Some of us have already commented about how the risk of chronic pain is higher for active people, or thin low body-fat people. Even the surgeons agree about problems with low body-fat people. Professional athletes avoid mesh, and even though they are more skilled than the average person, they are not that much more active than many of us. One of your doctors thinks that you might also have athletic pubalgia, which comes from too much physical activity, generally. In sum, even just using the generally accepted risk multipliers accepted by the professional surgeons you seem like a patient that would be most likely to suffer from mesh after the repair. Low body-fat, very active person with athletic pubalgia and an inguinal hernia. You seem ripe for mesh problems.
That’s what I see for you , based on my own experience and what I’ve learned over the years.
This is the one area where it seems like the surgeons just don’t pass on their knowledge. I think that you should see a surgeon that repairs hernias in professional athletes, without ruining their careers. One who understands both true hernias and athletic pubalgia. If you want to be physically active again.
It’s been very surprising how nobody can show the evidence that justifies using large pieces of mesh in an athletic person. I think that for some surgeons the win-some-lose-some principle is in play, because they see a cross-section of society. If you lose, he or she still has a bunch of wins out there. But you’ll lose a lot.
Good luck. If they can’t show evidence that their repair method will get you back to where you want to be, keep looking. Don’t become just a statistic.
Dr. William Brown is known for repairs on professional athletes. He has some thoughts.
https://www.sportshernia.com/no-mesh-hernia-repair/mesh-mesh/
p.s. it would be fantastic if a surgeon could reply with their own data about successful repairs using mesh, and not just the SAGES guidelines, which are very general and seem to accept chronic pain as normal. The data is out there. Dr. Kang is an excellent example.