Inguinal hernia questions
07/22/2020 at 11:24 pm #27678
Despite having being on fora for quite some time, I am still puzzled by these questions:
Chronic pain rate? I have heard/read 15%, but then some of these will get better after a year, while others will get into this group in the medium to long term…and does this mean that 85% are “pain free” after few weeks? From what I have read it is more of having minor pain; I wonder what is the percentage of the truly pain free/go back to my life…(I guess I will not get an answer to this one)
In the videos posted here it is mentioned that chronic pain happens with mesh as well as without; on the other hand I think Dr. Brown mentioned that chronic pain was virtually unknown before mesh arrived. So which is which? papers? studies? facts?
Some also say that re-absorbable meshes do not work, the recurrence rate is high: can someone point me to recent studies about this?
It has been mentioned that polipropilene is associated to higher risk of cancer and other diseases: what do doctors think and why they still stick to it if they do?
07/23/2020 at 7:21 am #27681
I forgot another one: us it true that direct hernias are less manageable with a pure tissue repair? I never saw any paper on it…
07/24/2020 at 10:50 pm #27693
– 12-15% chronic pain after inguinal hernia repair, regardless of technique (mesh vs no mesh) at 3 Months after surgery. Any pain is considered chronic after 3 month is no matter how minor or major. This value drops to single digits at 12 months.
– Yes, thank means 85% are pain free within less than 3 months.
– not true that chronic pain was unknown. It has been reported and was in the 15-25% range. People undergoing tissue repair were routinely hospitalized in the US for up to week. It was considered a painful operation. Recurrence was the biggest issue back then. And pain was not really studied as an outcome until more modern times when recurrence dramatically reduced with the mesh repair (Lichtenstein and Nyhus repairs).
– no study has shown acceptable recurrence rates with absorbable meshes. Many studies stopped following patients after 1-2 years, when the recurrences started showing up.
– there are no studies linking use of polypropylene with cancer risk. This statement has been extrapolated from a paper which showed cancer in an area where there was a mesh infection with fistula. We know that certain chronic inflammatory conditions of the skin can cause cancer. This includes the base of some bad burns. But to claim that all inflammation causes cancer and polypropylene causes inflammation so polypropylene causes cancer is a misrepresentation. Based on that logic, all patients with arthritis (inflammation) have cancer. And of course we know there is no such correlation either.
07/30/2020 at 11:46 pm #27718
Thanks for your answers!
I am wondering why people had to stay a week in hospital back then when mesh was not around, given these days even with a tissue only repair one is sent home the same day or the day after….
Absorbable meshes: no long term study would mean it is not known then, as opposed to being a studied and verified as a fact? Again I hear contradictory claims in both directions…
Leaving aside the recurrence rate war, are mesh patients more at risk of developing complications after years from the surgery, and if so does this still enter into the 15% of complications?
Thanks a lot again for your help!
10/08/2020 at 3:24 pm #28025
I am just 2 years out from my left inguinal repair with mesh – robotic laparoscopic. After surgery I had minimal discomfort where I only needed some tylenol for a few days. 2 years out I am fine no issues. Doing everything as before as far as exercise.
- This reply was modified 1 week, 4 days ago by tenreasy.
10/08/2020 at 9:57 pm #28029
What type of hernia was repaired and what type of mesh was used? And what kind of activities do you do? Weights, biking, running, sports?
Alephy’s situation is that she is very athletic and active and fears that choosing the wrong repair method and/or material will not allow her to be as active as she wants to be, without discomfort or pain. Like me and many others have experienced with mesh repairs.
There are many variations of materials, with very little data showing how they perform in the human body. Anecdotes like yours are the best there is at this time, as far as discomfort and pain are concerned.
- This reply was modified 1 week, 4 days ago by Good intentions.
10/09/2020 at 5:47 am #28032
It was a left inguinal hernia. I don’t know the mesh used – don’t have a clue. I run, cross-train, lift light weights, run, swim, etc. Had the surgery at 57 years old. I am not discounting others that do I have pain. I am just giving my experience. I was careful to choose a very skilled surgeon specializing in laparoscopic surgery.
10/09/2020 at 2:48 pm #28035
Your description of you is a pretty good match to me. I also chose a surgeon skilled in laparoscopic surgery. Part of a group that trained people in latest techniques and certified that they were trained. Chair of surgery at a very large clinic in a large metro area. Well-respected by colleagues. He used Bard Soft Mesh, supposedly developed for active people, to give supposedly lower chronic pain levels. Implanted using the state-of-the-art recommendations of the time, covering as much area as he could with the mesh and doing the other side also even though he only found a small lipoma. (Supposedly not recommended but many surgeons do it anyway.)
I knew that I had a problem after just a few months. Tried to live with it for a year and half. Started looking for removal options, and finally found the time and the right surgeon at three years.
So without the details of your procedure there’s no way for a person to know if they’ll end like me or end up like you. If you can get that information, it might be helpful.
No offense, thanks for sharing, but without the details it’s just a story about being lucky.
10/09/2020 at 3:14 pm #28037
Ignore Debbie Downer (“Good Intentions”). Despite the alleged credentials, his surgeon screwed up and its easy for Good Intentions to instead blame everything on mesh. When someone like you comes along and is doing well, he cannot stand it due to bitterness. Many people do well with mesh. He had bad luck I guess.
10/09/2020 at 4:08 pm #28042
@Dom – thanks. It’s so tiresome that he keeps on asking for more details, and if I don’t give specific details on the surgery than my success is just darn luck. Good luck to anyone needing to repair a hernia and hoping for the best to you.
10/09/2020 at 4:24 pm #28043
Thx Dom. I had a similar surgery to yours and I’m doing great and very active like you.
10/09/2020 at 4:40 pm #28044
I’m trying to define pathways forward for people looking for a successful result.
If you’re convinced that it was your choice of surgeon then please share the name of your surgeon. Without that, there is no value in these stories. In a way, you’re taunting people who have had a bad result. Share something useful please. So that other people can share in your success.
10/09/2020 at 6:33 pm #28049
Let’s keep the Discussion civil without personal attacks. Anything less is not fruitful and is counter to the spirit of this forum.
If you have had a great outcome, that is expected, and is the outcome for the majority of patients. It’s important to share positive stories alongside any problems you may have. For the benefit of the forum participants, feel free to share the name of your surgeon.
10/09/2020 at 7:05 pm #28052
No problem doc, but you have to admit I’m funny and I know it put a smile on your face.
10/09/2020 at 7:22 pm #28053
Dr. Mark Toyama was my surgeon. A wonderful & caring doctor. It was performed at Northwestern Memorial Hospital in Chicago – a fantastic facility.
10/09/2020 at 7:31 pm #28054
That’s great to hear! Dr Toyama was a few years ahead of me at the same surgical residency at UCLA. He is an asset.
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