Mesh vs No Mesh

Hernia Discussion Forums Hernia Discussion Mesh vs No Mesh

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    • #27963
      DrBrown
      Participant

      A recent article reviewed 25 randomized controlled trials that compared inguinal hernia repairs with and without mesh. The 25 trails included 6293 patients. After reviewing all the information, the authors determined that there was a slight decrease in recurrence rates in patients who had mesh. In absolute numbers, only one hernia recurrence was prevented for every 46 mesh hernia repairs than non-mesh repairs. In other words, 46 patients must be put at risk of developing chronic pain to avoid one hernia recurrence. I think this is more evidence that pure tissue repairs are the first choice in all patients.

      https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6513260/

      Regards. Bill Brown MD

    • #27970
      JamesDoncaster
      Participant

      It would be very interesting to see a similar study that compares the rate and seriousness of chronic pain with mesh and non-mesh repairs.

    • #27974
      DrBrown
      Participant

      Most recent articles state the the chance for chronic pain is the same with or without mesh. But it is not stated how the non mesh repairs were done and if the non mesh repairs were done by an experienced surgeon.
      If you try to find an article about chronic pain after hernia repair from the 1980’s (i.e. before mesh). There are no articles discussing pain.
      Regards.
      Bill Brown MD

    • #27975
      JamesDoncaster
      Participant

      Based on anecdotal evidence from myself and the people I have encountered in person and online, I simply don’t understand how any legitimate medical study could conclude that chronic pain rates for mesh are similar to non-mesh operations. There seems to be a huge disconnect between what the vast majority of surgeon think and what patients experience.

    • #27982
      drtowfigh
      Keymaster

      Multiple large population studies, modern and older, have shown that chronic pain rates are similar for mesh and non-mesh inguinal hernia repairs.

      These are both US and European studies.

      Let’s not forget that when mesh repair was invented, patients were admitted to the hospital for 1-2 weeks after their tissue repair. Pain was considered a given with the tissue repair. The invention of mesh repair was to reduce the pain by patching the hernia and thus reducing tension, which was why there was so much pain.

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