[Feuermann]

I let the issues run their course. I did take some Naproxen on the bad days.

[Feuermann]

Hello Andrew. I believe my procedure was similar to yours – open with mesh. There was no neurectomy on the GFN but the operative report did say that the IN was injected with some kind of anesthetic. My recovery was very slow. I experienced a wide variety of different sensations in the groin (burning, tingling, itching, aches) on and off on a daily basis for about 18 months. These gradually diminished with time, but progress was not always linear. My bad days were never severe enough to interfere with daily living – at most, the sensations I experienced made daily activities more uncomfortable. I am now two and a half years post-surgery and can say that most of these sensations are either gone or small and infrequent enough not to be bothersome.

[Feuermann]

I think it is important to understand that surgery of just about any kind is a calculated risk and that there are no guaranteed outcomes. This is why, in most areas, it is a last resort. Hernia repair, however, seems to be an exception. It was represented to me as a routine procedure that would make my life more comfortable. The risks were mentioned, but only in passing. My surgeon told me that he had done over 2000 repairs over nearly 2 decades and that only two patients had come back to him with chronic pain (and in both cases they resolved with time or treatment). I don’t think he was lying, but I doubt he followed up with his patients about long term outcomes in any systematic way.

I am two and half years from my repair, and doing much better after an 18 month period of gradual improvement in pain and discomfort. I do consider myself lucky – so far. I do not believe I would opt for a mesh repair if I could go back in time knowing what I know now. I may have even continued with “watchful waiting” since the odds of incarceration or strangulation appear to be much lower than chronic pain rates after this surgery.

I am active and engage regularly in weight lifting and cardiovascular exercise. I do worry that at some point I will have a problem. Mesh represents just one more variable that can go wrong with an operation in an area that is loaded with nerve fibers.

Anyhow, I wanted to weigh in and make it clear that it is possible to have a reasonably good outcome after this surgery while still having concerns and being highly sympathetic to the views and circumstances of those that have had their lives turned upside down by this ”routine” procedure.

[Feuermann]

I had open surgery about 15 months ago and the bulge is gone. There was a healing ridge under the incision for several months after the surgery, but that is also mostly gone now. The site of the incision and surrounding area feels harder to the touch than it used to, but there is no bulge.

[Feuermann]

Two weeks is pretty early. It is not unusual to experience a variety of uncomfortable and painful sensations for weeks and even months after this surgery. As long as your symptoms are improving with time, you should be good.

I agree with you about the pain killers – I only took them for about a day. Ice and over the counter anti- inflammatories did the trick for me.

[Feuermann]

There were several interesting points:

1) The comment about surgeons taking plug and patch and PHS implants out of patients weekly.
2) Most of the cases of disabling pain mentioned in the presentation seem to present immediately or soon after surgery.
3) The recommendation not to send patients to pain management for pain the surgery clearly caused.
4) Dr. Jacobs’ aversion to algorithms.

I also got a sense that mesh can easily be mistaken for other pain causes.

The most striking phrase from the presentation: “…and I know there’’s not one surgeon in this room who thinks that’’s their outcome”…” when introducing the 6% chronic pain statistic.

[Feuermann]

My surgeon felt that short-term recovery was better with open than lap. That surprised me, since the studies I read didn’t seem to support this. However, my surgeon made a small incision and my early post-operative pain was quite a bit less intense than I expected. I was able to manage the pain effectively with ibuprofen and ice by the second day after the surgery. I could have returned to work after a week – but decided to not push it and took two.

I really think long-term discomfort and pain are the bigger concerns with this surgery, because of the quality of life implications. I don’t see a preponderance of evidence that lap is superior to open in this area.

[Feuermann]

I don’t have a lot of detail on my dad’s surgery other than it being open on the right side with a single piece of mesh.

Mine was open on the right side with mesh placed both posterior and anterior and fixated with prolene sutures. My incision was small, less than 2 in.

[Feuermann]

My dad’s surgery was on the right side, with a single piece of mesh placed on top of the opening – an anterior onlay, I believe. He had a different surgeon from mine. Because it was so long ago, he doesn’t know what type of mesh was used. Since it was in the 1990s, I assume it was a heavier mesh, but I can’t be certain.

My surgeon placed two pieces of mesh in me – one posterior and one anterior. It is a medium sized Kugel Modified Hernia Patch, according to the operative report. I don’t believe this is a particularly lightweight mesh, but I am not sure if it qualifies as heavyweight either. The report says he used prolene sutures to secure the mesh pieces in place. My surgery was also on the right side.

He was a very confident surgeon. He said he had done around 2000 open repairs, with no patients returning to him with a recurrence and only two returning with chronic pain. In both those cases, he said his patients’ pain eventually resolved.

At the time, I thought doing two pieces of mesh would be a good idea – especially given my surgeon’s confidence and reported recurrence and chronic pain rates. After comparing my dad’s experience and reading the accounts on here, I am not so sure. My dad’s long-term recovery was definitely quicker (he said he felt completely normal again about 6 months after the surgery) and I wonder if this is the case because his body only had to deal with one piece of mesh. I also worry that if something goes really wrong with the mesh, it will be more difficult to fix with two pieces in there instead of one.

On the other hand, my surgeon’s track record seems very good and my discomfort issues are minor and continue to improve. The repair does feel very solid.

[Feuermann]

My dad had open inguinal surgery with mesh 20 years ago and has had no issues. I had the same surgery about a year ago and I am still experiencing mild discomfort daily, but it does not interfere with my work or family life and I can exercise. My symptoms still seem to be getting better, very slowly, with time.

I wouldn’t say my experience is a huge success story – but the bulge is gone and I remain healthy and active. Time will tell.

[Feuermann]

I agree with Momof4. I am a year out from open inguinal hernia surgery with mesh and the long-term recovery has been a “2 steps forward, one step back” kind of experience. I have felt burning, tingling, aches, heaviness, hypersensitive skin, itching, leg and back pain and discomfort. Since the initial post-operative pain went away, I have had some or all of these symptoms daily. Some days have been better than others and the issues have improved over time, but very slowly.

I don’t want to give the wrong impression – I have been able to live my life. I have just been surprised at how long these sensations have persisted.

That all being said, I am in much less regular pain and discomfort than I was even a couple of months ago. I hope this provides you with some comfort. For some of us, recovery from this surgery may be a longer road.

I have also found that there is a psychological element to all of this. I don’t know if it is perception or if it is real, but I feel these sensations less when I am involved in something immersive like playing an instrument, reading or writing.