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Chronic pain – Dr. Krpata – Cleveland Clinic – video worth watching
I found this video when responding to somebody looking for a mesh removal surgeon. It’s on the Cleveland Clinic’s Youtube channel. The title is “The Surgical Treatment of Chronic Pain After Inguinal Hernia Repair (Graphic)”.
Dr. Krpata does a great job of summarizing the overall situation and adds a few things that I did not know. He confirms what seems to be true, the 15% chronic pain rate, but he phrases it in terms of inguinal hernia repair, not tied to mesh implantation. But the focus of the talk is mesh, and it ends in mesh removal. The new part is that only 3% seek treatment. This is 3% of all inguinal hernia repair patients. 22,500. Apparently the remaining 12% (90,000) just continue to suffer, which is terrible, of course. He does touch on the fact that many patients are deflected by their surgeons which makes you wonder how much larger the real numbers are. How many more sought treatment but gave up?
The video is definitely worth watching for anyone who wants to understand the world they will be entering if they get mesh repair. The case study that he presents is a patient who had a failed “exploratory” surgery, trying to find the cause of the pain, with partial mesh removal, then eventually had the mesh removed in a 3rd surgery. The mesh removal removed the pain. But Dr. Krpata still, after his whole presentation, implies that “maybe” the mesh was not the cause of the pain. “For whatever reason” most mesh pain patients do not want more mesh (at 28:00). I get the impression that he doesn’t actually believe what he is saying but he knows that tying the pain to the mesh is blasphemy in today’s hernia repair world. And still no recommendations for prevention. Mesh removal is just another part of the business.
I have made a list of the interesting parts which I might add later for those who don’t have half an hour to spare to watch the whole thing.
The video is essentially, in sum, the life cycle of a laparoscopically implanted mesh patient’s pain, if they have pain. From implantation to pain/mesh removal. Everything from physical therapy, to pharmaceuticals (including gabapentin), to neurectomies, to the eventual solution of mesh removal is discussed. He even shows the “scarred battlefield” that I have called what’s left after mesh removal, from the cauterization.
“The Surgical Treatment of Chronic Pain After Inguinal Hernia Repair (Graphic)”
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2 Replies
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@good-intentions Great info as always man, much appreciated.
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Here’s an example of the tendency to downplay or take the least offensive approach to describing mesh-caused groin pain. Dr. Krpata clearly showed the 15% chronic pain rate for patients who undergo inguinal hernia repair, in his video. But, on the front page of the Cleveland Clinic Pain Center page, of which Dr. Krpata is the Director, it says 10%. It makes you realize how hard it is to describe the reality. Choose the smallest number possible. But at least there are some professionals acknowledging the problem openly.
https://my.clevelandclinic.org/departments/digestive/depts/hernia/chronic-groin-pain#overview-tab
“Overview
The Cleveland Clinic Center for Chronic Groin Pain is a multidisciplinary clinic where patients are evaluated for pain following inguinal hernia surgery. Chronic groin pain is an unfortunate potential side effect of having an inguinal hernia repair than can impact up to 10% of patients. …”
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