[DrBrown]

[USER=”2987″]dh305[/USER]
If the pain is in the skin, then it may represent fibrosis around the nerves and a nerve block may be helpful.
If the pain is deep, then there may be scar around the mesh.
In most cases, the pain improves with time.
I advise waiting for a year before considering the removal of the mesh.
Keep in close contact with your surgeon. He/she is responsible to care for you until you are fully healed.
Regards.
BIll Brown MD

[DrBrown]

[USER=”2899″]PeterC[/USER]
The Vas Defersns can usually be separated from the mesh without damage to the Vas deferens..
In most men the pain during sex goes away and the sperm counts remain normal.
Regards.
Bill Brown MD

[DrBrown]

[USER=”1391″]UhOh![/USER]
I agree that with proper coding more accurate information about mesh problems would be available.
But I am not going to hold my breath.
​​​​​​​Bill Brown MD

[DrBrown]

[USER=”2998″]Ericajane1987[/USER]
You could have a spigelian hernia. They are often not identified on imaging tests.
But you also need to be evaluated for adhesions, pelivc organs, and colon.
See your surgeon and get a complete evaluation.
Regards.
Bill Brown MD

[DrBrown]

[USER=”2029″]Good intentions[/USER]
In Photo 1, the patient had had a laparoscopic hernia repair about 12 years ago. Lightweight prolene mesh was used. He started to have pain about 8 months after the operation. He tolerated the pain until he fell with a twisting motion late last year and the pain became debilitating. Rest, Steroid injections, and analgesics were not helpful. As you can see from the photo then flat mesh had scarred into a complicated three-dimensional mess. So far he is doing well.
In Photo 2, the patient had a laparoscopic hernia repair 4 years ago. He had noticed a bulge and pain with exercise starting about 6 months after surgery. Physical examination and ultrasound documented a recurrent hernia. At the time of surgery, the mesh did not completely cover the inguinal floor. I do not know if the mesh was placed incorrectly or if the mesh contracted with time.
In Photo 3, The patient had a Lichtenstein hernia repair and had pain almost immediately after surgery. He had allodynia in the distribution of the ilioinguinal nerve. Repeated nerve blocks provided only temporary relief. He did not improve even after waiting for 6 months. As you can see, the nerve was densely scarred to the mesh.
In Photo 4, The patient had pain during intercourse. Spermatic cord blocks provided temporary relief. Analgesics and time did not help. I suggested that he celibate, but he did not like that option. When the mesh was removed the vas deferns was scarred to the mesh.
In Photo 5. Anytime mesh is being removed, it is very common for the epigastric artery and vein to be scarred to the mesh. Several times I have accidentally damaged those vessels and had to deal with significant bleeding. Now, I identify the vessels early and I am prepared to ligate the vessels quickly if they are damaged. The scarring of the mesh to the epigastric vessels is probably not a source of pain but can make mesh removal difficult.
Regards.
Bill Brown MD

[DrBrown]

[USER=”3002″]MamaJmn[/USER]
Hernia repairs are tolerated very well in children.
Mesh is not used in children.
Regards
Bill Brown MD

[DrBrown]

[USER=”2921″]Hiway40blues[/USER]
Dear Hiway
I have been very happy with the results of pure tissue repairs for hernias. The recurrence rate is low. The incidence of Chronic pain is low.
The operation takes longer than the mesh repairs, that is the only downside.
Regards.
Bill Brown MD

[DrBrown]

[USER=”2921″]Hiway40blues[/USER]
Dear Hiway.
Be patient with your body. It will be at least two more weeks before you notice a big difference.
It would be very difficult to damage the repair.
Regards.
Bill Brown MD

[DrBrown]

[USER=”2955″]B_Rebovich12[/USER]
The umbilical hernia can be repaired at the same time that your ovarian adhesions are treated.
Talk with a surgeon that is experienced with umbilical hernia repairs (it could be your gynecologist).
A 3cm hernia can be repaired with either mesh or a pure tissue repair. Mesh has the advantage that it will decrease the recurrence rate, but can result in adhesions or chronic pain. A pure tissue repair has a higher recurrence rate but has less chance for pain.
Your surgeon needs to evaluate your anatomy, the strength of your tissues, and your personal needs.
Regards.
Bill Brown MD

[DrBrown]

[USER=”2922″]kipthor[/USER]
Dear Kipthor.
I am glad that you have gotten better.
Most athletes with pain related to the mesh improve with time.
Best wishes.
Bill Brown MD

[DrBrown]

[USER=”2051″]ajm222[/USER]
Dear AJM
If you had a nerve block than can affect motor function, but should resolve with time.
Distending the abd with C02 can also stretch the muscle, but this should resolve with time.
You could have a hernia at the trochar site.
Follow up with your surgeon.
Regards.

[DrBrown]

I can not agree more. Meshes are introduced with minimal research.
I wonder how many of the pigs complained of pain before the researchers had a BBQ.
Bill Brown MD

[DrBrown]

[USER=”2029″]Good intentions[/USER]
I agree that more information about chronic pain after mesh and pure tissue hernia repairs are needed.
The situation is complicated by the numerous techniques and the skill level of the surgeons.
Until then, I will continue to do the non mesh repairs.
Thank you for all your work on this forum
Bill Brown MD

[DrBrown]

[USER=”2029″]Good intentions[/USER]
Only the ring is removed.
Most of the mesh was left in place.
Bill Brown MD

[DrBrown]

[USER=”2921″]Hiway40blues[/USER]
Fixing the new hernia should not affect the previous repair.
Best wishes.
Bill Brown MD

[DrBrown]

[USER=”2989″]Waynemyers99[/USER]
Your best chance to find a no mesh surgeon is to consult with a surgeon who is at least 60 years old.
Regards.
Bill Brown MD

[DrBrown]

[USER=”2777″]Mariel[/USER]

You may need multiple imaging tests.
All the tests can miss problems such as adhesions, fibrosis of the mesh, nerve entrapment.
Bill Brown MD

[DrBrown]

Dear Dill.
Remember that some of your calories are going to heal the hernia.
Usually at three weeks is when most patients are feeling almost normal.
Give your body another week,
If you still feel tired, check with your PCP to be sure that you are not anemic or hypothyroid.
Do not hesitate to call your surgeon.
Regards.

[DrBrown]

[USER=”2777″]Mariel[/USER]
An MRI may show the mesh, but the MRI usually does not show whether or not the mesh is causing trouble.
Bloating can be related to the mesh, or you could have changed your bacterial flora because of antibiotics given during surgery.
Seeing a GI doctor may help.
Your doctor is responsible for your post-operative care. If the doctor does not respond to your calls, then contract the medical board.
Regards.
Bill Brown MD

[DrBrown]

[USER=”2966″]Tino_7[/USER]
I suggest the open non mesh repair with sedation.
Bill Brown MD