Patients are routinely told that the most important risk of hernia surgery is recurrance. The number one risk of hernia surgery is chronic pain. Large medical studies have shown repeatedly that the risk of developing chronic pain after mesh hernia surgery is 20-30%. Mesh manufactures try to distance themselves from these studies by saying that they have reengineered mesh and that it is better than the old mesh. However they will tell the FDA that the new mesh is substantially the same as the old mesh so that they can get it released to the market without additional testing by way of FDA 510(k).
What makes chronic pain after mesh hernia surgery so serious is that there is no effective treatment for it. Narcotic pan medications mask the symptoms but often sedate a patient to the point that they cannot function. Injections and nerve interruptions at best only provide temporary relief. For those patients who cannot live with the pain the only effective treatment is to go back to surgery, remove the mesh and redo the repair without mesh. Dr. Petersen has been contacted by over 1,000 patients with hernia mesh pain and has successfully operated on over 100 patients with severe mesh pain in just the past three years alone to remove mesh and redo their hernia repair without mesh.
Everyone is at risk for developing chronic pain after mesh hernia surgery but those with the greatest risk are patients who have pain before hernia surgery.
The risk of hernia recurrence after hernia surgery for routine hernias is about 2-3% for both mesh and non-mesh repairs. There has been a tendency of the surgical community to over emphasize the importance low recurrence rates however a recurrence is much easier to deal with than chronic pain and is less likely to have life altering consequences.
The risk of bleeding and infection is less than 0.1%. This remarkably low risk is achieved by screening for and treating risk factors, by doing the surgery at an outpatient surgical facility rather than a hospital, by using prophylactic antibiotics and by using immaculate sterile and hemostatic technique.
The risk of impotence, sterility or loss of a testicle is theoretical but I have not seen it in 6,000 routine hernia repairs.
The risk of a serious anesthesia complication in a routine hernia repair for a healthy patient is 1 in 50,000. Risk of dying in a car is 1 in 17,000 per year.
Hernia surgery is one of the most common and safest surgeries preformed in the United States today. The most important risk of hernia surgery is mesh related chronic pain. Most hernias can be repaired without mesh avoiding this risk.
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"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