Failed bilateral inguinal hernia after 3 months

[Jnomesh]

Personally having my mesh ball up into a rock hard ball and suffering for 5 years as all the professionals said all is well- I would get the mesh removed. I don’t say this flippantly but the fact that your hernias came back so soon after surgery means the mesh probably moved and is even more probable since the mesh was self fixantkng and not sutured or stapled down. So to leave that failed mesh inside of you would be crazy in my opinion. It can continue to migrate and attach to all sorts of structures and become way worse. Get it out while it is still relatively new inside you before it can go more damage. My situation got been more dire 5 years later and become severely more painful.
Get it in your mind that you will have to travel.
to have your mesh removed laparoscopically (mine was placed and removed laparoscopically ) you will want to go to either dr. Brice Ramshaw, dr. Igor Belyanski or Shirwin Towfigh.
dr. Towfigh has been doing laparoscopic repairs on select patients and this might fit the bill for you. Have ithe Mesh removed and the hernias repairs innone Surgery. Ofcourse you could have the mesh removed and then the hernias repaired non mesh openly in the same surgery if you don’t want mesh. And I rx not getting more mesh placed.
there are really only two doctors I know of. Who repair hernias without mesh and are experts:
dr. Kevin Peterson in Vegas and dr. William brown in San Fran. So another option would be to do a two staged process get the mesh removed and at a later date after you recover get a open pure tissue repair.
therr is also the Shouldice Hospital in Toronto which does nothing but non mesh repairs.
I had my mesh removed by Igor Belyanski and when it was removed the hernia was no longer present filled in by scar tissue sobtjerr was no need to do a repair but for you that will be different .
best wishes

[Good intentions]

quote nesd:

I did have two of the doctors I’ve seen question me why I went in for surgery. It made me wonder if it was even a hernia. The Sioux Falls Dr. Peery said it could of been pulmonary, what ever that meant.

I would spend extensive time on really understanding what is going on with you. It doesn’t sound like your situation is clear, even to the experts.

In my experience, most of today’s surgeons specialize in doing certain specific things. They have trouble working outside their specialty, either because they’ve never had the training or they’ve just gotten rusty, or they are not allowed to by the organizations they work for. They’re not really “general” surgeons. Most of their professional interactions with patients are boiled down to 15 minute consultations and snap decisions about if they should do what they specialize in doing, not so much about if they really understand what’s happening. It’s a byproduct of automating the health care system.

You’ve seen four surgeons and had four different suggestions about what to do, but nothing concrete about what went wrong the first time. I would go back to the beginning and try to understand if a mistake was made in the original diagnosis and/or if the first procedure failed because of the material or the procedure, or because the wrong problem was treated. So far, it sounds like you’ve just had four people tell you that they’ll take another try.

Unfortunately, you kind of have to go from gut feel about the doctor that you are talking to. And learn more about what they are telling you. “Pulmonary” has to do with the lungs, so, dealing with air, in principle. If one doctor said you could have a “pulmonary” issue, how does that translate to inguinal hernia? Was he suggesting that you had an air bubble in your abdomen? Could it actually be a seroma?

One big positive for you is that you seem to be in a stable condition and able to think clearly and function well. So you have some time to put a good plan together. Good luck.

p.s. these are actually, in general, my thoughts for anyone who sees a surgeon. You have to help them help you.

[drkang]

Hi,

I thought you had the open mesh surgery.
I’m so sorry for having misunderstood your history.
Removing the meshes which were inserted laparoscopically might be very difficult and invasive, so it should be decided very carefully.

Anyway if you prefer no mesh tissue repair, there are, I think, two options for you.
1. Removing the old mesh laparoscopically or robotically, then doing the open tissue repair at the same time or later.
2. Undergoing the open tissue repair without removing the old meshes.

Sorry again.

[nesd]

Hi, Thanks for the replies… When I first went to the original surgeon for my colonoscopy I showed him my two bulges that were right above my penis. I did notice last Spring that they seemed to be getting bigger in time. I had no sharp pains, only aching or you could tell there is annoyance going on down there.
He said “oh yeah its defiantly a hernia” it come from when your born where the inguinal tube doesn’t close. You should have it fixed in 6 months before an intestine could pop threw. He made me very concerned to have it fixed. He seemed like a trusting surgeon. He said I’ll do it laparoscopic with progrip self affixing mesh versus the open method without mesh has a high rate of failure.

So I scheduled the date. After surgery I also discovered my right side mouth was badly bruised from the incubation tube. It was not put down my throat in a careful manner. It bled for two days if I opened my mouth to big.

After surgery my right side was swollen for over a month plus. I had doubts right away if it was done right from the start. I went in for my 3 month exam and told him the right side still has a swollen look to it. He did the cough test on the left and felt a small bounce and a bigger bounce on the right side. So when I cough or blow my nose or urinate it swells out or bounces back and fourth like air in there.

He then said you need a ct scan to find out what’s going on. He calls me 2 days later and said you still have both hernias. Not sure what happened. The mesh must have moved. He said maybe you want to see my associate surgeon. It won’t hurt my feelings. I figured he don’t know what to do or he wants to keep this incident in his office.

The surgeons I’ve seen read the surgical reports and ct scan and ct scan report.

I did have the Edina, Mn surgeon tell me “he must of did something wrong that morning it’s uncommon for both sides to fail like that. He knew my surgeon from his surgical rotation at his hospital.

I did have two of the doctors I’ve seen question me why I went in for surgery. It made me wonder if it was even a hernia. The Sioux Falls Dr. Peery said it could of been pulmonary, what ever that meant.

I’m not in severe pain. It aches everyday, or gets sore. It hurts on the left side more when I’m driving for an hour or more. I’m really worried about having long term chronic pain or mesh problems being I have mesh in me that is not useful or doing any good. And the aches and pains continue everyday.
How long does it take to heal from this kind of hernia operation? Do most people leave the mesh in, in my situation? Or do most people in my situation have more mesh put in?

I’m not fond of having more mesh in me again. I was told more mesh more mess! It’s matter of finding a doctor that will help me besides wanting to put more mesh in me. I feel I’m going to have a hard time in my tri-state area finding a doctor who will do the open no mesh method. I feel I might be traveling long distance to find help. I was thinking maybe the mesh removal would help in preventing longer term or future pain. But it sounds like I need to accept this hernia failure and live with this mesh in me. Mesh removal must be a risky procedure as I hear you could end up with more problems and chronic pain. Just trying to find the best fix for my problem and less future pain.

[drkang]

quote nesd:

Is exploratory surgery something that can be done safely to see if the mesh is removable or not?

Hi, nesd.

You don’t need exploratory surgery.
Mesh removal does not depend on the finding of exploratory surgery, but mainly on your mind.
If you want, mesh removal would be carried out.
Sometimes, of course, we have to leave some portion of the mesh for the safety reason, but it doesn’t happen so often.
In most cases, the open mesh could be removed though not easy.

However, you’d better leave it as it is if you have no significant mesh problem.
Just do hernia repair then.

[Good intentions]

nesd, your case is unusual because you have reported a failure of the mesh repair, a recurrence of the hernias. That’s not supposed to happen. But it’s unclear from your first post that any of the three surgeons you saw afterward actually confirmed a failure. You said that they told you what they would do to fix what you told them had happened, but you didn’t say that they confirmed that the prior repair failed. Your description of a “bounce” during the examination is odd also. And the fact that your surgeon said that he would like to get his associate involved makes one wonder if he is unsure about what’s actually happening. It’s also unclear what type your initial hernias were, direct or indirect.

I’m not sure anyone can give good advice beyond “find a surgeon who is known to be knowledgeable in hernia repair”. I reread your first post and there is really not much information about what your actual condition was before the mesh implantation, or what it is now. It doesn’t sound like you are in pain or discomfort so taking the time to understand your true condition would be worthwhile. Unfortunately, apparently, there are doctors ready to accept you as a patient and do what they do, but it’s not clear what you need to have done, to be well again. I would try to learn more about your condition, and get your medical records together so that you can accurately describe what your problem is.

[nesd]

Hi,

Thanks for the information. I don’t know where to start to look for a doctor for the non mesh repair. Every doctor I’ve seen so far wants to put in more mesh and call it good. Sounds like I might be flying to find a helping doctor.

Is exploratory surgery something that can be done safely to see if the mesh is removable or not?

[nesd]

Hi,

Thanks for the information. I don’t know where to start to look for a doctor for the non mesh repair. Every doctor I’ve seen so far wants to put in more mesh and call it good. Sounds like I might be flying to find a helping doctor.

Is exploratory surgery something that can be done safely to see if the mesh is removable or not?

[Jnomesh]

I’m not a doctor but I would highly consider removing the mesh and then in my opinion get a non mesh repair. But definitely consider getting the mesh out. If you don’t and you get more mesh put in the opposite way it is called a mesh sandwich and is even more difficult to remove.
i would not want a failed mesh left inside of me.
reaesrch experience surgeons who remove mesh:
dr. Igor Belyanski, dr. Towfigh, dr. Bruce Ramshaw . I would not go back to the same implanting surgeon-it sounds like he totally screwed up in the mesh placement or something.
its early so it can be easier to get the mesh out.

[drkang]

Hi,

I understand you, but it is just what those doctors said.
I always do no mesh hernia repairs successfully even for the multirecurrent hernias after open or laparoscopic mesh surgeries.
So it is valuable to try to find a doctor who can do it for you.
Adding or replacement of the mesh in your situation would be very risky.

I guess that polypropylene mesh can be seen as the hyperechoic line on ultrasound, but they can be seen on CT scan in small proportion.

I don’t think we can evaluate whether the open mesh could be removed or not by any test.
Ultrasound just shows whether the mesh is there or not.
It doesn’t tell if it is removable or not.
It is just a matter of deciding to do or not to do.

[Good intentions]

I suggest seeing a surgeon who has experience in mesh removal. Because they might have seen the symptoms that you’re describing and will know the signs of mesh rejection. There are hundreds or thousands of surgeon who know how to implant mesh but few that know what to do when it doesn’t work. Dr. Towfigh, Dr. Billing, Dr. Belyansky, and others will remove mesh if it is the cause of your problems.

You also mentioned that the mesh that was implanted is the “self-sticking” type. There are at least two type of “self-sticking” or tackless mesh. You really need to get your medical records so that future doctors know what they are dealing with. That should be your #1 focus – get those medical records. It might be that one or more the new mesh designs isn’t working well.

Many surgeons will work with you via email or phone as an initial consultation. Get your medical records then email, or paper-mail, a descriptive letter and your records out to them. Paper mail if you’re worried about confidentiality. When I had my problems I didn’t care who knew about them but it is something to consider.

Also, don’t assume that any “good” surgeon should be able to help you. It’s the individual surgeons that put the extra time beyond their general medical education that will have the answers. You’re not part of the general population any more. Mesh is supposed to work, always.

Good luck. Don’t despair. There are doctors out there who are willing and able to deal with these problems.

[nesd]

Hi, drkang.

Thanks for responding… I asked the 3 doctors I’ve seen and all said I’d need mesh replacement or more mesh. Not sure where to look for help to have my situation revaluated if the mesh is even removable or can be repaired with out mesh. I asked the 3 doctors to do an ultra sound to see where the mesh is at and all 3 said the ct scan is fine and no ultra sound is needed. How does one find out where the mesh is at? I read here that ultra sound sees the mesh. They told me they cannot see the mesh in a ct scan. I’m confused why I can’t even get an ultra sound test.

[drkang]

Hi, nesd.

Sorry to hear your story.

You look like thinking about only two options, adding another mesh or changing to new one.
Why don’t you consider the third option of no mesh hernia repair?
I think it would be the best option for you.

Adding another mesh could increase the risk of mesh problem, and changing mesh could have even more difficulties.
Mesh removal during the hernia repair depends on the state of the old mesh.
If it is solidly fixed to the adjacent structure without significant complication, it would be better to leave it there.
But if you have any significant complication or the old mesh is displaced and dangling, it could be removed.

[Beenthere]

I am in Wisconsin and again my issues go back many years. At that time I could not find anyone in the Midwest that I would go to or trust for the type of surgery that you are possibly looking at needing, but things might have changed. Avoid Madison W i

I know have a sports hernia and the local expert when I asked how many has he done this surgery and the answer was significant! Since this is the same hospital system that caused all of my issues when my first Dr and staff said he did them all of the time and was an expert and found out afterward he had not done one in 18 months. I look at my current experts answer as dodging the question.

If your insurance covers it and can afford it go to California. I spent a little over a week recovering from my removal of mesh, IH on the left side and a femoral hernia on the right at the in laws in Florida but I could have gone home in a couple of days.

Hang in there and good luck.

[nesd]

Thanks for your responses… I’m hoping and praying that I can make it through the Spring without bad pains because of my current job. I’m hoping to get things, opinions and help by July sometime to get this hernia fixed right.

Is there a hernia specialist in Minnesota, South Dakota or North Dakota that anyone had good help, results from, could recommend or from another state? That could help me with my situation. I’ve looking at visiting with Dr. Shirin Towfigh because my brother lives in California and told me he is about 1 hour drive from Beverly Hills. Plus I could stay at his house.

What would most people do if you were in my shoes? Add more mesh or find someone to do mesh removal and reset it. I’m in my 50’s. I hear mesh removal is very risky with possible nerve damage. How hard is it to remove mesh and redo it?

I ache everyday from this surgery failure and sometimes it hurts. Not sure if my body is accepting the mesh yet. I have no redness or signs of infection right now.

[Beenthere]

Sorry to hear about your problems, it seem everyone makes it out that it is just a simple hernia, nothing to worry about.

Get copies of all of your medical records. Make sure they are correct. I was amazed out how much was missing or incorrect in mine!

If you can see one of the true specialists noted on this and a couple of other websites. Buyer beware there are a lot of so called experts but maybe only 10-20 real specialists in the US who try to fix what the others have done.

It is hard when you are in pain and the medical community makes you feel like you are the problem and it is a very rare occurrence.. My expert and staff stated he did hernia surgeries all of the time but years later I found out he had not done one in 18 months! and I was repeatedly told the hospital had a 8 or 9 % total problems post surgery but again I found a published study from this hospital that found they had a 25% post hernia pain 1 year after the surgery. If I would have been told the truth I would have never done the surgery at this hospital.

Good luck and ask the forum for any advise.

[Good intentions]

Since you already have mesh implanted you should make careful note of how your body is responding to the mesh itself. If you feel like the area is more inflamed than when you had the hernias then more mesh might be a bad idea. It might solve the hernias but leave you with new problems. Excessive inflammation from mesh is a real problem, but not one that the repair industry wants to deal with.

Take a little more time and get a copy of your medical records from the surgery. There might be some information there that will help a good knowledgeable surgeon, who stays current with what’s happening in the hernia repair field, to figure out why your first surgery failed. It might be that your body is just rejecting the mesh and that it never did “bond” to the muscle wall like it was supposed to do. Just floating in a sea of inflamed tissue, moving in to the original hernia sites. If that’s the case then more mesh would not seem like the solution to your problem.

Try to get more detail about the material and the methods the surgeons that you see propose. There is much more detail available than just “open” or “mesh”. The details are what matter. There many different types of mesh, and device designs, some of them pretty bizarre. And some of them have a history of problems, so you can avoid those if you know they are part of the plan.

Good luck. Most of the doctors that you see will only have experience in implanting their type of mesh, their way. You need to find one with a broad base of experience since you’re outside the norm.