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Opinions on mesh removal & managing chronic pain
In 2007 I had laparoscopic bilateral inguinal hernia repair done with Polypropylene 3D Max Mesh.…I recovered fully… until injuring myself two years later lifting a table in 2009. The injury was a recurrent left inguinal hernia. About a year after the recurrence, I continued to have issues, some of which appeared to be of a urologic nature. I then had the recurrence repaired again (this time open surgery by same surgeon with a Pariotex Pro Grip Mesh… The surgeon called it a mesh sandwich…
So, two surgeries all together. Ever since the second surgery, I have had constant sensation of foreign material and often discomfort in my left groin. Parts of the area are numb and have been for a few years. Though at times, it feels like tiny batches of flesh suddenly awaken and regenerate sensation… Sometimes I have an itching sensation “beneath the surface” at the very top of inner thigh where it meets my scrotum… no rash or anything, just a deep itch at the top portion of that tendon.
From time to time, I experience a “pressure” feeling in the area beneath my incision as if things are very crowded in there. Irritation of this area can also be triggered by the seatbelt in my car. Wearing elastic pants reduces irritation that might be triggerred by regular pants/belt. I have a difficult time with several forms of exercise and I’m a little overweight but managing the best I can. I’m about 5′ 9″ 185… After my most recent flare up, I was re-evaluated by my surgeon who does not think I have a recurrent hernia. He believes I have some nerve damage as well as scar tissue and we are looking into several forms of non-operative methods to seek relief. I’m planning to start with some light swimming soon and I am scheduled to start physical therapy this week with a pelvic floor/groin specialist. I’m told myofascial scar tissue release may help some of my symptoms. Anyone have experience with that? I have a friend who has had three inguinal hernia surgeries and he is experiencing some relief with his physical therapy.
I have not yet experienced any testicular pain or swelling. Just a tightness/soreness in the area just beneath my incision from the open surgery. A few times while moving my bowels, I feel that same soreness as the stool passes beneath that area of my incision/mesh. Any thoughts on this and whether or not it could be nerve related? For example, maybe the stool is putting a tiny bit of outward pressure on the abdominal wall and/or mesh and triggering the soreness in the same way that pressure from the outside (seatbelt in car) creates the same sensation?
As much as I hate having layers of mesh in my left groin, mesh removal is an absolute last resort for me as I’ve been told more surgeries (even those to remove scar tissue) can lead to more scar tissue, more chronic pain, as well as the inevitable use of mesh again if there is not enough tissue to fix the defect without mesh. No to mention the possibility of losing a testicle in the process. I also want to find the perfect surgeon for removal if it ever becomes necessary. Thanks for listening.
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11 Replies
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No mesh hernia surgery|No mesh repair|inguinal hernia|hernia|Desarda
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No mesh hernia surgery expert Dr. Robert Tomas utilizes the Desarda technique to repair inguinal hernias. His No Mesh repair has been proven successful by repairing over 2500 hernias since 2009. No Mesh hernia surgery is gaining popularity. If you have an inguinal hernia you must call us today. -
If you’re going to have an open inguinal removal with a triple neurectomy understand this. You’re going to trade your mesh with paralysis, loss of penial function, more pain and be permanently nerve damaged and disability. Two of us are in this boat and didn’t have to be if the surgeon told us the truth, you better be prepared and in a serious painful position to trade your mesh for these symptoms. If the surgeon forgot to fill you in on this then that’s malicious and criminal in my opinion.
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Momof14
Really the forums that I was referring to were more general forums like Topix, Ehealth forum etc. Not from reputable websites set up by surgeons like Herniatalk. I apologize as this has distracted you from my main point regarding mesh removal. I still do not think it is right for any surgeon to troll these general forums where people are usually distressed and desperate for relief. To me there can only be one motivation for the surgeon coming to you in these general forums. If a patients wants to go to a surgeons site then fine.
JG
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I think you may have read me wrong. I am thankful for the truth and honesty about the potential risks of mesh removal. I just found it funny to be on a surgeon’s forum saying not to use surgeons who are on forums. It seems as though you both have had bad outcomes from the same doctor who has an extensive website about mesh removal. It is definitely difficult when we feel desperate for relief from pain and get sold a procedure that is not optimal for our situation. I believe everyone’s case is unique and therefore removal needs to be tailored for each individual patient. We all react differently, too. I had a triple neurectomy back at the start of this nightmare. While I haven’t had any pain effects from the procedure, like some, I had muscle atrophy and bulging, which show that these nerves are not just sensory! I would not recommend using a surgeon who promises “instant relief”. I do hope to get relief from many of my symptoms and realize there will not be instant improvement and recovery will take a lot of effort on my part. Trust me, I have done lots of research and reading and had discussions with multiple people, doctors and patients alike, and feel that I am making the best decision possible. Like I told Jgens, I hope you begin to improve and regain your quality of life. I appreciate your honesty and effort to help others learn from your experience.
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Thank you JGens that was written very well. It floors me how so many people and doctors know how risky mesh removal is prior to removal when we were told/sold that no one ever got worse after removal. That’s the problem the unrealistic and inflated statistics that site seems to project. Momo25353636 I don’t think you’re reading JGens correctly. If I read that statement prior to my removal, I would be thinking twice because I’m no where near myself after removal. The list is long of how detrimental that procedure was for me. Kudos to JGens for being kind enough to share a realistic and truthful statement that most would simply avoid to do. There seems to be other reasons for pushing mesh removal other than promising patients “instant relief.”
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Jgens,
So, are you on Dr. Towfigh’s forum saying not to use surgeons who participate in online forums? This forum has several reputable surgeons that are kind enough to answer our questions and give advice, the most prominent being Dr. Towfigh. I certainly agree that you need to do your research and be very careful when choosing a mesh removal surgeon, but some of us who still have mesh and are having problems that are believed to be caused by the mesh itself, need to have the mesh removed. I am scheduled for mesh removal and am apprehensive, but I don’t not see another option. I am so sorry to hear that you are worse off after removal and hope that you can find some resolution to your pain. This situation has certainly affected every aspect of my life and I am hoping to be able to move on and put this whole nightmare behind me. I wish you well! -
I had my mesh removed over 2 years ago by Dr. Kevin Petersen. I had many of the symptoms that Groundfaller describes in his post. My mesh was implanted laparoscopic but removed open mid line, big mistake. I should have waited but i was distraught and desperate after suffering for a year after mesh implantation. A lot of people have come to me for advice and to hear what happened to me. Mesh removal is risky. Obviously the more experience the surgeon has the better as is with any surgical procedure. The mesh removal is a bad bet if only because mesh is not meant to be removed and the inguinal meshes are in a very complex area of the body which is kind of like a super highway of vessels nerves cord structures etc. Unfortunately once a complication arises after a mesh implant then it is either wait it out and hope or have it removed. Both are uncertain choices.
Another poster “Mesh” has described his nightmare with Dr. Petersen. I too am far worse after my mesh removal and was also offered very little (actually none) information regarding the possible complications of removal. The only answers this doctor will provide is if you ask him specifically about something and then the answers are often contradictory to any medical information available, or any symptoms you actually are experiencing especially in regards to nerves and regrowth. Be careful, mesh removal almost always involves nerve damage. Mesh removal almost always results in a recreation of the original hernia or leaves you a prime candidate to re-herniate. If mesh is hopelessly adhered to other structures or vessels the surgeons will leave some of it there. The most common advice for chronic pain before or after mesh implant/explant is a Neurectomy, also another bad bet and gamble. The best way to avoid all of this is to not have mesh implanted in the first place. The debate about mesh or no mesh will carry on I am sure but it is undeniable that people experiencing pain after mesh implant can safely say that the cause was because of a mesh implant. Chronic pain only happens in a small percentage of patients but when you have say 5% of 800,000 people then it is a big number that is worthy of being recognized and addressed. Surgeons are way too quick to implant mesh unnecessarily and way too quick to remove it as well. If you insist on a mesh removal do not have your Lap mesh removed openly. Do not go to a doctor who advertises surgery or participates in online forums or Facebook websites. Do not have your mesh removed unless absolutely necessary, it is a measure of last resort.
One last thing. From many mesh removal patients I have spoken with. The pain after mesh removal, especially nerve pain, seems to happen later in the recovery process, at around 3-6 months, this is almost always a nerve related pain by that time. The same is true for post Neurectomy pain. A lot of mesh removal patients think they are fine but later on…….. look out. I urge you to go to Dr. Petersen’s website and look at the picture of the piece of nerve that was removed with the mesh from one of his patients, see link below.
http://www.noinsurancesurgery.com/he…sh-removal.htm
I promise you this nerve will not grow back by itself or without an extensive nerve graph or transplant and even with nerve surgery there are no guarantees on the other hand if a nerve develops a neuromatos condition because of the mesh as pictured then your also in trouble.The result in either case is chronic pain.
This picture in itself summarizes every concern anyone should have about mesh implantation-removal and it’s complications. There are other complications but this is the big one and the amazing thing is it is posted right on his website.
Scary,
JG
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quote groundfaller:Opinions on mesh removal & managing chronic pain
What helped me out the most has been physical therapy and movement. It may not be right for everyone but the surgeons offered me very little medical advice and there is an almost criminal lack of information regarding follow up treatment/care for hernia surgery complications. Given the frequency of this surgery and the high rate of complications, it baffles me that research isn’t blazing forward on post surgery treatment modalities. I hate to sound so negative but once a surgeon has done the surgery then you have left their field of expertise and they are not much use. So, back to my point, physical therapy might help. I am in the process of seeking out a couple new therapists for help. One specializes in cesarean complications in women and the other is a sports medicine PT that focuses on my activities. I have my fingers crossed that they can provide more positive results with better encouragement for a happy future than they surgeons who all just threw their hands up in the air.
I agree about the lack of post-surgery advice and care. The surgeon will release a typical patient to full activity at four weeks but physical changes will happen for months and years. So the patient lives in fear for that length of time as they feel pain and soreness and experience odd sensations. Even a simple instruction book would help but there is nothing. I think though, that the surgeons really don’t know what to do because they are mainly trained in surgery, not healing. As noted, once the patient leaves after the followup visit, they are assumed to be okay unless they come back with a recurrence. And, back to costs, physical therapy costs money, It’s cheaper to let the patient fend for themselves, than to ensure that they will be okay, mentally and emotionally. That’s not on the surgeons, that’s on the medical industry.
One of the beauties of the laparoscopic mesh implantation is that there’s almost no way to prove that there is a pain problem. None of the tests can show pain. So denying further treatment is easy to do.
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Opinions on mesh removal & managing chronic pain
Based on your symptoms, it seems there are no neuropathic (nerve-related) symptoms.
The Parietex ProGrip mesh is a Velcro-type Polyester mesh placed as an onlay mesh. Usually it is not sewn in or a maximum of one stitch is used. Can you describe what technique was used to repair your hernia? Was a separate tissue repair performed before mesh onlay? Was the mesh sutured in place?
It sounds like your symptoms armed due to a tight repair. Tight repairs include symptoms such as inability to stretch out in bed, pain with any fullness, such as full bladder, full colon prior to a bowel movement, full stomach after a meal. Also, muscle contractions, such as during orgasm, can be painful. Physical therapy does not help because the mesh does not stretch and the scar tissue associated with the mesh is not the primary problem.
Mesh removal may be necessary if the pain is debilitating. If not debilitating, sometimes time will allow your muscles to accommodate to the tightness. If mesh is removed, it should be done by a skilled surgeon who does these routinely. Risk of testicle loss is not zero but it is very low. You may or may not need more mesh placed. There are also mesh alternatives such as hybrid mesh.
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Opinions on mesh removal & managing chronic pain
I haven’t been on here in a while but there was time when I posted a lot of questions on this site.That being said, I have also seen several doctors in person too. I had a left inguinal hernia repaired about 15 months ago and I felt hopeless for a very long time after the surgery due to continuous complications and chronic pain. It has only been in the last 3 months that I have noticed any improvement but I still worry constantly about the implant. I can feel it inside me and it does still cause me discomfort. Every doctor I see tells me to just live with it.
Some of the symptoms I have had (and still do experience) include a tugging sensation radiating into my scrotum, pain and tightness near my hip bone, and nerve sensations shooting through my thigh. At present most of these are 70 percent gone although they do come back. Some have been gone for a few months now such as the tugging sensation
The upside is that I have been able to resume some of my favorite activities such as biking, rock climbing, and hiking, although to a lesser degree than before. There was a phase in January of this year when I was barely able to walk two city blocks and although I am wildly unhappy with the overall results I have to take what I can get at this point…and I can move again and things seem to be progressing forward again.
So what have I learned from my experience…I don’t have a lot of trust in surgeons, plain and simple. For a while I considered the prospect of having the mesh removed but that meant going to the same professionals who have been so dismissive with my post surgery treatment. What helped me out the most has been physical therapy and movement. It may not be right for everyone but the surgeons offered me very little medical advice and there is an almost criminal lack of information regarding follow up treatment/care for hernia surgery complications. Given the frequency of this surgery and the high rate of complications, it baffles me that research isn’t blazing forward on post surgery treatment modalities. I hate to sound so negative but once a surgeon has done the surgery then you have left their field of expertise and they are not much use. So, back to my point, physical therapy might help. I am in the process of seeking out a couple new therapists for help. One specializes in cesarean complications in women and the other is a sports medicine PT that focuses on my activities. I have my fingers crossed that they can provide more positive results with better encouragement for a happy future than they surgeons who all just threw their hands up in the air.
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Opinions on mesh removal & managing chronic pain
I should also note that I am a Male… 38 yrs old. One symptom I forgot to mention is that I often feel a tightness on the left side during erections. Its very hard to describe but it almost feels like the tightness travels (like tissues are rubbing together and sometimes a tiny bit of throbbing) as that area seizes and tightens during ejaculation. I had never felt this tightness sensation until AFTER the second open surgery for left inguinal hernia. Could this be related to scar tissue as well?
Thanks in advance!!!
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