Reply To: Non Mesh Repair Questions
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Very good questions about nerve damage and chronic pain with mesh vs with tissue non-mesh repair. It is a myth that non-mesh repair has lower chronic pain or nerve damage risk. The best study on this was also the first to study such an issue. It clearly shows a significant chronic pain risk with non-mesh tissue repair. See attached. Note that this study was done during an era where most of the surgeons were skilled in non-mesh tissue repair. Everyone was focused on reducing hernia recurrence back then (hence the advent of mesh repairs) and that was the main outcome that was measured. Pain was assumed to be part of the profile of hernia surgery. But once hernia recurrence was a lesser issue (due to use of mesh), then the importance of and interest in chronic pain increased.
Today, the outcome numbers quoted for non-mesh tissue repairs are all over the place. The reason may be that the recurrence and pain/nerve injury rate is very much a factor of the surgeon’s technique and experience. Each surgeon and institute has their own data. For example, recurrence rate may be between 0.5% and 15%. Chronic pain may be between 1% and 20%. The outcomes from tissue repair are no longer as predictable as the more standardized mesh technique.