Serious complications occur in 20% of patients who have mesh hernia surgery. The number one complication of mesh hernia surgery is chronic pain. In extreme cases mesh has caused death but the most dangerous of mesh products have been removed from the market and are not the current issue. In spite of this chronic pain remains a significant risk.
The most serious mesh complications were bowel perforations which are potentially life threatening complications. Mesh used in the abdomen is plagued with a curling problem. This results in hernia recurrences. One of the modifications that was tried to avoid curling was a memory ring, that is, a stiff plastic ring secured around the edge of the mesh and preventing it from curling. The problem was that scar contracture would exert a tremendous force on the ring and cause it to fracture. The fractured ends of the memory ring would penetrate the intestines causing peritonitis, intra-abdominal abscesses and bowel obstructions.
Memory rings are no longer used. The problem of mesh curling and migrating remains unsolved. Curling and migration leads to hernia recurrence. Attempts to mitigate this must anticipate other undesirable consequences, most notably, chronic pain. For example, a new experimental technique for securing mesh and avoiding pain is biological glue. This goes on the theory that tacking mesh with sutures or screws is what causes pain in mesh hernia surgery. Tacking mesh may be responsible for some cases of chronic pain but only a small percentage. Mesh can cause chronic pain no matter how it is secured.
Infection is an inherent risk in all surgery but it is a particularly difficult and serious problem in mesh hernia surgery. Surgical infections rates for clean elective surgery vary depending on the setting. Hospitals have higher infection rates at about 1% to 2% nation wide. Free standing outpatient surgical facilities have the lowest infection rates at about 0.1%. If mesh becomes infected, frequently it requires removal of the mesh. Antibiotics and wound care can cure some mesh infection but not all of them. The problem is that the mesh prevents the antibiotic from reaching the bacteria in high enough concentrations to sterilize the mesh. This happens in particular with composit mesh and mesh plugs.
The diagnosis and treatment of mesh complications is a complicated subject. This web site has a lot of information on the subject and you are welcome and encouraged to browse and find general information. For in depth information and medical advise about your mesh complication you will need to have a telephone consultation with Dr. Petersen. Consultations with Dr. Petersen are free of charge to patients who complete our Online Consultation. The Online Consultation provides Dr. Petersen with basic medical information he will need to complete your telephone consultation.
"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