Groin hernia experiences

[Good intentions]

A recent paper for Patsient. If you’re young, why take the chance? Too much to lose.

https://herniatalk.com/forums/topic/mesh-vs-no-mesh-in-young-males-a-recent-study/

https://www.thesurgery.or.kr/search.php?where=aview&id=10.4174/astr.2021.100.4.246&code=6037ASTR&vmode=FULL

Mesh vs no mesh in young males – a recent study

[Good intentions]

Hello Dr. Towfigh. As a researcher and a scholar you, of course, know that a person should cite their references when they make statements like yours. “Head to head” studies are numerous and show vastly different results, among the multitude. Which one are you referring to? Type of surgery and type of mesh will be important to know, of course.

To Patsient’s point – could you choose the mesh product most likely to give Patsient a good result, and the one that is most likely to give a poor result? I have compiled an incomplete list of choices, so if you know of others, please offer them up. I put the link to my other Topic below. At the least, he can increase his/her odds of a good result. It seems a shame to just let Patsient make the wrong choice if a better one is known.

Unfortunately, there seem to so many possible choices that even the experts are lumping all of the products in to one big mesh bucket. I think that people come to this site to find answers supported by real-world facts. Which mesh should be avoided and which mesh is supported by real-world results? Even a person who doesn’t believe in “mesh” can get some value from the answer to that question.

And, if a pure tissue repair and a “mesh” repair (whatever “mesh” means) both give equal possibilities of chronic pain, which one is the easiest to solve after the pain manifests? In other words, would you rather work on a patient with pure tissue chronic pain or one with mesh-based chronic pain?

I understand the great pressure to just accept the world as it exists today. But the bulk of the data, including the head to head comparisons, lead to the conclusion that there are very valid reasons to avoid using mesh for inguinal hernia repair. The mesh problem is not getting better. It is, by definition, a chronic problem. It will be here as long as “mesh” is here.

https://herniatalk.com/forums/topic/types-of-mesh-and-their-manufacturers/

• This reply was modified 3 years ago by  Good intentions.

Types of mesh and their manufacturers

[drtowfigh]

Just know that tissue based repairs have their own risks, including chronic pain. Head to head comparison studies showed the same rate of chronic pain after inguinal hernia repair with and without mesh. Just the reason for the chronic pain is different with tissue repair. I have plenty of patients that I treat for chronic pain after tissue repair.

[JamesDoncaster]

I am in the camp that had a mesh repair and it has ruined my life. There is zero reason to take the chance of getting chronic pain when there tissue repairs that have much lower chronic pain rates. Get a tissue-based repair from a surgeon that specializes in this.

[Scarletville]

I’m the same age as you with a relatively small right inguinal hernia but It’s always caused me great discomfort and pain since before it protruded. If you don’t want a mesh there are a lot of tissue repairs techniques available to name a few: Desarda, Shouldice, Bassini, Kang and McVay. Assuming you’re of average weight at your age if you get a tissue repair by a skilled surgeon I think you can expect a very low chance of recurrence similar to that of the Shouldice Hospital. There are pros and cons so definitely inform yourself on this and if you definitely don’t want a mesh repair look for the best surgeon you can find you’re willing to travel to. I’m personally getting a Desarda repair this month or next by a surgeon with great reviews on an independent website and in a recent survey to which 110 patients answered had 0 recurrences (Most will be mesh repair patients).

[mitchtom6]

I had mesh repair in my mid-twenties. It is still holding, but I aggravated it about 5 years later and it took about 10-12 months of chronic pain before it settled down (cortisone helped). I now have tolerable levels of pain. My cousin was an NCAA athlete who had mesh, and he did fine with his. But other forum members would give anything to undo their mesh implantation, some even undergoing mesh removal procedures.

That being said, most people do alright with a standard mesh repair. But some have compared it to Russian Roulette. As Good Intentions has stated, when it goes bad, it goes REALLY bad. We on the forums tend to have experienced complications, and many regret having mesh implantations.

If you are concerned about mesh aggravation, you could consider going to the Shouldice Clinic in Canada. They are one of the only clinics worldwide who does non-mesh repair. They recently operated on a US Senator, so they are legit. However, you’d have to pay out of pocket most likely.

Overall, it is a difficult choice. If the hernia is not affecting your lifestyle in a significant way, you could consider leaving it untreated. Just don’t do anything outrageous (deadlift a car or something). Best of luck to you, and we are rooting for you.

[Good intentions]

Nothing is different today than on the first post of the forum. Just go back and read all of the posts and you’ll know much more than you do now.

“Open with mesh” can mean many many different things. Some are bad, some are very bad. Learn more about what, exactly, your surgeon is planning. Make sure that you avoid the worst. The patch and plug seems to be the worst. Make sure that you don’t get a surgeon who performs neurectomy during the mesh implantation. It is unnecessary, especially for someone with no pain.

Read all of the posts about watchful waiting. If you have no pain and just want to avoid future problems your best option might be to avoid surgery. Many people get hernia repair surgery and end up in worse shape than before.

The results are not as rosy as they seem from the literature in the doctor’s office. Be careful. Start reading, and good luck.

• This reply was modified 3 years ago by  Good intentions.