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Hernia mesh repair site condition after a year
I need some help answering a few questions related to relieving pain long after hernia surgery. My background is that I had an open inguinal hernia surgery in April of 2016 on the left side. It was repaired by implanting a Bard keyhole mesh, 4.5 cm X 10 cm. The problems started right after the surgery. An outpatient procedure turned into a three-day hospital stay because of the pain. Pain persist at the original site of the hernia and in the left groin area. About a 1 cm section of the ilioinguinal nerve was resected before the mesh was implanted. In follow-up appointments, the surgeon confirmed that there is not another hernia. I have followed up with the surgeon three times in the past year and have seen a physical medicine and rehab doctor six times, three of which were for ilioinguinal nerve blocks. The nerve blocks helped a lot. The groin pain has decreased by about 50%. The problem that persists is at the original site of the hernia. I’ve also had two CT scans done. The surgeon said the CT scans did not show anything remarkable about the hernia site or mesh. He was at a loss as to what to do. He suggested doing an exploratory surgery to clean up any scar tissue and see if he could see any other problem. I declined since both the surgeon and the rehab doctor said there would be less than a 50/50 chance of improving my pain. The surgeon advised against taking the mesh out or replacing it with a biologic tissue because of the possibility of future hernias. I have lots of pain to the point that everyday life is not normal. I don’t have a normal sleep because I keep waking up with pain. I can’t sit for long because of pain. My new normal is miserable.
I am looking for another surgeon with the prospects of taking the mesh out and repairing the hernia with sutures. With all of that said, here are my questions. After a year, what is a hernia mesh patient’s original hernia site like? Is there still a perforation? Does the mesh just seal the perforation or does it bring the tissue together to heal? If the mesh is taken out, can the original hernia site be repaired by suturing tissue or a tendon to repair the perforation? Are there times when attempting to remove mesh that a hernia cannot be repaired by sutures? Thank you for any input you may be able to provide.
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2 Replies
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texas…how are u feeling
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I strongly recommend against mesh removal at this time. It is not the mesh. Removing it will open a whole other can of worms.
If the nerve blocks helped, why not pursue that? More blocks or perhaps nerve transection if it’s a neuroma.
If it’s no longer the nerve, then maybe it’s a recurrence or too tight of a repair. A 4.5x10cm mesh is on the smaller side, so these options are not unexpected.
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