Reply To: How long can inguinal hernia repair be expected to last

Hernia Discussion Forums Hernia Discussion How long can inguinal hernia repair be expected to last Reply To: How long can inguinal hernia repair be expected to last

quote WasInTN:

I had right IH repaired by Dr. Goodyear of PA and it was 3+ years since and I have had no worries. An occasional dull twitch happens once in a while for a few minutes when I sit in wrong posture or twist my legs, and then it goes away. I think it is kind of nerve irritation. I am happy with what I had. If I remember correctly (yes I do), Dr. G said the mesh will stay for a life time. And it is 8x stronger than the original body tissue. I think the mesh is Ultrapro or something like that. Not sure of that exact name but you can find it from Dr. G’s office or website. He even said that when a person with mesh dies, it can be retrieved intact. Anyways…

As I have been saying on this forum and elsewhere, this much I know about IH repair. It happens due to a weakness in your tissue that holds the internal organs. Once that tissue is weak and a bulge forms you have IH and it can get worse over a time depending on your activities. Does a surgery fix it? It is immaterial to know what type of surgery but does it fix it? Sure it does but does it fix it FOREVER? The answer is “Nobody knows.” Why? Because it depends on what you do after surgery. Since surgery fixes the tissue it does *NOT* mean it makes you a superman. It makes you fit for day to day life and usual activities. If you think you can lift the mountain and hurl it towards the moon after surgery, do not even try it because now that the fixed hernia is 8x stronger and since your tissue was weak in the first case you will have hernia in another location (usually the other side). What if you fixed both sides and try to hurl the mountain? The answer is, I do not know and my suggestion is not to try it 🙂 But if you still want to try, I can guarantee you will have hernia elsewhere.

So does the mesh last forever? The answer is “usually yes” but will it break? Yes it can, depending on what you do. Even the most difficult things in life can break down. Like everything else in life, all items have a life span. You can buy a wall clock that will work for 40 years or even 80 years but ultimately it will die and catch up with Murphy’s law. So is the case with mesh. It all depends on what you do after you get the mesh.

My point is this – surgery makes you feel good and makes you almost normal but yes there are limits. How to find the limits? Listen to your body. That’s my 10 cents. And of course I am not medical professional though I have a doctoral degree in biomedical Engg and I do understand from my research how the mesh and the body works. The bottom line is, it helps you but will NEVER make you a superman. There is no such thing as superman BTW. Even the guys who act as supermen in movies are vulnerable to disease and may be even hernias. Even the strongest athletes in Basketball and NFL have the hernias.

Thanks! I really appreciate this perspective.

I actually have had two additional follow-ups since my original appointments and I think I am getting a much better understanding of inguinal hernias, mesh and surgery now. I had two PCPs tell me that I do seem to have a hernia developing at least on one side, but that it is still very small and may not have even broken through yet completely. Neither recommended bothering with surgery yet as I’m mostly asymptomatic. I had one surgeon tell me he thought I had one indirect inguinal hernia on one side, and likely the same on the other side. He recommended robotic laparoscopic surgery with Bard 3D Mesh as soon as convenient. Finally, today, I had a last surgeon tell me that I do for sure have the one hernia on the right side, but he thought it was direct rather than indirect, and small. And he said it doesn’t seem like I have one on the other side yet, though he can’t be 100% sure. He also recommended robotic lap surgery with likely the same type of mesh as the other surgeon. But he said no rush. Whenever convenient. Next month or next year or whenever it bothers me.

I liked both surgeons but I know that the latter surgeon does tons and tons of hernia repairs specifically. And knowing he can also do the robotic lap as well, I will probably use him and go with that. He can do pure tissue repair as well I think but did state that though results are good short term, in all likelihood years down the road I have a higher chance of recurrence. I had tons of questions for him and he basically reassured me that though nothing is guaranteed, the incidence of chronic pain is related to certain things that I am personally pretty low risk for, and it’s also related to experience and skill of the surgeon. The robotic lap surgery behind the abdominal wall by a skilled surgeon seems to be a great way to avoid most potential issues. It’s all about skilled placement and avoiding infection and avoiding critical nerves and other tissues. He also reassured me like you did that the repairs and the polypropylene are effectively permanent. While anything that comes into contact with anything else will influence it, the rate at which poly is affected by the body makes it essentially permanent (assuming no complications like infection or folding over or damaging nerves and other tissue etc requiring removal). I was worried it would weaken during ones lifetime and need replacement every so often. But it seems that’s not the case. And my understanding is they usually use a piece large enough to cover the area that has the most possibility of future tears, so as to strengthen the region even more. He said he’d look to see if the other side showed a similar weakness and would put mesh in there if he thought it would avoid inevitable surgery in a few years, but said he wouldn’t bother if everything looked normal.

It’s interesting you mention they told you it makes the area 8x stronger. The first surgeon suggested things will never be as strong as before (maybe 99%), but then again the area tore in the first place. So maybe I misunderstood exactly what he was suggesting. Maybe he meant the general area compared with the strength it had when I was younger before weakening it with certain regular activities.

I think at this point I’ve decided to get the mesh repair (I have to get some kind of repair eventually one way or another) because of the statistical likelihood of recurrence if I don’t use mesh, and because it’s a skilled surgeon with a great rating who does lots and lots of hernia surgeries and uses a technique and a mesh that in the right hands minimizes the chances of complications. Again, nothing is guaranteed, but I feel better and more informed now about my decision after talking with four different people including two surgeons, and I will hope for the best. I also feel better knowing that if all goes well, the material should hold under normal circumstances and permanently fix a problem that must be fixed. Tissue repair MIGHT be a permanent fix without the concern about a foreign body, but I’m only 41 and anticipate many years of activity ahead of me and I would worry that a pure tissue repair might find me back in the surgery room eventually, and a second repair after a failed pure tissue repair sounds like it would be more complicated. I also hope that I only need it on one side but will trust his instincts when he gets in there.

Thanks again for sharing your experience. It’s good to hear the bad stories and the good stories and everything in between. I’m in no rush to get this done but do expect I will probably schedule something within the next year or so at most. I don’t like the idea of this getting worse and having a larger part of my insides potentially bulging out. I lost about 55 pounds in the last year and a half and two doctors suggested I might not have even noticed anything if I was still that heavy. So I think it’s small enough to be patient, and he said unless it gets huge (which he said he wouldn’t expect for a long time) there is no major advantage to getting this fixed today versus say next year.

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