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Mesh and Surgery Concerns
Been diagnosed with inguinal hernia – had for ~ 20 yrs w/only occasional small non-tender bulge (lower groin right of pubic bone) able to be pushed back in. Recently I’ve had a few episodes – two near incarcerations as small bulge felt harder and was unable to be pushed back in for ~ 3 hrs & thruout episode I had pain w/bloating as if Ihad an intestinal illness. Bulge flattened and episode passed after lying down or reclining. Surgery is inevitable -been recommended Open Surgery with Mesh. As an active, thinner, tall, nonsmoker, good diet, 58 yr old woman who worked physical outdoor job for many years, I am interested in your statement in one of the discussions about “no mesh in thinner women”. I am very concerned about any mesh due to all of the literature on nerve entanglement in the years following surgery, “sensation of mesh”, shrinkage, +/or toxins from internal placement of mesh.
I am also concerned as to why the Round Ligament is cut? All I can find on the Round Ligament is that it supports the uterus – wouldn’t this create a future problem e.g. prolapse? I am amazed at the lack of info on female inguinal hernias yet general surgeons say it is such a “common surgery”?
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4 Replies
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Mesh and Surgery Concerns
Yes to all. The recurrence rate of tissue repair is highly variable from surgeon to surgeon and depends in the patient’s risk factors, tissue quality as well.
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Mesh and Surgery Concerns
Thank you for your response Dr. Towfigh – Of the female patients that you have performed Open Tissue Repair (No Mesh) on – were they able to remain active w/o recurrence? If enough healthy tissue – does it grow around repair enough to allow streching and strengthening to the area? Is there more suturing and then more pain in recovery?
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Mesh and Surgery Concerns
I absolutely agree with your pain management doctor. Multiple studies looking at chronic pain after open hernia repair with mesh show the incidence is highest among the young an among women. See below for links.
In my practice, for super thin women, I offer open tissue repair (no mesh). For thin women I also recommend laparoscopic repair with lightweight mesh. Open mesh repair, especially with normal heavyweight mesh runs a high risk of chronic mesh-related pain among women and I do not recommend it
Some links:
http://m.generalsurgerynews.com/Article.aspx?d=In+the+News&d_id=69&i=May+2012&i_id=837&a_id=20819 -
Mesh and Surgery Concerns
Where have you read about mesh not being appropriate for thinner women, and about any toxic chemicals? My pain specialist wanted me to have my last hernia repaired without the use of mesh, but the dr said she disagreed. She said that mesh has been used since the 1950’s with no problems. The pain specialist said he believes a surgery with no mess causes more pain initially, but after has less of a chance of chronic pain associated. I’m now wishing I would have listened to him. I’m not sure what is the cause of my chronic pain (since I did not have it with my first hernia on the other side), and I did have mesh with that repair.
Please send any links that go to any articles that you have read.Thank You!
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