[DrBrown]

Dear Timothy.
Your symptoms are more extensive than I would expect.
You should have imaging tests to evaluate for a recurrent hernia and scarring of the mesh.
Diagnostic injections can be very helpful.
for example, if you have an ilioinguinal and iliohypogastric nerve block in your symptoms improve that would be evidence that these nerves are a component of your trouble. In a similar manner, the mesh itself can be injected with the local anesthetic. If you improve that would be evidence that the mesh is a significant component of your trouble. The more information you can get prior to considering surgery.
Regards.
Bill Brown MD

[DrBrown]

@aldpeev
Removal of mesh is not an easy operation and the results are mixed.
My advice is that if you can do 90% of what you want to do, then strongly consider leaving the mesh in.
Regards.
Bill Brown MD

[DrBrown]

Whether or not there is muscle weakness after neurectomy depends on where the nerves are cut. The ilioinguinal and the iliohypogastric nerves are both motor and sensory initially but become purely sensory at about the level of the internal ring.
Before mesh is removed, it is important to determine whether or not the nerves are a component of the pain. Physical examination and nerve blocks can help make that determination.
I agree with Good Intentions. A patient can often have nerve pain without staples.
Regards.
Bill Brown MD

[DrBrown]

Dear Luke.
There are numerous methods for hernia repair and that should tell you that no one method is perfect, otherwise, all surgeons would use that method. When I fix a hernia I try to pick the type of repair that will give the best result. I often mix methods together.
Regards.
Bill Brown MD

[DrBrown]

@good-intentions
I hope this means that more patients will be getting non mesh hernia repairs.
Thank you for the update.
Bill Brown MD

[DrBrown]

@good-intentions
It is scary what is being taught.
Bill Brown MD

[DrBrown]

Dear Scott.
Most likely it is nothing serious, but follow up with your surgeon.
Regards.
Bill Brown MD

[DrBrown]

Dear Mark.
Probably indirect hernias on both sides.
Bill Brown MD

[DrBrown]

Dear Alexander.
All the mesh procedures have similar recovery times.
The surgeon you choose is more important than which operation is performed.
Regards.
Bill Brown MD

[DrBrown]

Dear Mark.
There are many types of tissue repairs. The Shouldice is an excellent operation I would advise you not to lock yourself into one choice.
Review.
https://www.sportshernia.com/no-mesh-hernia-repair/repair/
Regards.
Bill Brown MD

[DrBrown]

@deeoeraclea
Dear Deeoeraclea.
Be patient. It takes 6 months to a year to get the full benefit from mesh removal. Also, consult with your surgeon to see if there are any additional treatments that might benefit your recovery.
Regards.
Bill Brown MD

[DrBrown]

@joseph
Dear Joseph.
Then I would advise you to have the operation that Dr Meyer suggested.
Regards.
Bill Brown MD

[DrBrown]

@joseph
Dear Joseph.
The surgery should be directed to repair the injury that is causing pain.
If your adductor longus is the source of your pain, then you will have pain high on the inside of the thigh that gets worse when you squeeze your knees together.
If the symphysis pubis is the source of your pain,then you will have pain in the middle of the pubic hair above the base of the penis.
If you have a rectus or oblique injury is the source of your pain then you will have pain near the external inguinal ring.
Which injury do you think you have?
Regards.
Bill Brown MD

[DrBrown]

@ajm222
Dear AJM.
You need to see a surgeon to have have a history and physical exam.
If the pain is deep and high on the medial thigh that gets worse with adduction, then it is probably the adductor longus.
If the pain is in the skin, then it is probably nerve related.
Your hip joint also needs to be evaluated.
regards.
Bill Brown MD

[DrBrown]

Dear Matt.
The mesh can be removed.
But your surgeon needs to determine the cause you pain. Is a nerve scarred to the mesh? Has the mesh shrunk? Has the mesh become a meshoma? Otherwise just removing the mesh may not solve your trouble.
review
https://www.sportshernia.com/treating-mesh-pain/
Regards.
Bill Brown MD

[DrBrown]

@joseph
The sutures in the periosteum can be a source of pain, especially if tied too tightly. But if necessary the periosteum can used as part of the repair of an inguinal hernia.
Regards.
Bill Brown MD

[DrBrown]

@dbernard
Dear Dave.
The most commons causes of pain are:
Recurrent hernia
Scarring and fibrosis of the mesh.
Damage to one of the local nerves or to the spermatic cord.

Since the nerve ablation was not helpful, then it is probably one of the other two.
review:
https://www.sportshernia.com/treating-mesh-pain/

Regard.
Bill Brown MD

[DrBrown]

Dear Christina.
The three most common sources of pain after mesh hernia repair are:
Recurrent hernia or missed hernia.
Scarring and fibrosis of the mesh.
Or, damage to one of the local nerves.
review:
https://www.sportshernia.com/treating-mesh-pain/
Regards.
Bill Brown Md

[DrBrown]

Dear JLee.
The mesh is probably stuck to the bladder. A cystogram can help identify if the bladder is distorted by the mesh. A cystoscopy can evaluate the bladder mucosa. She should also be checked for recurrent endometriosis.
https://www.ncbi.nlm.nih.gov/pubmed/28903762
https://www.ncbi.nlm.nih.gov/pubmed/29103256
https://www.ncbi.nlm.nih.gov/pubmed/19657592

Regards.
Bill Brown MD

[DrBrown]

@alephy
In a recent article about the treatment of chronic pain after hernia repair, all the patients that required a second operation had had a previous mesh hernia repairs.

https://www.ncbi.nlm.nih.gov/pubmed/31668283

Do not have a mesh hernia repair.
Bill Brown MD