Watchful your 1 percent tissue repair pain data….

[Chuck]

Brother Watchful —i have been scouring the net trying to find your data about only 1 percent chronic pain rate with tissue repairs. Other than idiot doctors simply making these statements on websites I can find anything. If anything I keep finding studies and references showing that lap surgery provides the lowest risk of chronic pain. Dr. T makes this claim all the time…but if you really dig into the studies, they don’t say what she is saying. Your doc at shouldice told you that your risk of chronic pain would be less if you did your own repair with Lap surgery correct? The whole reason I stupidly went with Lap surgery is because i kept reading over and over and over that it had the lowest risk of surgical pain and chronic pain longterm. It looks like maybe that was wrong…it should have occurred to me that dumping huge sheets of plastic into the body was a bad idea…but all the articles interviews and studies kept repearting that MIS was the best way to avoid pain issues…If there was clear data showing 1 percent pain risk for tissue repair vs 12 percent for mesh repair and i missed it…i would be quite depressed…but i just did not see it anywhere.

[William Bryant]

Chuck, I think Watchful, like The Shouldice Clinic, revised the pain percent upwards. The figure wasnt Watchful’s it’s just what surgeons claim. Not sure where they get these figured from whether mesh or non mesh.

For example when I asked a consultant I saw about how many of his patients ended up with chronic pain he said about 1 percent. He was a mesh surgeon.

[Watchful]

Yes, it’s information from surgeons, and I don’t believe it’s correct. Dr. Bendavid was reporting 1% chronic pain at the Shouldice Hospital. Dr. Lorenz says 1%-3%. Dr. Conze says essentially no such cases with him. Dr. Muschaweck says none.

[Chuck]

Bryant – thanks…its just hard to believe there is no data at all on this…but i dont think there is. I feel really stupid because i believed doctors when they told me complications were rare. Two local surgeons specifically told me they had seen patients with chronic pain from “that shouldice clinic.” Maybe they were lying or maybe that is a standard mesh surgeon BS to sell you…but on of the surgeons was a really nice genuine guy. Watchful has probably looked at this as hard as anyone…and even he doesnt seem to know the answers. Unlike Good Intentions, at least me makes some recommendations based on his extensive research…go to conze and pray. Conze says he has had only 2-3 cases of chronic pain…can we believe that? What can we believe—I guess I am a control freak trying to control the uncontrollabe…but it would be nice if someone could say….as a general rule the shouldice technique or the kang technique…or desarda …or lap mesh offers lowest risk of chronic pain

[Chuck]

watchful —thanks…but if you asked lap surgeons they would say the same thing….my surgeon told me 1 in 5000 had chronic pain—now i know he just made that up right on the spot–i cant beleive i didnt suspect differently…so where did you come up with the 12 percent risk of chronic pain for mesh…you said you made the decision to pursue a tissue repair due to the difference in chronic pain rates…otherwise you would have just selected mesh …since its demonstrably more durable

[Chuck]

And of course…how are the defining chronic pain…if they are defining it like kang…1-3 percent is life altering…but there is prob a much higher overall pain rate. I just thought all the cutting and sewing from tissue repair would end up more painful than just placing a piece of plastic between a muscle

[Watchful]

It’s quite possible that the skill and attention to details of the surgeon make the most difference, not the technique, so there is no useful generic answer.

For mesh, I saw numbers in the 12%-15% range in studies, but you’re right – mesh surgeons don’t give you such numbers. For example, a robotic mesh surgeon told me that he had only one chronic pain case after doing about 2,000 of these procedures.

[William Bryant]

I agree Chuck, it should be possible for some organisation or body to oversee the figures and say which of the tissue repairs has least cases of post operative chronic pain and which has best, and worst, record for recurrences. That would help an informed choice.

Similarly I can’t believe it’s never been researched which meshes are most trouble and pain free and which are not.

Can quite see why Watchful uses Russian roulette example.

So crazy in this day and age.

[Watchful]

The biggest problem is that surgeons don’t follow up, and they don’t collect the results. They simply don’t know their chronic pain rates. Even if they wanted to be transparent and honest about this, they wouldn’t be able to tell you.

[drtowfigh]

The Danish and Swedish have the most robust national database. Here is just one study that addresses chronic pain.

https://academic.oup.com/bjs/article/91/10/1372/6150885

There are others.

I won’t be able to convince many people, especially Chuck, that personal experience is not the same as population data. Nor does I seem to be convincing to those like Chuck when I say that a poor outcome or complication by a surgeon is not representative of outcomes expected from that technique in general.

I’m just getting tired of having to respond to the same question and concern over and over. Posting dozens of the same type of post over and over daily is starting to become spammy and overwhelming new posts by new users who have other stories to share.

[Watchful]

The chronic pain rates reported in this study are awfully high 🙁

[William Bryant]

Blimey they are high. You’re right Watchful. Even after 4 years, 18 percent.

No difference or little between mesh and non mesh repairs. Very worrying.

Thanks Dr Towfigh for posting this.

Strangely I think there’s been quite an influx of new or newish posters recently so the forum is quite vibrant at present.

Chronic pain is likely to be a major issue in the minds of prospective patients, seemingly for some reason less so amongst surgeons, which I did find weird as ending suffering is the image many have been lead to believe is true of medical professionals. With that in mind I’d have thought understanding and reducing chronic pain would be in everyone interests.

[Chuck]

Dr. T – your comment is quite annoying…I have never suggested that my botched surgery means all lap surgeries will have bad outcomes. I have just been incredibly frustrated by the lack of any crystal clear data that shows one type of repair has less risk of chronic pain than another. You have a habit of making statements that are not supported by the studies that you cite. I have read the studies that you post closely…and they don’t say what you say they do. Just because we are not hernia surgeons doesn’t mean we cant read. You repeatedly state in your interviews…and i have watched nearly all of them…that lap mesh surgery has the lowest rate of pain…both post surgery and chronic of any of the repairs…I have looked far and wide for studies that say this…and there simply arent any comparing lap to open non mesh. There are some studies cited by Voeller that say lap is superior to open mesh…what a coincidence —he is a lap surgeon…and is very well compensated by the mesh companies…but for his own surgery he went to shouldice….I think that says more than any study….When Lorenz or Koch or Voeller want a repair…they don’t get lap mesh —they get shouldice repairs. You have mentioned yourself that you have have some hernia issues…I look forward to seeing what you select….I suspect you will be on a plane to Ontario.

[pinto]

Dear Chuck,

I appreciate your knowledge and spirit here, but I didn’t like what seems to be is abrasiveness of a doctor. Despite however knowledgable you are, you cannot possibly approach the level of an MD for correctly interpreting a research study—unless you had the same rigorous training and practice. Even if the MD is wrong, civility demands recognition that they could be correct—due to their well deserved standing. Please show more respect and backup your claims. For example you incredibly claim:
“You [Dr T] have a habit of making statements that are not supported by the studies that you cite.” Whoa, whoa. Any doctor can make mistakes, but I’m sure Vegas odds-makers aren’t putting their money on you. Please prove me wrong by offering point-by-point referencing how you are correct. Thank you.

[sensei_305]

What’s good Chuck, I have been reading your post’s and would like to better understand where you are currently at. Do you have a recurrence at the moment like me ot what’s going on?? Is it that you are still hurting from your mesh removal repair? Just trying to understand brother why you are putting so much energy into all this? End of day doc here does not take health insurance. Its all just a business end of day regardless of the surgery outcome. Some docs are not in the business of helping the masses just those folks who can cough up 20k or more.

[Author]

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