[Alephy]

That’s exactly my point…it seems in Europe there is still the assumption that patients should shut up and “trust the doctor”…

[Alephy]

Definitely take it out! You will be fine and at least you will have one less thing to worry about!

[Alephy]

@drbrown which procedure would you recommend for an adult perfect weight with a small indirect inguinal hernia?

[Alephy]

I agree with the new forum user experience!right on spot!

As a question: do you currently feel better the same or worse than before the originally surgery? If worse or same take the mesh out…my 2 cents

[Alephy]

Thanks for the answer!

[Alephy]

Did you get the mesh in the end?

[Alephy]

I see….is that due to everyone having nerves in different places do you think?

[Alephy]

I could only find mention of cyanoacrylate as part of a glue to attach the mesh. … 🤔

[Alephy]

The most often reason is that the surgeon often only knows how to do it with a mesh…also I was told two open procedures at the same time are not done….in laparoscopy it seems it is hard to do anything other than mesh…

I have spoke. To two surgeons explained why a mesh could be bad for me and at the end of the discussions they were still enumerating the big advantages of mesh…the last one was honest in saying that that’s what he knows best….none mentioned chronic pain risks…

[Alephy]

Interesting post….what about creating a mesh with “cloned” tissue from the patient in the future? at the very least no inflammation response will be triggered, which would also mean no nerves growing over it (not sure about adhesions though)? depending on the tissue the flexibility long term would also be guaranteed…

I cannot see the market of plastic meshes continue much longer frankly…I am wondering if this is why nobody is interested in any long term follow up: they know it is the past and that the future will be quite different

[Alephy]

Same here even before the surgery….I am wondering if it’s a nerve connection somehow….although at rest I am fine..

[Alephy]

I still cannot understand how the patients recover so quickly after the surgery….and they get back to full activities in no time

[Alephy]

@good-intentions

Looking again at the first article you pointed to, I do not understand the statement: “The data about mesh is not so good, but we think it is safe”…..collect more data and come back, I would argue!

The thing that also bothers me is that we live longer and longer, so even in the elderly I question whether a mesh should be suggested….

Anyway I assume then that the complications/chronic pain rate at 5, 10, 15 and 20 years is and will probably remain unknown…

[Alephy]

@cshelter yes I am supposed to have a ct scan at the end of February. I don’t know if a US can locate precisely the nerves but probably doesn’t hurt…in any case I am willing to have a simple stich up repair but no remodelling or strengthening as that implies more manipulation of the area? From the forum discussions it sounds as if chronic pain was almost unknown in the old days….although Bassini Shouldice etc were practiced….

[Alephy]

I wonder if a simple stiching of the hernia is less risky and in fact always to be considered?…btw have you tried a diet change first? Also exercising just a little bit everyday might help…just stop short of pain…and do it slowly and soft.which is anyway the correct way no matter what

[Alephy]

I saw a youtube video of a sages conference where this surgeon showed how much the position of the various nerves around the groin changes from person to person…there are 3 important ones with lots of ramifications..doctors can chime in and explain what they do upfront to minimize the risk….I also read that many surgeons fail to correctly identify these nerves and I doubt they would have say they made a mistake and Cut a nerve..

[Alephy]

This is one of the nicest posts I have seen so far….and @drtowfigh answer was a truly interesting one, and one you will not hear much from other doctors!

For the exercises that have been discussed, I would add from my own experience that perhaps one should check if they work for them, as some of them can exacerbate back pain. In general from the 7 or 8 that you can find on YouTube I have started doing 2 or 3 that I like and do not put my back under stress (that is just me, mind you)..

As for the medicine and the medical community consensus, let me tell you an anecdote: some 40 years ago it was believed that the meniscus did not play any important role in the human body, and so many people with a say knee injury were operated where the meniscus was simply and totally removed! I don’t need to tell you what the consequence of that for the patients was, and we know a great deal more about the role of the meniscus now (thank God)…

BTW we often hear that this or that works 90% of the times, or that only 5% of people really recover from this or that disease….well it is time we move to worrying about the 10% who do not respond to treatment, and if I have something serious I WANT TO HEAR ABOUT THE 5% WHO RECOVERED AGAINST ALL ODDS…especially considering the big number of variables at play…

[Alephy]

@drtowfigh how small in cm does a direct hernia have to be to be eligible to this procedure? I am still wondering how one measures the size….

[Alephy]

Nobody?

[Alephy]

I am thinking a surgeon of the abdomen might be better at times and oftentimes the so called specialists know only mesh or at least mostly operated with that technique….a general one will also have the same downside but may be more prone to adapt to the patient 🤔 I spoke to two specialists and the discussion always ended with mesh ie it’s inert goodo very well tested in the US no problem very low chronic pain