[Good intentions]

This is a very interesting topic. Neurectomy is almost a standard procedure for mesh removal,with from one to three possible, as I understand it.

It’s easy to understand what it is, but not so easy to get details on what happens afterward.

The topic has come up in many past threads. Use “site:herniatalk.com neurectomy” in Google to get a list. Good luck.

[Good intentions]

Hello Greg. I don’t have actual experience with the steroid treatment for pain relief but I have read about it. It seems to be one of the older “standard” options for treating mesh related pain, and many other types of chronic pain, or injuries that need to heal quickly. I think that the actual steroid is cortisone based, and lidocaine is a pain reliever that is injected along with it. Cortisone injections are often used in professional sports to get athletes back on the field quickly. They promote healing. In your case, it seems like there would need to be some sort of physical therapy involved to get the hard body, the mesh, away from whatever it is irritating. Otherwise, why would it be a long term solution?

Can I ask the details of your original repair? I’m guessing that it was an open surgery? 16 years is a pretty good run for a repair. Has it been a good 16 years? I’ve been collecting stories to try to find these types of experience, in a thread called “Successful, good “mesh” stories”.

Dr. Brown seems to be very knowledgeable and experienced. Worst case, you would probably suffer some immediate pain and discomfort from the procedure itself but it wouldn’t work in the long-term. I think that the risk of creating more damage is slim. I believe that, big-picture wise, it’s one of the treatments attempted before taking more drastic measures.

Good luck.

[Good intentions]

quote Chris k:

Sorry.. Had a bialateral hernia operation nearly 5 weeks ago. I get stomach aches that come and go and my Doctor said that is refered pain.
.

You need to add even more detail. “Bilateral” just means both sides. Laparsocopic, open, type of hernias, type of mesh, etc. The more detail the better.

Good luck.

[Good intentions]

I can’t really speak to “normal” since mine never worked the way it was supposed to. I had bilateral Bard Soft Mesh via TEP. Wish I could help.

Good luck. Your surgeon should know best from his own history of patients.

[Good intentions]

The area that the mesh covers is much larger than the entry points for the implantation. Typically a 6×6″ piece of mesh is cut, per side, to fit the space they create. You can measure across your abdomen and see that they cover all the way across your abdomen and down to the pubic bone. Bard 3D Max is different in that it is preshaped, but it is still covers a large area. So you will feel discomfort in areas you would not expect. I provided a link below showing the sizes. They range from 3.1 x 5.3″ to 4.8 x 6.7″.

What are you doing for recovery? Walking, stretching, light workouts? Your symptoms are not unusual at all, they’re actually somewhat mild, compared to what others have experienced.

Most surgeons will say that the mesh is pretty well locked in place at 2-3 weeks. Although it’s not clear that that is always the case. So, more “healing” is kind of vague. Not clear what you would be looking forward to.

Good luck. Provide more details and you’ll get some answers.

https://www.crbard.com/davol/en-US/products/3DMax-Light-Mesh#SpecificationTable

[Good intentions]

There are quite a few comments on the site about how the images need to be read by somebody with specific expertise in hernia repair. If you can get the images and your medical records it will be be very useful for you. Contact the facilities where you had the work done and they will send them to you, probably on a CD.

And your story could use much more detail. Tell the whole story. How long ago? Type of hernia – direct, indirect, inguinal, ???. Type of surgery – TAPP or TEP. Bilateral or one side. Brand of mesh. What was the initial reason that you thought you had a hernia? How was it diagnosed.

Also, more detail about what you mean by pressure and inflammation. I know it’s probably difficult to sit at a computer or your phone to type out the information but it would be helpful. I felt like I had a sponge inside me in the early months after my mesh implantation, which made it difficult to sit in one spot for very long.

If you tell your general location people might have advice on who to see. I know that TAPP can give a good internal view of potential problems but I think that the surgeon would need a good reason to try it. Good luck.

[Good intentions]

Some of us have already commented about how the risk of chronic pain is higher for active people, or thin low body-fat people. Even the surgeons agree about problems with low body-fat people. Professional athletes avoid mesh, and even though they are more skilled than the average person, they are not that much more active than many of us. One of your doctors thinks that you might also have athletic pubalgia, which comes from too much physical activity, generally. In sum, even just using the generally accepted risk multipliers accepted by the professional surgeons you seem like a patient that would be most likely to suffer from mesh after the repair. Low body-fat, very active person with athletic pubalgia and an inguinal hernia. You seem ripe for mesh problems.

That’s what I see for you , based on my own experience and what I’ve learned over the years.

This is the one area where it seems like the surgeons just don’t pass on their knowledge. I think that you should see a surgeon that repairs hernias in professional athletes, without ruining their careers. One who understands both true hernias and athletic pubalgia. If you want to be physically active again.

It’s been very surprising how nobody can show the evidence that justifies using large pieces of mesh in an athletic person. I think that for some surgeons the win-some-lose-some principle is in play, because they see a cross-section of society. If you lose, he or she still has a bunch of wins out there. But you’ll lose a lot.

Good luck. If they can’t show evidence that their repair method will get you back to where you want to be, keep looking. Don’t become just a statistic.

Dr. William Brown is known for repairs on professional athletes. He has some thoughts.

https://www.sportshernia.com/no-mesh-hernia-repair/mesh-mesh/

p.s. it would be fantastic if a surgeon could reply with their own data about successful repairs using mesh, and not just the SAGES guidelines, which are very general and seem to accept chronic pain as normal. The data is out there. Dr. Kang is an excellent example.

[Good intentions]

Thank you chaunce and jnomesh. I might start a thread soon myself. I haven’t really developed a consistent base of fitness that I can use as a reference point yet. I feel much better but I am still very far from where I was before the initial hernia. It’s easy to see how people with problems will just give up their old life and develop a new and weaker life. It happens almost without realizing it, if you don’t keep track of what you’re capable of, and compare it to memories of your old self.

I think that that is one reason there aren’t many stories, good or bad, about how people are doing with their hernia repairs. Only the doctors can generate that information, via surveying their past patients. I wouldn’t be surprised if their are surgeons who have done those surveys but are not sharing the results. The surgeon who did my repair said that he was going to survey his patients after he got to 500. That would be a year or two ago, easily. I’m considering contacting him to see what he found.

[Good intentions]

Can you be more specific? Have you already had a mesh repair? For a hernia? what type of hernia? Where in the pelvis is the pain? Pelvis covers a lot of area.

There was somebody recently who had a similar issue. Dr. Towfigh is an expert on sources of difficult-to-diagnose pain.

Good luck. Add more details and somebody will have suggestions.

@drtowfigh

The @ function does not seem to be working today.

[Good intentions]

Your repair was like mine, the “state” of the art for laparoscopic mesh repair. The odds say that you’ll be okay. It will still be worth your time to get your medical records. I’ve been trying to collect information about what works and what has problems, but the information is hard to find.

Stay in touch and report your progress and you can get some advice on if what you’re experiencing is normal or not. Good luck.

[Good intentions]

The first thing you should do is to get a copy of your medical records, from the first doctor to the last. It sure does look like some corners were cut and assumptions were made. It might be even more clear when you see it in writing.

You might not need to sue but once the people involved realize that the error is theirs and you’re not going to let it just slide by, they’ll probably be open to negotiation on your fees.

Beside that, you need your records for the future, especially since they did all of that and did not fix the problem.

Good luck.

[Good intentions]

It would probably help you to re-summarize your problem. You have 34 posts to look back through, plus things might have changed since you originally posted, like your bladder problems. I can’t remember if you have a confirmed recurrence or if you think that you might have a recurrence.

Good luck.

[Good intentions]

It depends. I have had my records emailed to me, sent via CD, and mailed in paper form. I’ve done it by phone, by filling out a form on a web site, and by emailing somebody. They all seem to be different. Mine were held in two different places, my surgeon’s office and the facility that he used to do the surgery, an ambulatory surgery center.

It’s very common, for both personal records, and for referrals to other offices. I’d just call the main number of your surgeon’s office and start there.

[Good intentions]

I don’t know a lot about wound healing but I would guess that the hypergranulation is a response, not a cause.

Do you have your medical records? You can learn a lot even if you’re not an expert. There might be something there about suture materials, method of surgery, etc. that will tell you or someone on the forum something.

One thing that I’ve learned about education is that when you get out you’re just a generalist, not an expert. They can only teach the basics within the relatively short amount of time that a person spends in coursework. Expertise comes from focusing and working in a certain field for a lengthy period of time. You should probably move on from the expert in urachal cyst surgery to an expert in difficult wound healing problems.

Another thing that I’ve learned is that when problems happen, the original surgeon might spend too much time trying to solve the problem themselves rather than admitting it’s beyond their level. It’s a big problem in hernia repair with mesh. The people that implant it often don’t know how to deal with the problems, or don’t want to.

[Good intentions]

There’s really little point in being concerned now. If you had the surgery over a few months ago and you’re in good shape now then any ill effects will be slow in coming. There are, apparently, combinations of patient, surgical method, and material that work well. It’s unclear what that combination is, so there’s no readily apparent way to avoid the bad and seek out the good. That’s one thing some of us are trying to do via this forum, is to identify the good and the bad so that people can make better choices.

Can you get a copy of your medical records and post the details of your surgery? There might be some clues there that will give some ideas of what to expect. Type of mesh, extent of coverage, TAPP or TEP.

Good luck. Don’t worry too much about what is past. Please share more details if you can though.

[Good intentions]

Two clinics that seem to have much experience in that area are OHSU, in Oregon, and the Carolinas Healthcare group, in North Carolina. Dr. Martindale and Dr. Heniford. Abdominal wall reconstruction is the topic you want to focus on, I think. The University of Tennessee Health Science Center also seems to have a focus in that area. Dr. Voller.

This video is scary but gives some idea of how far they can go to solve a problem. Find an expert soon, I’d say, and don’t feel bad getting a second opinion. And don’t spend too much time trying to make insurance work for you. Our compartmentalized insurance system keeps people from finding the specialists that they need.

https://www.youtube.com/watch?v=w9c8JThMdAM

[Good intentions]

quote Jnomesh:

Hi good intentions as someone who had his mesh removed 2 summers ago In which it was found to have curled up k to a rock hard ball I think knit would also be interesting to find people who have had successful mesh removal and more to the point successful recovery of symptoms prior to mesh removal.

That would be a good thread topic. We could offer details about the experience, including what to expect over time, after mesh removal. I’m finding that the normal time to healing, after working the area, is much longer than for other types of injuries. Maybe due to lower blood flow, and the fact the area doesn’t move a lot while recovering. Unlike a limb or a muscle.

I feel like I might be overposting on the site as-is, but would certainly add to a thread on that topic. Could you start one? Excellent idea to round out the topics.

[Good intentions]

I can only give an opinion based on my experience of having a mesh implant. After tissue ingrowth the mesh gets stiff and inflexible. It pulls and pokes at the tissue at its perimeter. I think that when surgeons say that the mesh is not causing the pain, they are only thinking of it as a primary cause, not a secondary cause, meaning that the strained tissue at the edges is a secondary pain, caused by physical movement, not by the mesh itself. It’s splitting hairs for sure, but that’s how things are done. I suspect that Dr. Earle is also focused on the secondary tissue strains, as potential hernias, causing pain, but not yet palpable. One common method of fixing those mesh edge-induced hernias is to cover them with more mesh. Dr. Towfigh has said in previous posts that mesh-induced pain can be caused by pulling on nerves. It might be that your injury and rehealing has caused tightness that is pulling on nerves.

As far as mesh repairs “failing”, it’s really a matter of definition. If the original defect is still closed up, that will not be seen as a failure. If new hernias are created by the stiff mesh that will be considered a new problem. If the mesh stiffness itself causes inflammation during activity that will be considered a “mesh reaction”, a new problem.

In the end, after mesh implantation, you have to develop a much higher awareness of what’s happening in your abdomen, to decide what to do about it. Over the curse of the three years that I had mine at times I could feel tissue rubbing across it where it sat on my pubic bone as I pedaled a bike, I could feel it poking in to my groins when I crouched. I could feel the seam down the middle between the left and right side pieces at times. It turned in to a stiff plate-like material across my whole lower abdomen. Like a plastic bucket.

In many ways, the reasoning and solutions to the mesh problems show that the dynamics of the abdomen aren’t being considered. They are thinking of it as a static “bowl” that just needs to be patched up. Considering the fact that when they do surgery there is no movement, it’s not too surprising. Dr. Brian Jacobs even described moving a patients leg while operating to see what moved inside. A crude, and irrational way to learn, considering that there was no muscle tightening or tension, or torso twisting, or heavy breathing, just moving a lax leg. But it showed how he thought the abdomen worked while a person moved, like a static non-flexing bowl. Just a leg moving back and forth. It was surprising to see, it’s in the video I posted a few days ago. Having had the mesh inside my while I moved I know that’s not how things work.

So, you probably already know what’s happening inside you. If you think that it is a stiff piece of mesh poking and pulling, well it’s not going to get softer. It’s going to stay that way. Since you had both sides done, you can compare one side to another to get a better idea of it’s the mesh or not, if the pain is caused by tightness or just movement. I found that I could reduce my problems by reducing activity, but they came back with resumed activity. I suspect that many people who don’t report problems just aren’t very active.

Watch Dr. Kang’s video in post #8 of the link below to get a better idea of how it works. Since you had a very small piece of mesh implanted, 1×4″, compared to 6×6 inch pieces implanted laparoscopically, it almost seems like a surgeon would want to remove it just to get it out of the way so they can find your real problem. It’s probably about 3/4″ x 3″ by now.

Wish I could add more. It’s really an individual decision. Good luck.

Here is the link to Dr. Kang’s video, post #8. https://www.herniatalk.com/7365-please-watch-60-minutes-sunday-regading-mesh-in-the-human-body

[Good intentions]

I’ve been browsing threads and found a success story. But I don’t know the details yet, beyond that it was performed by Dr. Goodyear, and might have used Ultrapro mesh (he was not sure in one of his posts. “pro” is used in many mesh brand names). And the description sounds like a direct hernia. Another post about scar tissue sounds like an open repair. Three years as of August 2017. I sent him a message, hoping for a response.

So until corrected, another open surgery that has gone well.

https://www.herniatalk.com/5335-3-years-after-surgery

https://www.herniatalk.com/5099-femoral-hernia-new-to-all-this

https://www.herniatalk.com/5953-how-long-for-bothersome-scar-tissue-to-go-away

[Good intentions]

Here is an old thread that I just came across.

https://www.herniatalk.com/195-lumbar-hernia-mesh-patch