Removal of mesh after inguinal hernia repair.

Hello, 

i had had an abdominal open hernia repair carried out on 21.6.17- I was doing ok, until last Sunday when all of a sudden the area where the mesh has been put in gets extremely sore, especially when I walk any distance.  I have been to see my Dr who advised me it's because I'm still healing.  I'm not convinced.  The day before the pain started I did mow my lawns and emptied the grass box... so I'm not sure if I have caused the pain or not.... I really don't know where to go from here.. any advise you can give me would be grateful.  I'm in the uk.  Thanks Sandra 

Omg. I cannot believe that I just found your post. I have been SUFFERING with this same exact pain for two years. My plastic surgeon want to operate soon. Drs hab been baffled as to why I have this pain and I swear I've really thought that I'm losing my mind and that my doctors don't believe me. I would really like to talk to you if you'd be ok with that. I would be so grateful. 

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Hi Adele,

I'm so glad you've raised the question of mesh removal.

I'm so sorry to hear that you and many others have suffered as a result of mesh being implanted as part of a hernia repair.

In May 2017 I had an inguinal hernia repair. The lump was reducible when I lay down and really wasn't causing any issues except for one - my mind set. I was advised that it could strangulate the bowel if I left it.

The general consensus was mesh must be used to prevent re-occurrence (I was told it will act as re-reinforcement for the fascia).

After surgery (had open cut), I experienced the following

* Numbness around the incision

* Wound that just wouldn't heal - bled occasionally and kept scabbing over

* Abdo pain (always mild, sometimes moderate, sometimes severe), 

* Lower back pain (I thought this could be from not moving properly)

* My Abdo area felt bloated, and my digestive tract just wasn't like it used to be.

The more I was upright or mobile, the worse all of the above became (mornings were good, evenings the worst).

After 12 weeks of having the mesh plug and mesh overlay implanted, they were removed by a much more experienced surgeon (I'm in Australia too, just north of you).

3 days Post Op 2, I feel more mobile and my Abdo area feels so much better, than it did 12 weeks Pot Op 1.

From my understanding, the Ilioinguinal nerve was "stuck and trapped" by the mesh overlay, and during the mesh removal had to be cut.

On my very first  Post Op consult after having the mesh implanted, I was advised the tear in the fascia would never result in the bowel getting strangulated (did I really need mesh in the first place?)

My mesh was made from polypropylene – once thought to be inert in the human body, but has now proven to react.

I just wanted to share my experience/feedback if it helps others.

?I sincerely hope all those suffering pain from a repair get a resolution

Hi Adele

I have been following your posts and thank you so much for sharing your experience in this forum.  It has been extremely helpful as I have been trying to look for answers to help my husband who has been suffering from terrible pain from his bilateral inguinal hernia repair.  

He had his first laproscopic inguinal hernia repair (right) in Feb 2013 and all seemed to have gone well.  Then he had his left inguinal hernia repair, also laproscopic in May 2014 and all seemed well until Dec 2014 when he developed bilateral groin pain which he has suffered since then.  It has had a huge impact on our family - he is always on edge as he never knows when the pain will flare up and it is so exhausting for him and for our family.  He has only had a groin ultrasound which suggested that he probably had bilateral illoinguinal neuralgia. His surgeon referred him to the pain clinic in mid 2015 and since then, he has been going there every few weeks to learn how to cope with his pain.  No one (ie surgeon, pain clinic) has mentioned mesh inguinodynia since all this started and he has given up on anyone being able to help him.  He took some Lyrica initially but found it didn't really help, so hasn't been taking any thing to help with the pain.  He just soldiers on with the constant pain and it is really wearing him down.

His pain seems to be getting worse in the last few weeks and I have been doing research on the mesh he has (Bard 3d Max) and there seems to be many in the US complaining of terrible pain from this mesh. There are law firms now preparing class actions. So now I am wondering if it's the mesh causing the pain.  I guess he needs to have more imaging done so we can understand what is going on. Do you know what type of mesh you had? 

I am also in Sydney so am considering whether my husband should see Dr Garvey for his opinion. Would be grateful for any advice you have.

Hi Adele, and everyone else in this post. I have read all this stream with interest. I had a mesh repair 20 years ag in U.K., then 7 years ago had the mesh removed in Australia by the same surgeon who removed mesh for Adele.

I understand the pain and frustration in these posts. I had a left inguinal hernia repair with mesh about 20 years ago in the U.K. The hernia was minor. I had always done a lot of sport. I started having pain issues not that long after, and went back the surgeon more than once but he insisted nothing was wrong. I was still at university, got on with life, with pain as an on/off normality. Saw pain specialist, got exercises etc. but no real fix. I have always continued with sport and exercise as something I enjoy and beneficial for general health.

Over time the pain became worse. 7 years ago - 2010 - I reached a point where I decided I had to do something. I saw three specialists each of whom recommended a different solution.

One said he would remove the mesh and put a new mesh in via laparoscopic approach. I didn't like the sound of this for various reasons. Primarily the idea of placing a new mesh even closer to internal organs - with risk of adhesion, scar tissue - sounded a poor choice. 

The next said he would remove and replace mesh with new better mesh using open surgery. 

The third explained he no longer used mesh due to the types of problems we are talking about. He said he would remove the mesh and repair without new mesh. I went for this option. The op revealed the original repair had sutured a nerve into the mesh and that the mesh had curled up inwards.

Unfortunately there are no perfect solutions. It was only reading the post op report that I realised how complex and involved the surgery - a lot of tissue is removed. And otherwise healthy tendons may be used (stretched and sutured) to effect the repair.

My realisation is that there is always a trade off. You hope to get rid of pain, but the area will be weaker and will not function as it had done. You also get a new wound, with new permanent sutures which logically may tear the tissues they sit within.

You may have new pain. And limitations on sporting activity. I continue to do sport. But can feel the weakness and pain can be significant. Today pain is still present most of the time. It is worse after physical exertion involving that area, long periods of sitting or standing, and also after eating a proper meal. I believe the bowel is affected to some degree which seems obvious to me as it is the protrusion of the bowel that is the origin of the hernia.

I think removal of mesh is something to consider given the pain the mesh can cause. Counter considerations are how active you wish to be. Depending on the situation keeping the mesh may be "pain while retaining strength of the area". While removal may reduce pain, risk creating new pain, and accept a weaker groin. 

Removal may may be a more obvious solution if you accept a sedentary life. If you want to remain highly active I would consider carefully the potential trade off.

Sadly no definitive solution. A key learning for me (at least in my case where original hernia was minor) is that where surgery can be avoided, it should be. There are likely  plenty of cases where minor hernias can be approached with non surgical management.

There is good reason for the existence of the Hypocratic Oath: first do no harm.

I wish everyone here the best with their own situations. And would be very happy to discuss further where it may be helpful.

Hi Adele,

Its now 5 weeks since the mesh plug and mesh overlay were removed.

I no longer have the feeling of having an iPhone stuck in my groin when I bend, and the stomach and digestive tract functions so much better.

The wound is heallng very well and I'm starting to see Dr Garvey's recommended physio. 

I think these stretches etc.. are going to cause some irritation and pain but if it means getting everything moving correctly and reducing scar tissue formation then I need to endure through it.

Overall, I'm hoping to be 'mostly' ok. But like you, with the Ilioinguinal nerve being cut there will always be some numbness.Enough of me, you're the one whose's been through a lot. How are you doing overall? 

Something I've been taking is "Fossil shell flour" (Food grade). Google it - it has many health benefits but importantly its rich in Silica.  Collagen is largely made up of silica and is great for the skin and soft tissue.

Cheers Pete

My active life came to a complete stop. Now starting every afternoon

My stomach bloates up, sharp pains etc. Can’t do anything really rest of the day. I am completely holed up at home. Really hard as I have always jogged and walked/ hiked every day before surgery. Even with the hernia.

Had Ct scan and MRI- all looks good, nothing wrong.

My surgeon referred me to gastro specialist who concluded I have scar neuroma.

He sent me to pain clinic and they now want to do a nerve block, through my bellybuttom straight into scartissue.

Anyone with experience from nerveblocks?

I am too nervous- the thought of anyone inserting anything through my already painful bellybutton he said it will hurt, no topical anesthtic will help that the dr said....