News Feed Discussions Patterns of recurrence associated with specific types of inguinal hernia repair Reply To: Patterns of recurrence associated with specific types of inguinal hernia repair

  • Mark

    Member
    May 6, 2023 at 9:48 am

    Since the original post by Good intentions is regarding “recurrence and repair”, I am posting this statement from Dr William H Brown, who performed my hernia surgery, and is one of the many reasons I chose to go with him;

    Most Surgeons argue for the use of mesh because of the lower recurrence rate. But their argument is flawed. If you look at the numbers, the chance for a recurrent hernia after a mesh repair is 3%. The chance for a recurrent hernia after a non-mesh repair is about 4%. But to achieve this 1% lower recurrence rate the patient runs about a 15% chance of chronic pain.

    The argument for a hand-sewn repair (i.e., no mesh), is that there is no foreign body placed in the body. It is common for people to develop scar tissue around the mesh. This fibrosis causes the mesh to become stiff and hard. Then when you bend and twist, and the mesh does not bend and twist with you, the sheer stresses causes pain. Sometimes one of the nerves or spermatic cord gets stuck to the mesh, and severe pain can result. Then exercise becomes impossible because of pain, and ejaculation causes a severe burning sensation in the spermatic cord and testicle. Chronic pain after mesh hernia repairs affects 15% of patients. A significant number of those patients with pain have to have the mesh removed with another operation. Even after removing the mesh, the patient is often only about 80% better.