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Other types of surgery with similar problems, long-term or short-term
One way to quantify a problem with a procedure is to compare it to similar procedures. Much of the discussion about hernia repair with mesh focuses on surgeon skill or method. So, a comparison for this problem might be something like gall bladder surgery or appendix removal. Both used to be commonly done via open incision, now it’s more common to do them laparoscopically, I think. So you would expect similar issues as the new methods are developed.
Hernia repair is, apparently, done about 800,000 times per year in the USA. Apparently, gall bladder surgery occurs at about 600,000 per year, a comparable rate. The information for gall bladder surgery looks about like that for hernia repair. But the complication rate seems much much smaller. The main difference is the mesh prosthetic.
Just offering a reference point, for thought.
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I had a very rare surgery for a condition called Tarlov Cysts. A sacral laminectomy was performed and a reabsorbable mesh/plate was used to close the laminectomy. This was in 2012 and although the mesh has “dissolved”, I continue to have a foreign body reaction. Many I know who have had this surgery with this reabsorbale plate have also had continued issues. I think some people just can’t tolerate foreign materials in them. Wish there was some way to test for this prior to surgery.
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Vaginal prolapse repair with vaginal mesh carries high risk for chronic pain and horrible complications. Fortunately women have been incredibly effective at advocating for changes in that field, but thus far men and women have had little to no success advocating for changes in groin hernia repair.
My hunch is that some patients do not respond well to having an object placed into a highly innervated region, such as the pelvis or the groin. The pelvis/groin is one of the most sensitive areas of the human body after all. But then some patients do fine, who knows why that is. I am not sure anything will ever be able to predict who will do well or not with these surgeries, because sometimes you can have the same patient with the same repair on both sides and only one side is problematic, and who knows why that is.
I do think it’s interesting that there are some other mesh repairs that do not have the high of chronic pain problems; umbilical hernia repair and other upper abdominal hernia repairs with mesh are fairly routine and apparently have much lower chronic pain rates. My assumption is that’s because those areas are not full of nerves the same way the pelvis and groin is.
Some people report problems with breast implants, though it appears to be at a significantly lower risk incidence. And I believe those are easily removed if needed to be.
Other abdominal surgeries like c-section birth, appendectomy, or cholecystectomy are incredibly common with very low chronic pain risk.
And of course surgery for broken bones and fracture repairs are incredibly common, with very low chronic pain risk for most broken arms, legs, etc.
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