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Second opinion
My husband had exploratory laparoscopic surgery on April 30, surgeon Dr. Prats found a indirect inguinal hernia on right side and repaired with mesh. The hernia was so small (size of a dime) that wasn’t able to be seen on ct scans. Since surgery my husband has had burning pain at groin/mesh area, hip pain that also radiates around back and inside thigh numbness, tingling, jolts of pain. His stomach area is also tender and as he describes swollen or puffy more so on the right side, but generally all over. He had a cortisone injection on 8/28 into ilioguinal and iliohypogastric nerves which hasn’t helped much. The pain is pretty much constant but seems to get worse if walking a lot of sitting on hard surface chairs. Not sure if the pain is nerve related (he is taking gabapentin also) or scar tissue, etc. His surgeon did refer him to see Dr. Pauli at Hershey for a second opinion, any other recommendations? We are in central PA. Thanks
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13 Replies
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sorry, don’t know Dr. Tiru.
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Thank you, he did have consult with Dr. Pauli, who put him on ibuprofen 3 times a Day for 2 months until follow up. Believes its inflammation because of how his pain moves round and isn’t in one area. Have you heard of Dr. Tiru in York, pa, he specializes in Shouldice technique.
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Dr Eric Pauli is an excellent surgeon and super intelligent. He is among our go-to hernia specialists. I do recommend you see him in consultation.
Sounds like there is a combination of feeling the mesh and nerve pain. If it’s early after the surgery, the goal is to tame the inflammatory response to the mesh and allow time to heal. Ibuprofen and sometimes steroids can help. Nerve blocks and local anesthetic can also help.
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quote Liz52408:My husband had exploratory laparoscopic surgery on April 30, surgeon Dr. Prats found a indirect inguinal hernia on right side and repaired with mesh. The hernia was so small (size of a dime) that wasn’t able to be seen on ct scans. Since surgery my husband has had burning pain at groin/mesh area, hip pain that also radiates around back and inside thigh numbness, tingling, jolts of pain. His stomach area is also tender and as he describes swollen or puffy more so on the right side, but generally all over. He had a cortisone injection on 8/28 into ilioguinal and iliohypogastric nerves which hasn’t helped much. The pain is pretty much constant but seems to get worse if walking a lot of sitting on hard surface chairs. Not sure if the pain is nerve related (he is taking gabapentin also) or scar tissue, etc. His surgeon did refer him to see Dr. Pauli at Hershey for a second opinion, any other recommendations? We are in central PA. Thanks
Do any of the Dr’s have a recommendation on next steps or what could be causing pain? He was told to take 800mg Ibuprofen 3 times a day for 2 months until next follow up in November. thank you!
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Does anyone have any experience or feedback on Dr. Eric Pauli at Hershey Med Center in PA?
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quote Jnomesh:Hi Liz. I had the same mesh implanted in me 7 years ago. Unfortunately this type of mesh has the tendency to fold over and clamshell on itself Bc of its design. It is concave in nature so any force from the muscles or tissue can cause it to fold over. I had inflammation, the feeling like my stomach was bloated and distended and a overall feeling like something was stuck inside of me.
there are many posts on this form from people who are in pain and have the same bard 3D maxx mesh and I am on a FB mesh forum and have come across about 10 men and women who ended up having their 3D maxx removed and it was discovered that it was folded up. All were told everything was fine with the mesh by doctors and other Surgeons.
for me after about 5 years of dealing with flare ups of pain and alway having a brick like feeling I’m my abdomen, things got really worse-and I developed pain that was even more horrendous and this time crippling, to the point of not being able to work for a while and not being able to socialize and do much with my family and kids.
i did some research and googled the bard 3D maxx mesh and saw a bunch of lawsuits against it and the flaws in its design.
after joining the mesh forum I visited about 3 surgeons who specialize in mesh issues before finally going with dr. Igor Belyanski in MD.
he saw on a cat scan, same cat scan that all the other radiologist and surgeons said looked fine-that the mesh had bent and shifted. I had the mesh removed in a lengthy 3.5 hours surgery as it was much worse then he expected-the mesh had completely balled up and was rock hard.
i personally believe the Belyanski is tops when it comes to removing mesh laparscopically. He got a bout 90% of the mesh out. It was attached to all sorts of structures-the spermatic cord, illiac vein and bladder, and the mesh was also pressed up on my colon. He was carefully able to direct all the mesh off these structures leaving a some chards on the illiac vein and artery Bc it was to dangerous to remove.
pleaae feel free to message me if you have any further questions. I and sorry he is going through this but there is help out there-you just new to break free from your local networks and be willing to travelthank you… I will message you!
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quote Good intentions:Yes, I had the mesh removed by Dr. Peter Billing of Shoreline WA. In my case it was just the constant inflammation from the mesh. Depending on what activities I had been doing recently the location of the soreness/discomfort/swelling would move. Sometimes it was my complete lower abdomen, both groins, the centerline under the navel where the two pieces overlapped, and the pubic symphysis. Everywhere the mesh had been implanted. At times I could feel the unnatural periodic nature of the mesh sliding against the pubic bone. I could feel the corners of the mesh poking in to my groin when I crouched to work on something low. Eventually, about a year in, my penis started being affected in ways that were worse than just erectile dysfunction, especially after simple exercise like biking or running. I spent about year accepting the fact that I had been badly screwed up by the mesh and trying to develop a way to stay healthy yet still have full function of all of my parts. It was absurd to think about planning ahead for certain activities but that’s what life was like then.
Since having the mesh removed, most of those symptoms have resolved. I still get some soreness at the what seems to be the internal ring area of the canal, after more intensive running or work actions, but the soreness resolves in a normal way over a day or two. It’s been about nine months and I’m still healing.
That description of my situation is more for you to hang on to and consider as time goes by. Since your husband is only four months in there will be attempts to save the mesh and fix the problem via other means. In the meantime, one thing I found that seemed to reduce the swollen spongy feeling was lifting weights. I had got to the point where I realized that my surgeon was out of ideas so had to improvise based on what I was feeling. Creating abdominal pressure seemed to help compress whatever swollen tissue was there and stretch things out to where I was comfortable for a while. But I could still not run or bike without causing soreness and pain, and the other problem, again.
Here is a recent paper showing the typical pathway for chronic pain resolution. Hopefully it helps you to form a plan.
thank you for your response… so how long after the original surgery where mesh was placed did you have it removed?
How did your Dr. determine that it was the mesh causing the problem?
Also when they removed the mesh did you have any problem with tissue or nerves being irritated with the removal? What did they use to repair the hernia when they removed the mesh- tissue? I am wondering why mesh is automatically used if there are so many known problems with it. my husband said it feels like someone has their hand placed where the mesh is (like applying light pressure), not sure if that is normal or not?
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quote Liz52408:Ok thanks did you have your mesh removed? It’s hard to determine what’s causing pain if its inflammation, scar tissue, tacks or the mesh…..
yes his surgeon kept telling us that he did the least invasive surgery and best technique for surgery, and basically surgery was a success…he didnt have any of this pain before surgery.Yes, I had the mesh removed by Dr. Peter Billing of Shoreline WA. In my case it was just the constant inflammation from the mesh. Depending on what activities I had been doing recently the location of the soreness/discomfort/swelling would move. Sometimes it was my complete lower abdomen, both groins, the centerline under the navel where the two pieces overlapped, and the pubic symphysis. Everywhere the mesh had been implanted. At times I could feel the unnatural periodic nature of the mesh sliding against the pubic bone. I could feel the corners of the mesh poking in to my groin when I crouched to work on something low. Eventually, about a year in, my penis started being affected in ways that were worse than just erectile dysfunction, especially after simple exercise like biking or running. I spent about year accepting the fact that I had been badly screwed up by the mesh and trying to develop a way to stay healthy yet still have full function of all of my parts. It was absurd to think about planning ahead for certain activities but that’s what life was like then.
Since having the mesh removed, most of those symptoms have resolved. I still get some soreness at the what seems to be the internal ring area of the canal, after more intensive running or work actions, but the soreness resolves in a normal way over a day or two. It’s been about nine months and I’m still healing.
That description of my situation is more for you to hang on to and consider as time goes by. Since your husband is only four months in there will be attempts to save the mesh and fix the problem via other means. In the meantime, one thing I found that seemed to reduce the swollen spongy feeling was lifting weights. I had got to the point where I realized that my surgeon was out of ideas so had to improvise based on what I was feeling. Creating abdominal pressure seemed to help compress whatever swollen tissue was there and stretch things out to where I was comfortable for a while. But I could still not run or bike without causing soreness and pain, and the other problem, again.
Here is a recent paper showing the typical pathway for chronic pain resolution. Hopefully it helps you to form a plan.
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Hi Liz. I had the same mesh implanted in me 7 years ago. Unfortunately this type of mesh has the tendency to fold over and clamshell on itself Bc of its design. It is concave in nature so any force from the muscles or tissue can cause it to fold over. I had inflammation, the feeling like my stomach was bloated and distended and a overall feeling like something was stuck inside of me.
there are many posts on this form from people who are in pain and have the same bard 3D maxx mesh and I am on a FB mesh forum and have come across about 10 men and women who ended up having their 3D maxx removed and it was discovered that it was folded up. All were told everything was fine with the mesh by doctors and other Surgeons.
for me after about 5 years of dealing with flare ups of pain and alway having a brick like feeling I’m my abdomen, things got really worse-and I developed pain that was even more horrendous and this time crippling, to the point of not being able to work for a while and not being able to socialize and do much with my family and kids.
i did some research and googled the bard 3D maxx mesh and saw a bunch of lawsuits against it and the flaws in its design.
after joining the mesh forum I visited about 3 surgeons who specialize in mesh issues before finally going with dr. Igor Belyanski in MD.
he saw on a cat scan, same cat scan that all the other radiologist and surgeons said looked fine-that the mesh had bent and shifted. I had the mesh removed in a lengthy 3.5 hours surgery as it was much worse then he expected-the mesh had completely balled up and was rock hard.
i personally believe the Belyanski is tops when it comes to removing mesh laparscopically. He got a bout 90% of the mesh out. It was attached to all sorts of structures-the spermatic cord, illiac vein and bladder, and the mesh was also pressed up on my colon. He was carefully able to direct all the mesh off these structures leaving a some chards on the illiac vein and artery Bc it was to dangerous to remove.
pleaae feel free to message me if you have any further questions. I and sorry he is going through this but there is help out there-you just new to break free from your local networks and be willing to travel -
Ok thanks did you have your mesh removed? It’s hard to determine what’s causing pain if its inflammation, scar tissue, tacks or the mesh…..
yes his surgeon kept telling us that he did the least invasive surgery and best technique for surgery, and basically surgery was a success…he didnt have any of this pain before surgery. -
You might consider seeing a surgeon who repairs hernias but also removes mesh. Dr. Igor Belyansky, in Maryland, is a possibility. He would be more likely to objectively assess the issue, and recognize the symptoms of a mesh sensitivity. Many many surgeons will waste precious time, the patient’s time, avoiding the realization of a mesh problem.
Dr. Belyansky removed Jnomesh’s 3D Max mesh. You can search for Jnomesh’s posts on the forum to get more details. I’m surprised that he did not reply to your recent post, since he just replied to two topics, but he might have missed it.
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The mesh used was 3d bard max large size , tension free… not exactly sure of size , with absorbable racks into coopers ligament. Not sure if it was tapp or top, I can look later at surgery report . Yes he did use large piece of mesh, I don’t believe any was put on left, as he has no pain there and surgeon didn’t mention anything
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Do you have more details on the type of mesh used, and the size? There is a variety of materials for the surgeon to choose from, and the quantity depends on the surgeon’s choice also, along with location. The type of surgery, TEP vs TAPP, would be good to know too. The notes from surgery should have these details. Certain types of mesh seem to have more problems than others. After four months the mesh will have been “incorporated” in to the surrounding tissue so it’s unlikely that the problems will resolve on their own.
I had a similar swollen feeling with Bard Soft Mesh, after activity, while sitting. Not severe pain but constant discomfort. It felt like I had a wide flat sponge in my abdomen. I had to leave my pants unbuttoned to avoid pain. My surgery was laparoscopic TEP with mesh placed on both sides.
It looks like Dr. Prats is learning and using the main-stream guidelines, which call for using large areas of mesh to cover and extend beyond as much of the potential hernia areas as possible. It would not be a surprise to find that he also had mesh placed on the left side.
https://www.leadersurgical.net/doctors
Good luck. There is a much good information on this forum. It can take some time to find a solution though.
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