Our second annual mesh removal results survey has been completed. We have had 75% respondents. I am reporting result. I thank all of those who contributed. I promise that this information will be used to help other patients
The one finding that is the most significant and disturbing to me is the answer to the question "What have you lost or what has been the consequences of your mesh pain complication?" The reply given by 63% of respondents is "Lost faith in doctors."
Doctors are human to the extent that they cannot preform miracles and cure every patient. We try to. We want to. But we do not succeed in every case. In spite of this patients for the most part have tremendous faith in us. I believe this is because patients know that we care and are professionals. When they lose faith in us there is something seriously wrong.
Nearly all of my mesh pain patients have been told by more than one doctor "There is nothing wrong with your hernia repair. I do not know why you have pain. I suspect that it is all in your head."
Patients know better. And this is why they give up on their doctors. They have lost faith in their doctors because their reality tells them that their doctor does not have a clue, is not listening or worse does not care. If a single patient loses faith in me there should be a really damned good reason in my defense or I am not worthy of being called a doctor.
|Unable to exercise||73%|
|Gave up recreational activities||66%|
|Lost faith in doctors||63%|
|Had to put business plans on hold||28%|
|Forced to retire||13%|
|Tapped into retirement||12%|
|Took second mortgage||6%|
|Had to quit school||1%|
I think that these numbers are important because they reflect the real human cost of mesh pain. The number one end point result that hernia doctors are interested in is hernia recurrence. I believe that this is very short sighted. I'll take a hernia recurrence over a case of life long chronic pain any day.
A very common question that I have been asked by mesh pain patients is "Will my other symptoms or problems get better?" I can now answer this question precisely. This is a another important result of the Second Annual survey. I have learned just talking to patients that they have many different symptoms. Some of these symptoms are a more important issue for some patients than the pain.
|Symptom or problem||Affected||Improved|
|Difficulty passing urine||26%||65%|
Fatigue affects 56% of patients and 64% of these patients say mesh removal made this better. I talked to one patient today who told me that she drives 30 miles one way every day to visit her elderly mother. Before the mesh was removed she could not make the trip without stopping to take a nap. After the mesh removal she regained all of her get up and go. She does not need naps ever and she is back to work.
Constipation was improved in 57% of affected patients. From my hernia patients I have learned that constipation is a very important concern for many patients. My secretary keeps telling me I should create a website dedicated to constipation.
Impotence was improved in 70% of affected patients. Patients do not talk to their doctors about it as much as they should for obvious reasons. A 70% cure is a big deal.
Doctors tend to ignore complaints from their patients that they cannot explain or do not fit into their theory of what is wrong with the patient. This just goes to show and prove that a doctor has to listen to his patient's complaints.
Hernia mesh removal was preformed for treatment of pain. Prior to mesh removal our patients average pain score (1-10) was 8.4. After mesh removal it was 2.6. These results were distributed as shown on the following diagram.
Patients who say their pain was cured report their pain went from 8.5 to 0.4 out of 10. Much better went from 8.2 to 2.5. A little better went from 7.5 to 4.5. No change went from 9.0 to 5.6. Much worse from 9.0 to 5.7. These numbers are subjective and we have to be careful in their interpretation. Such is the nature of chronic pain. I am inclined to take a patient at their word.
"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