Good intentions
Forum Replies Created
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There are many different types of open repair. Plugs, patches, two layer systems, and variations of each of them. “Mesh” is not enough to go on.
I post this advice often – ask your surgeon if they have verified that their method will work for you through communication with former patients. There is no reason that they should not know that, it just takes a letter, or an email, or a survey after a year or more of time has passed. The medical device makers do not have long-term data for their products, only very short time frame animal study results. Animals can not describe their pain.
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Most hernia repair patients do not get a “pain pump”. So that is unusual. Since you were originally diagnosed with a groin strain, and the pain is associated with activity, it might be that the hernia was not the actual cause of the pain. I had a direct hernia that was only painful “after” strenuous activity but not during. And the pain resolved after a few days to a week. I only had it repaired so that I could, supposedly, get back to my high level of activity.
Consider the possibility that the pain is actually from something like a “sports hernia”. Athletic pubalgia. There is a “sticky” about it on the forum’s front page. Here is the link – https://www.herniatalk.com/6882-in-depth-sports-hernia-guide-infographic
There are doctors who specialize in the condition, like Dr. William Brown, Dr. Muschaweck, and Dr. William Meyers. Good luck.
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quote Dave Graham:I suppose at some point you h ave to assume the surgeon knows what he or she is doing.
Put your effort in to verifying that what your surgeon is planning for you will actually work for you. Otherwise you’re in the 1 of 6 category, generally. Like Russian roulette. 10 – 16% chance of chronic pain.
Many surgeons are expert at getting the mesh implanted. It’s the long-term results that are undefined. My surgeon had the best of credentials. But lost track of his patients after he was done so, as I found out later when I had problems, he could not say if past patients were doing well or poorly. Only that the surgery went well.
Ask your surgeon if they know, based on communication with past patients, that their methods work for your planned activities. If they don’t, then the risk is higher for you.
Good luck.
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Hello Baris. Can you tell more about your situation? The type of hernia and what made it fail? I saw your other post and replied but it is Unapproved at this time.
I was very athletic also but had a laparoscopic mesh repair. The mesh was worse than the hernia, it made athletic activity impossible without side effects.
Any details would be appreciated. Good luck at Shouldice.
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quote Baris:I believe its something he does quite common as he knew i was involved in high level sports at the time and still used absorbable.
Hi Baris. Could you give more detail on your situation? Your story sounds very interesting, in many ways. I think that the “holy grail” of hernia repair is one method that works for everyone. What type of sport, and did you gain the 35 lbs afterward, or does Shouldice just like very skinny people? Was your sport a high frequency sports like running, or a high intensity sport like weight-lifting? Or a combination of both like soccer (football)?
I was very athletic, mainly soccer, before my hernia repair with mesh and I found out why very few, if any, professional athletes get repairs with mesh. The mesh is a constant irritant to the surrounding tissue, which cannot handle the stresses and strains of continuous high level activity, with mesh. Since the mesh is gone I am slowly working my back to a higher level. All of my personal data, three and a half year’s worth, points to the mesh as the main cause, with the extensive unnecessary dissection as a secondary cause. It’s incredible how much healthy tissue was damaged to insert mesh in to areas that had no problem.
It would be great if you could tell more. Dr. Mucschaweck is known for working on athletes and her association with Biohernia is important.
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Type of mesh does make a difference. But what, exactly, the long term effects are is unclear. Most of the literature provided by the device makers focuses on the immediate feel of the material before and/or during implantation, Soft or Flex or Grip, and various other qualities, many to make implantation easier. It’s one of the great failings of the industry, that they have all of these different types of mesh, used on a regular basis, but there is no verifiable long-term data available to use for correlating problems or benefits to the mesh type. The new meshes are approved based on similarities to past meshes, meshes with, ironically, the very problems that the new mesh is supposed to improve.
Many surgeons do not get to choose the mesh that they use either.
Bard is a medical device maker. A brand. They have many different types of mesh products. Bard Mesh, Bard Soft Mesh, Bard 3D Max, etc. Here are three links, one showing how some surgeons just rely on their purchasing departments, another showing Bard’s product portfolio, and an different device maker’s products..
Click “cancel” in the print window that shows up and you can read the article – https://www.generalsurgerynews.com/Article/PrintArticle?articleID=34826
Here is Bard’s hernia repair portfolio – https://www.crbard.com/Davol/product-search?pg=1&devicetype=hernia+repair+%26+fixation
Here is another device maker’s, Medtronic – http://www.medtronic.com/covidien/en-us/products/hernia-repair/mesh-products.html
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Hello Chaunce. Great idea to start a topic for this. I think that Dr. Koch is the Holland-based surgeon in this partnership, along with Belgium. Dr. Muschaweck apparently handles the UK and Germany. Ireland is either. And there is a separate “International” link.
Looks like this person, Nahom Welldeiesus, started the partnership, after his/her own hernia repair in 2015. It’s on the About Us page. It looks like the three of them are the business, and both surgeons can be contacted through the Biohernia site.
Also note that they reference three methods – Shouldice, Desarda, and Muschaweck. And mesh removal.
Here is an excerpt that I translated from their Holland page, using Google translate. The web site is a bit clunky, it’s new of course. Click the “how does it work” from the info link.
“Kom voor een kennismaking met onze chirurg, Dr. Andreas Koch, langs op één van onze maandelijkse spreekuren.”
“Come for an introduction to our surgeon, Dr. Andreas Koch, along on one of our monthly office hours.”
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Actually, you have to click on one of the flags first, then the informative links will be available.
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quote routern7:are you sure Dr Muschaweck is there? I sent email and they said she left.
Apparently, maybe, she left to start something new. Somebody just posted about it. It looks very promising.
https://www.herniatalk.com/6229-inguinal-hernia-surgeons-london-uk
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quote Frank Chapman:I am curious if anyone here has experience with BioHernia?
The web site you linked was only just created, in 2018. Apparently, it’s not really clear what type of business it is. It seems to be a partnership of several surgeons.
https://biohernia.com/en-gb/about-us/
https://biohernia.com/en-gb/how-biohernia-works/
Somebody also recently posted that, apparently, Dr. Muschaweck had left her previous organization. Maybe she left to start this.
The web site is very impressive. It covers pretty much all of the issues often brought up when discussing hernia repair. The important links are at the bottom of the introductory page.
Very interested to hear how things turn out for you. Thanks for posting this.
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You can send messages directly to members of the site by clicking on their screen names to make sure that they see your topic. Otherwise you have to wait until they decide to get back on to the site, plus they have to open your topic when they do.
It seems odd that your doctor would not respect the opinion of a trained expert in radiology. The radiologist spent much time and effort learning to read images. Adhesions are a common problem for all forms of abdominal surgery.
The mesh shrinks over time so that alone, regardless of tack usage, could cause some discomfort. 4.3 cm = about 1 3/4″ so it’s not a huge piece of mesh though. 15 cm x 15 cm (~6 n x 6 in) is a common starting point for laparoscopic mesh implantation, cut to fit the space. I don’t think that have enough information to really determine if mesh removal is needed. A surgeon that actually does mesh removal would recognize the symptoms and be able to tell you more.
Good luck. Dr. Towfigh just posted her practice’s direct contact number in a separate post,if you want to contact her via her practice.
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Good luck jer. The healing process after mesh removal seems to take much longer than the healing after implantation. Probably because the tissues have been ravaged for many years by the mesh and the collagen types are messed up. Plus there is a lot more of it, in the wrong places.
I’ve found that letting things settle down completely while trying to get back in to shape helps a lot. Exercise, let things settle way down to a steady state, then start again. In other words, don’t try to push through to strength and health like you might with a normal injury. It’s a very slow process, at least in my case.
Can you share any details of what Dr. Brown found? It won’t be a surprise if everything looked “normal”. Take care.
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Hello Marjorie. I had a very similar experience to that of your son. I had bilateral TEP implantation of Bard Soft Mesh in December of 2014 by a well-respected experienced surgeon at a large well-known clinic, and eventually had the mesh removed at the end of 2017. It was uncomfortable from the beginning, with levels ranging from pain to just discomfort, even leading to penile dysfunction. More than just erectile. My surgeon’s response was very similar to your son’s surgeon’s response. A focus on recurrence, not pain.
Can you get copies of the medical records? They should be available from the facility where the repair was performed and/or the surgeon’s office. There is a very wide range of materials being used for mesh repair and many different techniques. There might be some clues there that will help define a path forward.
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The bump is getting smaller, which supports what the two surgeons told you. If he sutured the opening close there will probably always be a small bump there from where he pulled the edges together, a small healing ridge, or internal scar. Plus the sutures themselves. I can still feel a very small bump where a needle was inserted to deflate my peritoneum during TEP surgery. The single suture used to close the hole left a bump, smaller than a BB, which will probably be there forever.
It’s barely been two weeks, barely enough time for normal swelling to reduce. I’d say that you might be getting ahead of yourself. Beside that there’s not much to be done. If there is a defect allowing fat to extrude, then when you get more active the bump will get bigger. Then you’ll know more. The radiologist can only see the results of the hernia, which would be the mass of fat. They probably can’t see the detail that the defect has been closed. I don’t think that fat has enough structure to be pulled without coming apart. That’s why the surgeon left it behind. Minimal disruption.
Good luck.
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quote Good intentions:Another person on the same forum had open repair with mesh 8 years ago and said he is also very happy with it. Said it was “perfect”. Another weight lifter.
The person from the other forum posted some details on his procedure. Anyone in the southeast or willing to travel to Florida for a hernia repair should take note. I copied his post here, and added the link. It’s post #1388. I also posted a link to Dr. Kurland’s practice.
“To give everyone an 8 year status. My hernia repair is perfect. I had surgery August 2010 and 8 years later, I forgot that it even happened. I don’t come on the forum that often anymore, but every once in a while I get a private message, and I realize that it isn’t even on my mind anymore. The surgeon used a mesh and tied it to the bone. He allowed the mesh to be less than tight for what he normally does because he knew that I lift and he wanted the mesh to have the ability to flex or give just a little. I have not had any complications or anything. I am so glad that I had Dr. Brian Kurland in Fort Myers, FL. He knew exactly what he was doing. I asked him tons of questions before the surgery occurred. He recommended against the laparoscopic method because he wanted full access and view of open surgery method so that he can fine tune and get the mesh perfect, WHICH HE DID! If you have any more questions or anything you would want me to dive into deeper, let me know. I am glad to share any details with you since I had a 100% perfect experience. I even got stronger and hit PR’s afterwards. I am very lucky to have found Dr. Brian Kurland in Fort Myers, FL.”
https://forum.bodybuilding.com/showthread.php?t=133353003&page=47
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quote dog:I am thinking what if to do old school surgery but combine it with
Biological Mesh Implants …just in case ?There are so many materials out there, and so many possible ways to use them, but very little long-term follow-up on how well they actually work. It’s a dilemma.
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Dr. Muschaweck is still active in Germany. Her skills seem to fit your needs. She might have an explanation for your pain also. I think that she avoids using mesh if possible, and also removes it when appropriate. If I was in Europe she would be my starting point.
https://www.physioroom.com/experts/e…muschaweck.php
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I am not a medical doctor and have not had an umbilical hernia but the first thing that came to my mind was adhesions. Colonoscopy does not seem to be the common method of diagnosing adhesions though, so it’s not clear what your surgeon expects to find by that method.
Search small bowel or small intestine adhesion and you’ll find a lot to read. Good luck.
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quote dog:There is no evidence-derived basis for believing that the use of mesh is more responsible for chronic inflammation than biological mesh.
Did you copy that directly from the source? There is something wrong with the sentence structure since it basically compares “mesh” to “mesh”. The sentence does not really have any meaning.
Do you have the original link? It looks familiar.