Inguinal hernia athletes and meshes

[Unknown Member]

@alephy I believe Desarda and bassini. Pure tissue repair specialists have their own modified techniques. I am not 100% if modified shouldice is 100% tension free, but I think its close.

[Alephy]

[USER=”2899″]PeterC[/USER] “There is tension free pure tissue repairs for your traditional inguinal hernia repair much like the tension free mesh repair (lichenstein, etc.).” Which ones if I may ask? Shouldice etc? I understand sports hernia is not really a hernia to begin with…it’s interesting it’s not so publicly known so well what athletes opt for or are taken to when a normal hernia occurs….I know British athletics doesn’t allow mesh implants though ….it seems eventually they will be able to create meshes out of cloned cells from the patient which would resolve some of the issues….

[Unknown Member]

PeterC [USER=”3125″]Alephy[/USER] most professional athletes have sports hernia formally known as “athletic pubalgia” not your traditional inguinal hernia.

To my understanding it is different from direct or indirect inguinal hernia although it’s in the same region. Weekend warriors and avid exercisers do not have the same rigors of exercise and competition to develop sports hernia usually. That’s not to say they don’t.

It is well known sports hernia shouldn’t be repaired with mesh. There is a difference between the two. There is tension free pure tissue repairs for your traditional inguinal hernia repair much like the tension free mesh repair (lichenstein, etc.).

This all really comes down to an individuals anatomy, social factor, and lifestyle. Is it a direct or an indirect hernia? Risk with lap or open mesh is about the same and also depends on the type of mesh (phs, 3dmax, progrip, marlex) Not to forget the surgeons skill. Mesh maybe right for some people and others not.

Older the patient and if the hernia is direct, mesh is probably better. Younger a patient and if it’s indirect, mesh is probably not the best option since younger patients are more active and have many years of active and physical life ahead.

The recurrence factor is overplayed, a properly done tissue repair has just as low recurrence rate as mesh and a better long term quality of life outlook since it does not come with the risk of the same chronic pain with a polypropylene or a polyester mesh. That’s not to say pure tissue repair doe not come without a risk of chronic pain as the nerves in the inguinal canal are just as vulnerable and can be damaged during the procedure.

However, with mesh your adding another layer of problem if there is a complication and it is a permanent implant that is not designed to be removed easily after many years. As they say it’s like removing concrete from rebar. You can’t remove it cleanly like a silicon breast implant without causing collateral damage to surrounding tissues and nerves. Removal itself will can cause other problems especially with neurectomy.

Unfortunately, majority of surgeons don’t consider a patient’s long term quality of life factor and will recommend what they’re trained and accustomed to which is mesh. Risk of mesh will always be downplayed to not deter you away from mesh. Mesh is not as inert as they say it is as all man made products are. It can fold and tear from bio mechanical pressure and wear and tear over the years from an individual active and physical lifestyle.

For someone who did well with a tension free mesh repair for many years then started to have complication due to an injury and an active lifestyle (I am also fairly young) had I known the risk now, I would have forgone mesh and opt for a tailored tissue repair such as a modified Shouldice from a renown specialist. Unfortunately, my parents and I were told like the rest of the lay public on the gold standard of mesh and was not given a choice of a pure tissue repair.

To mesh or not is a very personal choice one that should be fairly vetted by the individual. Some people do well with mesh I was one of them till it went sour, some don’t from the beginning. Some people don’t do well with pure tissue, some do. It’s a risk regardless as it’s a surgery and no surgery is benign or “routine”. Wish you the best of luck and I think your on the right track by being on this forum. I wish this forum was available when I had my hernia once upon a time…

[Alephy]

Btw i am not super fit….I am almost 50 but in good shape and do train….184 cm for 73 kg so I am not overweight for sure…..(hoping this is not bad for surgery)…quite frankly I would choose a higher risk recurrence lower risk chronic pain any time….

[Alephy]

I would add people who do martial arts….

[drtowfigh]

Dancers and ballerinas and yoga instructors are a different breed of athlete. They tend to get tissue repairs or laparoscopic repairs with lightweight mesh, as flexibility is key to their career and they tend to be quite thin

[Alephy]

Yes but among the various injuries this one is a short one for them no matter what procedure they opt….I mean compared to some ligament problem or broken bone

[UhOh!]

Personally, I would be cautious in asking: “What do professional athletes do for hernia repairs?” when considering one’s own. Why? Because they are (likely) responding to an entirely different set of incentives than the rest of us, and it stands to reason would be considering an entirely different risk-reward profile.

To put it another way, you or I are probably quite concerned about what kind of pain, recurrence likelihood, or other complications we will experience in ten years. But if you get a hernia today, and your team has a realistic chance of going to the Super Bowl next month, all you care about is what ensures your ability to play right here, right now.

Perhaps laparoscopic with mesh is the best long-term solution for someone athletic, I don’t know. But even if it’s not, if it’s what puts the pro (whose career has a very limited shelf life regardless) back on the field the fastest, I’m guessing that’s the main consideration.

[PeterC]

quote Alephy:

So I was wondering, do athletes with a normal inguinal hernia go for a mesh surgery, or they stay away from them? Any examples/names? I have already read about British Athletics and the mishap with one of their top athletes….
I am just trying to understand if meshes are just a way to target the big number of patients, while those who can afford it or whose physical requirements exceed the average stay away from them?

I replied to your other thread as well – but stay away from mesh unless you have the tiniest hernia and everything else is 100% in TOP SHAPE. Its a foreign body inserted in your body. If you’re as fit as you make it sound – you will have no problem with a pure tissue repair. Google it – every hockey player or other athlete go to Meyers or Dr.Brown or even Muschawek in Germany where they get pure tissue repairs. Why do you think that is? Just a few weeks ago Sidney Crosby had a core injury repair with Meyers in Philly and they told him he’d be back in 6 weeks. Why would top professional athletes with unlimited budgets get pure tissue repairs if mesh repairs were the way to go?

I don’t know why Dr. Towfigh is suggesting that most of them get a laparoscopic mesh repair – from being in chronic pain over the past 2 years after having mesh surgery and being a pro dancer – I promise you that I have not read in a single place that athletes usually get mesh repair. If they were – you’d be finding those testimonials and stories.

[drtowfigh]

Usually they get laparoscopic repair with mesh.