Questions for everyone on if Shouldice fails

Hernia Discussion Forums Hernia Discussion Questions for everyone on if Shouldice fails

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    • #30330
      SFIrishGuy
      Participant

      All,

      Good morning from California everyone. I first just want to thank everyone tight off for reading and possibly responding. What I’m hoping to get is some responses with experience with Those who have actually had a shouldice surgery fail and how was the outcome to remedy it.

      I won’t get into all the legacy of where I’m at as a quick look or glance here on Hernia Talk will give you much of it. But the basics are I had a mesh surgery back in summer of 2019 with chronic pain in my hip and a feeling of Instability. I was diagnosed by two doctors in the field as they put it as mesh rejection. Fast forward had mesh removed and summer of 2020 with Immediate complications only few months afterwards. Fast forward to summer of 2021 I finally convinced my medical insurance to allow me to see a pelvic floor specialist and well-known surgeon and what was the issue. I was diagnosed as having the shouldice That seem to have failed or that it was unstable surgery with the shouldice. Currently next week I’ll be going on for third and hopefully final surgery. The surgery scope of work includes going back in laparoscopically and placing in another Mesh As that seems to be the only remedy for the situation. There was a lot of extreme pain that I’m currently going through, including left a secular pain and pain throughout my Iluiginal And genitofemoral. As well the current specialist surgeon has indicated that I never had a mesh rejection and I had this procedure done when I shouldn’t have.

      I’m dealing with a third surgery and very nervous and it is very hard to gather information online especially through Facebook groups of those who have had Shouldice issues and how they fared when they had a corrected.

      If anyone here had a tissue repair failure and had to have it repaired could you please let me know how you fared in the end and you came out OK.

      Thank you

    • #30331
      William Bryant
      Participant

      As far as I know, it isnt easy to do tissue repairs after having had mesh. It must be as simple as that as to why shouldice failed. On the other hand putting in mesh after a shoulduce shouldn’t be too much of a problem (other than the usual problems it may cause). Indeed one place I enquired about tissue repair said if it fails you can always have mesh after but you can’t have tissue after mesh.

      I hope the mesh is better for you this time. It may be an idea if you knew which type of mesh you had initially and avoid that one. There are lots of different meshes. Good luck

    • #30332
      MarkT
      Participant

      Granting that there appears to be a fail/complication following the mesh removal and tissue repair at Shouldice, I have a few question (not sure if you are able to answer all of them):

      1. How did the current surgeon ‘retroactively’ diagnose that there was no mesh rejection and that it should not have been removed?

      2. What alternative explanation did the current surgeon offer for your post-mesh repair pain and instability?

      3. Did you have any imaging done at some point before or after the Shouldice surgery?

    • #30333
      Good intentions
      Participant

      There are well-respected and well-known surgeons out there who refuse to accept that mesh can cause pain. Dr. Bruce Ramshaw, for example. Many of them will look for other reasons for the pain, like fixation, or contacting a nerve, or various other possible causes.

      The damage that mesh and mesh removal causes might have made the remaining tissue unsuitable for a suture-based repair at the time. The inflammation makes all of the surrounding tissue weaker. It’s unfortunate that you ended up with a surgeon who, apparently, is going to try to prove that mesh works. This 3rd surgeon is discounting the work of every doctor that has worked on you, proposing that he can do mesh implantation the “right way”. That is the basis of rejecting all mesh complications. Blame it on the former surgeons.

      I think that you are in a very dangerous situation. If mesh caused inflammation the first time, there is no reason to expect it to not cause inflammation the second time. There are theories out there about becoming sensitized to mesh or synthetic materials after mesh implantation. Even autoimmune diseases have ben proposed as resulting from mesh inflammation, or vice-versa.

      If you can collect all of your medical records it would be worthwhile to reach out to some of the well-known “non-mesh” repair experts, like Dr. Muschaweck, or Dr. Meyers of the Vincera Institute. If you send them an organized package of your records and a descriptive letter, they will probably respond.

      At the least, find out what mesh was used the first time and what mesh will be used this second time. You could end up with the same inflammatory response, but surrounded by tissue that has been abused for several years. I would guess that neurectomies are also planned, since you have specific pain.

      I am going to search your old posts, but when you are seeking help it really helps your cause to pull together a very organized and specific story. There is much chaos out there when it comes to mesh complications and it is too easy for doctors to avoid the problem if they can’t understand it.

    • #30334
      Good intentions
      Participant

      I found your first thread. The search function on the site is broken. You can use Google and put “site:hernaitalk.com” in the search box followed by search words to find things on the site.

      So it looks like Progrip was the original mesh, a large piece, ~4×6 inches. A typical mesh implantation.

      Stinging pain with popping and clicking

    • #30335
      Good intentions
      Participant

      I found the thread where you were looking for removal surgeons.

      Need help – advice on Dr’s

    • #30336
      Good intentions
      Participant

      Here is the thread about the results of the removal and Shouldice procedure. It’s not clear who did the procedure, just that it was done at Kaiser Permanente.

      Shouldice Post Op questions

    • #30337
      Good intentions
      Participant

      Here is another. I hope that I am not being too involved. Feel free to let me know in the public forum, if I am. I won’t be offended. The message function is broken. It might be that Dr. Towfigh is losing interest in the web site. I hope that she will keep it alive, at least for the wealth of past information.

      Doctors in Bay Area who specializes in hernia repair

    • #30338
      Good intentions
      Participant

      I will just follow those posts with a reinforcement of the warning to beware the 3rd surgeon who is discounting everything that happened to you and wants to start over again with another mesh implantation. One of my comments in a previous post to your early problems was about a surgeon I saw for mesh pain who did not read any of my history before my visit, but had already assumed that I had had a recurrence, and was ready to get right back in there and fix it. I spent 15 minutes explaining to a confused mesh-implantation surgeon that I did not have a recurrence, I just had pain and specific physical symptoms that something was wrong, caused by the mesh. All he saw was another mesh procedure sitting in front of him.

      I’m sorry that your problems are persisting SFIrish, it seemed like you were on a path to success. I think that they might be beyond the abilities of the common surgeon, especially the odd popping and clicking that continues. I would really consider finding a true expert in abdominal/core problems.

      Dr. Meyers would be my first choice. The people at the Vincera Institute are very considerate. Marcia Horner was the one I corresponded with when I was having problems. I sent them a letter, and my images, and received a reply soon after.

      Good luck.

    • #30339
      William Bryant
      Participant

      That’s a brilliant reply good intentions. I’m sure sfirish will find it helpful.

      Bit of a shame if Dr Towfigh is losing interest. Hope not. This is a great resource.

    • #30342
      SFIrishGuy
      Participant

      All,

      good morning. First I want to thank everyone who took the time to reply here with their concerns and their opinions. I realize that this comes from a place of caring and so I see firsthand that the community here very much wants the best for each other. I try to direct message many of you but unfortunately, the website is currently having critical failures and I’m unable to contact you directly. I’m gonna do my best to respond here.

      My only hope here was to find participants who’ve had a fail show dice and to gather what had happened with them afterwards. As good intentions indicated I am in a dangerous and precarious situation but I’ve done the best I can with the surgeons that I’ve met with to move forward. I wanna first say that I do not, nor does the current surgeon discount individuals who are having issues with mesh as it was explained to me there are situations where that is constituted. I should note here that yes I had mesh placed in and removed but I never had a mesh issue to begin with. Many may know or some may not but for context, I had a right inguinal hernia surgery with mesh almost 10 years ago and never had any issues stemming from that mesh implant which would indicate that I had any issue. I was never diagnosed with fever or soreness in the groin or had any kind of autoimmune ailments. When I had the corrective surgery a few years on the left side yes there was a pro grip mesh placed in and yet I was diagnosed in the beginning but I never had that additional ailment and many have indicated. The soreness which was located on the hip area was due to collective areas of scar tissue or to the mesh being attached to the spermatic cord. This lends itself to being a more physiological or anatomical issue more than any kind of autoimmune issue. I never ran a fever or had any other outlying issues. Even the director of the pain modality clinic that I visited said there is nothing he could do for me as this is more a anatomical and physiological issue based upon all the labs and the images.

      I’m gonna try to outline some bullets below based on some of the questions above.
      – yes indeed I had many labs that were done for last two years after the initial first surgery and after the shoulder surgery which included blood work, labs and many radiology reports. there didn’t appear to be any kind of poison or anything that would indicate an issue with the mesh. Yes I had soreness but this is due to the failed surgery and technique from the surgeons more than from the mesh. Radiology images indicated that both the previous mesh and with shouldice was unstable and not at an even curve which was placing pressure and the groin area which is why i’m feeling pain throughout my nerves. My current Doctor Who’s an expert and leader in the field of pain management also with alternative measures with hernia surgery showed me quite clearly on images that were done either with Kaiser and with her own request that there were a lot of built up scar tissue from surgeries that she wishes to remove and that their surgeries themselves were unstable. I even went so far afterwards to request a patch test with a few of the available mesh products and I did not react to any of them. As indicated from a current surgeon I never seem to have had a mesh issue to begin with.

      – pops and clicks have been equated currently to the scar tissue that is formed in around the surgeries and other removal from the intestines pressing against them. My hope is that with the current surgeon she will be removing most of scar tissue to best help me out.

      – other than the imagery from the radiology reports indicating that there is a failed or unstable shouldice surgery I know that it actually failed as I felt it ripped open one day. I had to go off how I feel with my body and I know that right now it is unstable and I feel every day the popping through the open area pressing upon my groin which is very painful. As it has been explained to me going through the front end and ripping open the shouldice repair is too dangerous as it would compromise nerves themselves. As it hasn’t explained to me the best option is it going through the back end which is relatively lower risk and patch it up to create a more secure repair. Minimanual observations and injections were done with the third surgeon which indicated that there is no permanent nerve damage which is a good thing and there could be hope to help me.

      – yes getting various opinions is vital but I don’t have years and years to spend and money to fly across the world and the United states for countless opinions. As I found out many surgeons I have a 6 to 8 month waiting list just to actually have consultations let alone waiting on a list for surgery itself. I was able to be seen by a leader in the field who after meeting many times has shown me the professionalism and technique that many of my previous consultations from doctors were missing. She was able to explain to me in detail and through the imagery what was going on and I believe that this was the best course go forward with.

      I appreciate everyone’s time reading this and I am not here to negate anyone’s experience with mesh at all. But at this point I’m left with either living with the increased pain and an unstable repair that is ripping open every day or having the best mitigation possible.

      I would like to message some of you including good intentions but like I said earlier I’m unable to as the website is currently having some issues. Regardless at anyone’s opinion on the matter i’m hoping that i can have everyones hopes and wishes with this journey.

      Thank you

    • #30343
      Good intentions
      Participant

      A failed Shouldice repair would result in a recurrence of the hernia. I don’t see that described. I only mention that for clarity. The description sounds like a guess that a suture pulled free, or impinged on a nerve, or something. They don’t know.

      Do you know what type of mesh will be used? I know of somebody that had a synthetic mesh removed and a biologic mesh implanted to replace it, on the assumption that biologic was better. The biologic mesh caused pain and had to be removed also. Beware of surgeons wanting to try the latest thing on you.

      Also, laparoscopy surgeons are experts in laparoscopy and tend to believe that it is the “best” way always. There would be no “ripping open” of the Shouldice repair if an open operation was done. It sounds like you will be having a TAPP procedure, with some dissection and a mesh implantation. If they have to remove the sutures from the Shouldice procedure it will probably have the same basic effect as if they were removed from the front. Removing scar tissue is a different issue though. She will be able to access all of the areas that the second mesh implant was contacting and all of the areas that were previously dissected. So that looks promising, if her premise is correct.

      I would offer words of hope but they won’t really help anything. It sounds like you have done the work and are already scheduled. Stay in touch.

      Good luck.

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