surgeons with <1% recurrence & chronic pain rate?

[neilbdm]

surgeons with <1% recurrence & chronic pain rate?

Dear Dr. Towfigh,
Thanks again for your reply. As a non-medical person, I realize there are large gaps in my knowledge – so eg I had to look up “standard of care”. Then I looked up “standard of care” hernia repair, & found I had stepped into a controversial area; so I’ll steer away from that.
As regards the rest, I’d still be inclined to argue that if chronic pain is at least partly mesh-related [opinions differ there also of course as to the degree], there might still be merit in my idea. I’m sure you know that there are claims of good results from [synthetic] absorbable mesh; also of better collagen growth than polypropylene mesh. I guess, as with a lot of things in this area, it may be too early to say for sure.
Thanks again,
Neil

[neilbdm]

surgeons with <1% recurrence & chronic pain rate?

Hi,
Thanks for the reply, sorry for not replying sooner – the notification went to my spam folder. It’s late here now – I’ll write a bit more later today.
Neil

[drtowfigh]

surgeons with <1% recurrence & chronic pain rate?

As far as we know to date, absorbable mesh is not a good alternative for inguinal hernia repair. Also, as you probably know, it is not the standard of care.

The logic that your pain will dissipate once the mesh is gone assumes your risk for chronic pain is purely mesh-related. That is rarely the case. The more common situation is pain due to recurrence, erosion of the mesh, nerve entrapment or direct nerve injury. Also, often the chronic pain is related to the inflammatory reaction of the mesh, and most absorbable mesh, with the exception of some pure biologic mesh, also cause significant inflammation.

[neilbdm]

surgeons with <1% recurrence & chronic pain rate?

Hi, thanks for the info. I only have a couple of surgeons whose names I know & have contacts for; that’s what I plan to do with those surgeons. Also, the British Hernia Centre seems to have a good reputation. Thanks for the links.
Re the absorbable mesh, do you think my idea is a good one, ie “..I’m thinking that if I’m unlucky enough to get chronic pain, maybe it will go in ~3 years, as they dissolve.”?

[Chaunce123]

surgeons with <1% recurrence & chronic pain rate?

Your best bet is to ask the surgeons what their experience and rates are.

As a fellow patient, if I was in Europe and I was going to travel I would either go see Dr Muschaweck in Germany / London, or perhaps the Gilmore Groin Hernia Clinic in London. They focus on a lot of professional athletes and have vast amounts of experience with hernias and related groin conditions.

http://www.leistenbruch.de/english/index.html

http://www.thegilmoregroinandherniaclinic.co.uk/surgery.php

I don’t know of any surgeons using absorbable mesh for inguinal hernias for anything outside of clinical trials, but it’s possible you may find otherwise.

Keep us updated on your decisions and progress, good luck.