Removal of mesh after inguinal hernia repair.

Hello, I live in Sydney, Australia. I had my mesh removed by a specialist surgeon here. One of

The only ones who will perform the

procedure. He does about one a month and people travel from interstate and overseas to see him. I also had illioinguinal neurectomy as the nerve was trapped in the mesh. I've had MRI's and US performed by his specialist radiographer who also did an US guided nerve block and cortisone injection just yesterday as still residual pain in the genitofemoral nerve. Likely because of that nerve being trapped in scar tissue with first mesh repair. The steroid can take up to two weeks to take effect if at all. I'm really hoping the nerve pain will settle on its own in time. I was also examined by the surgeons own physiotherapist who treats a lot of his patients who are athletes. So matter of eliminating what could be going on. All specialists believe it is the GF nerve causing pain. The nerve block did seem to numb the area for a few hours until the local anaesthetic wore off. So looking like we are getting closer to the problem. My conjoint tendon was also a bit inflamed which was also repaired when mesh was removed and there's residual fluid retention which is supposed to go away on its own in time and is quite normal. The non mesh hernia repair is strong and healing well. I don't want more surgery. Let me know how you go. The mesh can cause your symptoms if nerves involved. Don't stop looking for answers.

Hi - I am still following your progress. It is really quite distrssing to hear about all your problems when of course you were hoping for a much quicker cure. Australia has a really good reputation for their hospitals - my brother was recommended Sydney for a hip. I finally made time and got my surgical report from the doctor. It was brief, but apparently I had a darn repair by a senior surgeon. Since the operation I have heard of a lot of men with inguinal hernia repairs, all of whom have mesh repairs, but all with a good outcome. One had bad pain on his 2nd op, but is OK now after 18 months and no further treatment, and one had a plug repair re-done with mesh, but didn't seem to get the pain. Cardiff UK. 

I agree with you - if they can get the pain to go over a period of time, it does seem better not to have any more surgery, with the possibility of more complications, and more difficulty with healing. Again -good luck.

Thank you Anne. I really appreciate your thoughts. I'm sure I'll get better, positive energy

I am still trying to figure out what nerve which from what you indicate is difficutl to determine.  I thought ultra sound would show the mesh at least and have not had one done was was hoping to.  MRIs and EMGs show nothing and am going to have an us-guided injection to help with the pain and see if it is dagnostic as well.  In the states there is one surgeon who will to the triple nuectomy and if needed remove the mesh. My surgery was more than 20 years ago and the damage has caught up with me causing my knee and hip damage.  I have been walking in a way to advoid the pain but obviously I was not in as servere of pain as many of you.  It took a year after the surgery for most to the pain to go away.  I cant a new knee with the hip misalignment and my hip is not that bad.  Kinda wondering what to do-  if anything besides get injections for pain at least for now.  I had to leave teaching years ago because I cannot stand fr more than a minute on hard floors or go up and down steps in school buildings all day.  I became a counselor and work from home.  For years I did not know what was wrong with me and doctors did not recognize or investigate what happened.  Being a female must have confused them so I am naturally distrusting of doctors.  I have had to convince them after diagnosing myself with the help of a couple of physical therapists.  They are the only ones who have the time to observe over time.  Anyhow I am surprised that ultra sound does not allow for more information.  I have read that ultra sound guided injections do allow one to see more but so far at least from what I have read here I dont know if thats the case either.  I read reserch on Pub Med and then go looking for a doctor.  I wish I could find one that really knew more since the one that is an expert is 2,000 miles from where I live.  

So sorry to hear you are having so much trouble. The nerve block should let you know which nerve is involved. I had one and had nearly immediate relief a week and a half ago. Looking like Genitofemoral nerve entrapment because of the original mesh repair, but also a split in my conjoint tendon. I am still glad I had the mesh removed because other symptoms I had are now gone, although I still am having ongoing disomfort. Under the hands  an experienced radiographer you should get results if they know what they looking for. I had an MRI and US including nerve block. Report came back suggesting the GF nerve entrapment and conjoint tendon split. I will be seeing my surgeon again this week. Really hoping it will eventually be fixed. Mesh hernia repair and its complications a nightmare for many people. Let me how you go. I will keep in touch.

Hi where are you based? I have finally had the op to remove the mesh right hand side inguinal, surgeon found the mesh was twisted,infected,inflamed, attached to my bladder in 2 places and I had 3 nerves stuck in their, he removed 90% of the mesh as small part is stuck round important tubing so wasn't wide to remove. He also has to put a 50p sized of mesh back in to cover hole he went through, it's still early days as in 16 days and stil in pain with other nerve problems, but still at min 50% better than was at min

Wishing you well Adam. I am in Sydney, Australia.

I am in Ohio.  The best surgeon for mesh removal and a triple neurectomy.  I have not been referred for ultrasound guided diagnosis and am looking for some who knows what they are doing.  The MRIs and EMGs show nothing but by looking at my right thigh the lack of muscle strength is obvious compared to my left thigh.  I had to find the doctor that did ultrasound guided pain injections.  I would like to find a list of docs that are trained in this procedure since they aren't easy to find.  So far I am planning to avoid any surgery since I haven't tried the injections.  The implant does not sound good to me.  I wonder if the neurectomy would leave my muscles just as weak.  I think the nerve effected is also the genitofemoral nerve.  Seems like women end up with this injury more than men.  I finally got online and read the research myself.  

I had every X-ray and mri going but a doctor in the Uk sent me for a mri with a buscapan dye which shows a lot more information and can show the problem nerves and issues around your mesh, they did suggest the nerve block injections but they are only a short term fix. They cut the either the genital femoral or the femoral I can't remember but hasnt left me with weakness. Not sure if this helps but my surgeon in the Uk was called Aalia sheen and he's involved with a guy who's part of mayo clinic who's name am not sure but it might be worth getting intouch with Manchester hernia clinic and getting them to pass on details as would highly recommend

Thanks for your thoughts Ed. keep positive. I know it's so hard through all the pain and problems. We will get there. Lucky for this forum. Family members must be sick of my ongoing health problems. Take care and keep in touch.

Ah thank you. And the same to to you.

Soul destroying isn't it...??

It's awful, but we can't give up. Be strong. Let me know of your progress and vice versa.

You're so kind. I will. And same to you, please keep me posted.

I always remember that there are much worse off than me.

Keep smiling (be it through gritted teeth sometimes!)

??

??

You know your own body, I am sure you are right again. Do not take NO for an answer. I hope you heal soon. 

Just wondering how you are going? I am still suffering Absolutely so depressed with this.

 

Oh snap Adele. I am, have been in agony. Awake all night with the same burning, aching, pulling feeling. It's horrible and depressing.

And you? Sounds like you're suffering still? What pains are you suffering?

Thank you for thinking of me. Please let me know how you're doing.

X

Same pains as yourself, burning, aching, pulling feeling​, but also I wouls say a stabbing pain. Feels like a hot skewer being pushed into me. Awake at night too. I woke up at 3am this morning and could not go back to sleep. Exhausted. Painkillers do nothing. I really belive it is nerve related. Recent scan also showed my conjoint tendon is split and I have a seroma since my last surgery in May. Has been an absolute nightmare. Best of luck to you getting some answers.

Stabbing pain,yes! Infact when I say all those out loud it sounds so stupid. It is so good to hear someone is in the same boat. As weird as that sounds- I hooe you know what I mean?!

I had huge inflammation of the left side. My surgeon thought I may have an infection in the mesh. Had yet another CT which showed no inflammation but a great deal of adhesions?? No, really!!!?

But I sat up all night too, trying to read. Oramorph didn't touch it either.

I totally understand how depressing and frustrating it is. You truly do begin to doubt your sanity sometimes don't you? That is why this forum is amazing as you know your not along and that others are going through what you are.

I wishtiu luck with for quest to find answers. Please keep bugging your surgeon. If not find a new one? Are you based in London?

I am based in Sydney, Australia.

YES, sanity is truly tested! This must be able to be fixed???? I found the following article.

Inguinal neurectomy for nerve entrapment after open/laparoscopic hernia repair using retroperitoneal endoscopic approach.

Muto CM1, Pedana N, Scarpelli S, Galardo R, Guida G, Schiavone V.

Author information

Abstract

BACKGROUND:

Inguinal neuralgia after open and laparoscopic hernia, repair occurs in about 0.5% of treated patients. If the pain and the functional inability persist, it is possible that the genitofemoral nerve and ileoinguinal nerve are involved in entrapment, and surgical treatment is a possible option. This paper reports a personal endoscopic retroperitoneal approach for ileoinguinal and genitofemoral branches neurectomy.

METHODS:

A 12-mm trocar is inserted into the lower retroperitoneum and insufflated to create a work space. Neurectomy is performed under endoscopic guidance.

RESULTS:

Six patients were treated using this technique. The operating time was 55 min, and all patients were completely pain-free after surgery. All patients were discharged the first day after operation and there were no complications.

CONCLUSION:

This retroperitoneal endoscopic approach is proposed as a new surgical technique for treating inguinal entrapment neuralgia. It is simple and feasible.

 

Pain after hernia surgery

Inguinal (groin) hernia is a common condition with an incidence of six per cent to 12 per cent in adult males. It affects men more often that women. The condition presents as a lump in the groin, due to a protrusion of intestine through a weakness in the abdominal wall in the groin. This lump can affect daily activities and is often, but not always, painful.

Surgery to repair inguinal hernia is one of the most commonly performed operations: in 2010, 71,000 operations were conducted in England alone (93 per cent of these operations were done in men).  The type of operation can vary, some surgeons use key-hole or laparoscopic surgery rather than an open incision. A mesh is often used to repair the abdominal wall weakness, secured in places either using stiches, glue or staples. There is a small risk that the nerves in the groin can become irritated or inflamed by the implant (or internal stiches).

Chronic pain after inguinal repair surgery is now a well-recognised condition – it is one of the most widely reported surgical conditions with hundreds of articles reporting prevalence of up to and around 30 per cent. Approximately five to 10 per cent of patients report pain after their hernia operation that interferes with daily living.  There is now guidance recommending that it is safe for surgeons to ‘watch and wait’ with some patients who have a small pain-free lump, as long the hernia doesn’t impact too much on their daily activities.

Thank you Adele for this, it makes for interesting reading. I shall definitely ask my surgeon next time I see him. ( I'm sure I'll be seeing him again...)

And it's interesting it happens more to men, that's one less thing us girls don't have to worry about! But depressing to see that chronic pain is something we may have to live with.

Thank you for finding this for me, it was very kind.

Hope you're keeping well.

HI ed66, I am booked in for completion of triple neurectomy on August 15, but still not sure if this is the issue? I am so worried. Have you heard about pudendal nerve neuralgia? I have sent an email to my surgeon to rule out that is not be the cause of pain. I do not want to be cut opn again for no reason. I hope you are OK?

Oh Adele I'm so sorry to hear you're having such a grim time and the op must be do daunting for you. I truly hope it all goes well.

Stay strong and positive. I know it's hard to.. and I hope you get some relief after it.

Please let me know how you're going post op. I shall be thinking of you.

Em (ed are my initials!)

Hi - I am also in trouble after bi-lateral hernia repair. You are in London? I am trying to find someone that cam help me as i had the initial operation 3 years ago privately but the surgeon is actually based overseas and flies in to do the surgery. I am looking for a more local reliable option.

Hi Tom

Sorry the surgeon that carried out the procedure on myself is also based in abroad (Germany) and has clinics every 4 weeks in the UK.

Hi - I see ok, based on what you say then i think we have the same surgeon! Are you happy with how things have turned out so far? Would it be possible to swap some notes in a more private forum? Thanks!