based repair such as the Halsted repair. Each time a groin is operated on the available fascia is degraded and likelihood of permanent repair diminishes. Also when removing mesh do not excise the scar tissue around the mesh. In time the body will remodel this scar. Preserving structual tissue is critically important. It is helpful to lyse the adhesions around the spermatic cord because it takes stress off the cord.