[DrBrown]

Dear AJM.
I agree that the mind has to be considered in anyone that has chronic pain. Chronic pain may cause depression and financial problems. And the mind may make the pain worse.
It is important to try to determine the cause of the pain and try to get it under control.
Does the patient has a recurrent hernia? Is there a nerve involved? Has the mesh become stiff or adhered to something sensititve?
Regards.
Bill Brown MD

[DrBrown]

Dr Koch has an excellent reputation.
Your brother probably had an indirect hernia. In that situation the hernia sac travels inside of the spermatic cord and
Dr Koch would split but not significant damage the cremasteric muscle to get to the hernia sac.
Regards.
Bill Brown MD

[DrBrown]

Chronic pain after hernia repair is an area that all surgeons are working on to improve.
If the pain is deep, then occasionally injecting the mesh with steroids will help.
If the pain is in the skin then a nerve block may help.
Try to be patient.
Regards.
Bill Brown MD

[DrBrown]

Dear Katherine.
I agree with Dr Towfigh that in a small woman that a non mesh repair would be an excellent choice.
To evaluate the left side, consider a standing ultrasound with a Valsalva Maneuver.
If you wanted a non mesh repair on the left, then you would have to have an open repair. Your previous repair was a long time ago and
you are skinny, a repeat open repair should be possible.
Regards.
Bill Brown MD

[DrBrown]

Dr Towfigh and Dog have invited me to participate. I will try to add to this already great website and forum.
Regards.
Bill Brown MD