[Good intentions]

jnomesh had his mesh removed by Dr. Belyansky. Here is one thread in which he talks about it.

https://www.herniatalk.com/5829-simu…-hernia-repair

And the search function on this site works well. I searched “Belyansky” and a few stories came up. Since he also will remove mesh he should have some idea of what to avoid when repairing a hernia. The surgeon who originally repaired my hernia using Bard Soft Mesh wanted nothing at all to do with removing it. If I was starting over I’d find a surgeon who has seen, or at least is aware of, and accepted the problems with all of the hernia repair methods.

[Good intentions]

I’m not sure that size of the hernia is the issue for pain, it would be what tissues are being strained. Location, more than size. It sounds like you’re describing an indirect hernia, which would be an expansion of the inner ring of the inguinal canal. It’s not supposed to expand at all, it’s supposed to be just big enough for the spermatic cord.

If you read more threads you’ll find several on “hidden” or “occult” hernias. I think that these are areas that are starting to stretch and grow in to visible hernias, but haven’t created enough deformation yet to be visible. The tissue is being strained and creating pain, but there’s nothing to see. Read some of those and it might give you another point of reference.

On the other hand, some people have very large hernias, that are not very painful at all. My hernia was a direct hernia and the pain would go away after a week or two of no activity. I only had surgery to try to get my potential for activity back.

I’ve wondered sometimes if the words used to describe size of a hernia are describing the amount of material pushed through the defect, or the size of the defect itself. Even the size of the defect can be vague, since there are three dimensions to consider, along with shape. Round versus long and narrow, for example.

[Good intentions]

inguinalpete just posted something similar and I replied with my own similar symptoms. I wonder if something like tendinosis could happen, as the mesh rubs on the tendon. Does your problem reduce with rest, then come back with activity?

https://www.herniatalk.com/7084-2-hernia-surgeries-and-now-chronic-problems

[Good intentions]

Hi Katie. I saw your other post with the @ symbol used. I don’t think that all forum software use the @ notification system. It might not even be activated on this forum. I’m pretty sure that Dr. Towfigh will see a message though, if you use the messaging system. If you click her name on one of her posts there will be a link to messaging. You could refer her to your thread.

You injured yourself deadlifting, or something like it? Bouncing the bar off of your pelvis, if I recall correctly.

I experienced pulls and soreness periodically over the three years that I had mesh implanted. One thing that often caused soreness was any strenuous actions with my arms raised, that stretched abdominal muscles longitudinally, like putting a heavy object on a shelf or doing pullups. Felt like it was pulling something free from my pubic bone, or just overstressing that area. They like to get the mesh all way down to the pubic bone so it will form a good attachment and not move. Unfortunately it also reduces the flexibility of the lower abdomen as a whole, turning it into a leathery plate attached to the pubic bone, after tissue ingrowth in to the mesh fiber knots. Not the way the body was designed to work.

Good luck.

[Good intentions]

I also have a similar “ridge” that seems to follow a muscle feature. I don’t know my anatomy well enough to know exactly what it is. It’s in the same area as the original direct hernia lump. I had TEP placement of Bard Soft Mesh, both sides, but the side with the hernia is the only side that got the ridge. Initially, it only appeared after exercise, then reduced with rest, like a void that was filling then deflating. But eventually, over months and years, it became permanent. It was not a recurrent hernia, just a spot that swelled.

With TEP they often like to place as big of a piece of mesh as they can fit in there. To allow for shrinkage and movement. Do you know how big yours was? Do you have your medical records?

Your story seems to imply that the “sports hernia” repair caused your inguinal hernia. Since you’re out of the ordinary now you should probably find a surgeon who is an expert in both of your problems. Many surgeons are very well-trained in specific procedures and will try them on you but may not get he fine details right to achieve the best outcome for you. You don’t want to get in to the “more mesh will fix it” cycle.

Dr. William Meyers of the Vincera Institute is an expert on athletic pubalgia, aka “sports hernias”, and would be a good place to start if you can get there. He’s in Philadelphia.

[Good intentions]

Chaunce, do you have a link to the internet forum thread with the surgeon’s discussion?

Many of the SAGES presentations end up on youtube. I don’t know who decides what gets released but I hope that the mesh discussions are.

[Good intentions]

quote W.Parker:

I’m not sure of the material used to make the mesh. I was told it’s comparable or looks like fishing line tightly woven and they’ve(the VA) used the same mesh for 50 years. Really odd feeling the body trying to adhere to the mesh. It was a itching scratching feeling. I had a open RT inguinal hernia surgery where they layed and stitched the mesh together on the outside of the inguinal canal. The Doctor did confirm extra work was done repositioning the spermatic cord and extensive scared tissue which seemed really weird- extensive scared tissue?

It sounds like your surgeons are using something close to the original mesh repair methods, which generally worked well, but cause more short-term healing pain, requiring more time, and also left more external scarring.

One reason that laparoscopy is gaining popularity is because people get back on their feet sooner, and the signs of surgery are reduced. Tiny scars. Which, somewhat ironically, probably makes it easier, subconsciously, to think that there can’t be any problems inside, because there are no scars outside. Surgeons are people too. The people with problems from laparoscopic mesh implantation look fine from the outside. Especially the TEP procedure, which leaves almost no sign of surgery, but does the most internal dissection.

A good medical student could probably put a survey together that would show the difference in chronic pain between old methods and new. I’ve seen a few attempts, in research papers available n the internet, but they generally downplay the type of pain, ignoring the persistent low-level pain, focusing on more extreme pain, and they usually have some bias apparent in the discussion. Research to prove a point instead of research to solve a problem.

Your previous scar tissue might have been from the areas that were dissected so that the surgeons could get in to fix the hydrocele. I’ve wondered if the dissection process alone isn’t part of the mesh implantation problems. Peeling apart tissues that were perfectly fine just to “take a look” or make room for the mesh.

Good luck.

[Good intentions]

You should describe the major abdominal surgery. There might be clues there. You could also get checked for a hernia.

Good luck.

p.s. choosing a serious user name would make your problem seem more serious.

[Good intentions]

It’s been 3 1/2 (Edited – was 4 1/2) years since I got my right side direct hernia. Since then I’ve had Bard Soft Mesh implanted, then removed, and am now recovering, trying to get back what I can. I often wish that I had just lived with the hernia. I thought that I was choosing between staying at 85% of my former capabilities or paying the time, surgery pain and risk, and money, to get back to 95%. Nobody described the potential complications, or the probability of having them. It all seems hidden, and purposely ignored. The surgeons I talked to before-hand implied that it was an easy, outpatient procedure. All I needed was a ride home afterward.

It’s very surprising how many surgeons, and doctor’s just don’t acknowledge the problems with the current methods of mesh implantation, despite all of the lawsuits, and new forums like this one cropping up, and their own patients coming back with problems. I think that they might just realize that people won’t have the surgery if they tell the truth about what they know. It creates a whole undesirable atmosphere of distrust; of the medical profession, the insurance companies, and the various clinics and hospitals. It’s more than just a few patients that have their lives screwed up.

But there are honest, open, forthright individuals out there. I recommend staying away from the large clinics, because they have incentive to stay with the mainstream methods, right or wrong. They are large for the purpose of negotiating contracts, and subsequently have large outside influences pushing them to avoid acknowledging problems. Many surgeons in the big clinics don’t really have a choice of materials, their purchasing departments choose for them based on cost, assuming that the meshes are all the same, and they are probably also limited in methods of repair.

If your surgeon can’t describe a few stories like you’ve read on this forum, and discuss why they might be happening, then they’re either in denial or dissembling, avoiding the issue. Choose a surgeon who will acknowledge and confront the issue directly. One who keeps track of their patients progress and doesn’t assume that “no news means success”. Then you’ll have a better chance of a successful repair. The individual surgeons shouldn’t be avoiding responsibility for the work that they do. If yours denies there’s a problem, I would move on to another.

[Good intentions]

Welcome back ajm. I don’t think that you ever said what type of surgery you ended up getting. Type of mesh, quantity, placement. Could you share that?

Since the lower abdomen and abdominal wall are essentially like a bowl that your intestines sit in, weight gain seems like it would add pressure. So it seems sensible that it would cause more discomfort.

[Good intentions]

quote W.Parker:

Also, I was concerned about the type of mesh that was used…being a veteran they told me there mesh product hasn’t changed in 50years and only concern is with the dissolving mesh type.

Edited – Mesh was introduced about 50 years ago. But, still worrisome, that they think they’re all the same. Makes looking for a solution seem hopeless. Narrow-minded.

Do you know what type of mesh was used, and what procedure? Was it an open mesh implantation? How did you get the hydrocele for the first surgery?

Change will continue over the first few years, with the mesh shrinking, and the tissues around it getting pulled. Good luck, sorry nobody had some advice on your first post. I felt most of the soreness right at the spot of my direct hernia, in the first few months.

[Good intentions]

quote Khernia11:

So you had it done lariscopically when it was implanted and also removed? I saw somewhere here that the way It goes in is the way it must come out? I had mine done open and my first initial consultation from one of the surgeons who do open procedures on the list above said they could likely only get 60 to 90% out. Was that what you heard from your consultations as well?

Also, I was wondering what Were your main reasons why you went through with the removal…was it only pain issues or did you experience other symptoms such as feeling sick, intermittent dizziness spells\off-gate\fatigue or episodes of general malaise and rashes that would come and go? Thanks again for your reply.

I had mine implanted via TEP, but removed via TAPP. I’m not so sure that the procedures need to match for removal. TAPP is essentially like open just from the other side of the abdominal wall so if the mesh is a patch that was placed between the peritoneum and the fascia, it should be accessible via TAPP. But I’m not a doctor. TEP is a very specific procedure, to split the layers apart but leave them intact. I think that TAPP might be the preferred removal method, because they can see all of the abdominal wall, through the peritoneum, before they start removing, and they don’t have to cut through muscle or fascia to get to the mesh, just the peritoneum.

I had mine removed because things were getting worse, not better, and I couldn’t imagine spending the rest of my life like that. I was withdrawing from doing the things that I like to do. Spending all of my time managing my condition. It’s what I imagine people with cancer or colostomies or diabetes have to deal with. After being very healthy for many years I gained much empathy for people with chronic conditions, but I felt obligated to try and get out of it, since I have way too many years left to just wait for death.

I did not have any shooting nerve pain, or dizziness, or malaise, just the mesh hindering any attempts to lead an active life. It was like a prison.

Good luck. I seriously recommend that you don’t make your choice based on convenience or cost, unless you have to. As you can see from even very recent posts, surgeons who have been doing things a certain way for many years will generally just keep doing them that way. They’re not keeping up. Just like people are still getting mesh implanted that will cause them problems two or three or five years from now, there are surgeons who think that leaving 30% of the mesh inside is pretty good.

I had broken out my old German language books and was studying up to make a trip to see Dr. Muschawek in Germany, in parallel with talking to people in the states, while exploring my options. I had even called Dr. Petersen’s office down in Las Vegas and had the details needed to travel down there and have the open procedure done. But after talking to Dr. Billing I chose him, because he was very sincere, confident, and had the experience. Dr. Billing has been removing mesh for about eight years. From what I’ve read, Dr. Towfigh, Dr. Belyansky, and Dr. Billing use similar methods, TAPP, except that the first two might use robotics. Dr. Billing does not. The procedure is very time intensive, so I needed two surgeries, one for each side. I’m still not clear about the need for neurectomies, which might be another difference, and should be discussed.

[Good intentions]

I had the TAPP procedure used to remove the mesh. He got most of it, but like others who have had mesh removed there was a certain area that was too tied up with critical vessels to take the chance. That was on one side, where he left a small patch on the posterior wall. On the other side he thinks that he got all of it. Because of the constant irritation the whole abdominal wall gets scarred up. So, the hernia(s) are gone. After a few years of the body dealing with the scar tissue, they might come back, but there’s no way to predict it.

The recovery is ongoing. Even without the mesh, my lower abdomen is still stiff and flat, but getting more flexible. But, unlike when I had the mesh inside me, it’s a constant upward progression, rather than a slow stair step downward. There’s hope and I feel like I’m making real progress. I just don’t know how far I’ll get. There were some fairly immediate improvements, but getting back to pre-mesh levels might take some time. I’m taking it slow to allow time for tissue stretching and getting used to the new loads.

I’m hesitant to recommend removal in general because I see many different removal procedures being described, from open surgery with triple neurectomy all the way to my procedure, and beyond, using robotics. In my case, it was just a straightforward mesh removal, with no nerves cut, just a very tedious peeling of the mesh from the abdominal wall. But I know that many surgeons cut nerves as a matter of course when they do mesh removal, even the skilled and respected ones. I don’t know how they make that decision.

Ideally, expertise in mesh removal would become a skill that is shared and discussed widely, just like the skills for mesh implantation are. The robotic surgery trend seems to be promising, and seems so suited to mesh removal that mesh removal might yet become accepted as a normal procedure. Maybe then the mesh problems won’t be so quickly discounted.

Good luck. Feel free to ask more questions. I’ve delayed sharing my story because I wasn’t sure if it was going to “stick”. It’s only been 4 months and some days since the second surgery (one side at a time), but things are good so far.

[Good intentions]

Here is the link for Proloop, so that you know what is inside you.

If you look through the past threads, make sure to read Chaunce1234’s posts. He has a good list of surgeons who will remove mesh, if necessary.

http://www.atriummed.com/en/biosurgery/Documents/009966-PROLOOP.pdf

[Good intentions]

Here is a link to Atrium’s web site. If I post too many links I might get blocked.

http://www.atriummed.com/en/biosurgery/default.asp

[Good intentions]

I suggest that you spend a lot of time searching and reading about hernia repair mesh problems. There are many different forums out there where people describe their own situations. It’s difficult to tell how widespread the problem is, and there is some uniqueness to each person’s problems.

Your Proloop Plug is from Atrium, a company that is an example of how far out things have become in the mesh repair world. Atrium has a variety of “solutions” including, for example, a run-of-the-mill polypropylene mesh which they have coated with Omega-3 fish oil, a food supplement. The FDA has apparently approved this odd material as a bona fide hernia repair material. Not to make you more nervous, but your situation is kind of unique and the company whose product you have is not one of the big ones. The Proloop product is essentially a bundle of polypropylene fibers which are placed in to the hernia defect, apparently to encourage tissue ingrowth, creating a plug of polymer and human tissue. The directions for use are very much like those for a tubeless tire patch. Insert product in to hole, fasten with suture.

If I were you I would find a surgeon who does mesh removal, and also repairs hernias. As you’ve found, many will discount mesh problems with little thought. You need to find one who is broad-minded and experienced. You’ve had the product inside you for over three years. Obviously, to the open-minded doctor, something is changing, it might be the mesh. To the narrow-minded doctor, it can’t be the mesh.

Good luck. Keep researching and reading. Unfortunately, you’ll probably have to make a very impactful decision on your own, based on what you learn. You’re out of the main stream.

I’ll try to post some links to Atrium’s products in following posts.

[Good intentions]

quote SomeGreyBIoke:

Apparently majority of the problems experienced were with the old meshes, newer ones are better tolerated by body

No offense GreyBloke but I think that this is backward. The mesh materials are still about the same, old and new. Polypropylene or polyester, variations of weave and design, sometimes blended with absorbable fibers. And many of the threads you will have seen on this forum are from recent surgeries. I has state-of-the-art Bard Soft Mesh implanted by a state-of-the-art surgeon using the latest methods in late 2014. Then had it all removed three years later. It was almost the worst experience of my life, the three years of realizing that I wasn’t going to get better, and that the experts I had trusted really did not know and/or accept that the problems with the material and/or the procedure were real.

The majority of the surgeons who do this work are trapped in the mess. They really have no choice but to repeat or pass on what the medical device makers tell them.

I had the same general thought, back in 2014, just three and a half years ago, that you’re expressing – that the latest materials must be better. How could they not be, there’s no way that this could be allowed to go on for years? But it’s true – the problem with mesh implantation has been around for at least 10-15 years, probably longer. But they have committed to making it “work” and can’t go back. Don’t get lulled in to trusting the big institutions. Find an individual who can say, honestly, that they have patients who are known to be doing well with what they plan to do. Even then evaluate if they really “know” that to be true. There is a lot of psychological pressure to believe that it works.

This a big problem and these doctors really are stuck with it. They can’t get out from under it. Do them a favor and be very certain that the procedure you choose will deliver the results that you want. Surviving is not enough, you need to be able to live with it. Read the stories about the repetition of “no recurrence” when people go back to their surgeon with discomfort. Recurrence is the measure of success, not quality of life. And realize that the discomfort is constant and never goes away, if you get the wrong material and procedure, whatever that may be. Nobody is tracking results, good or bad.

[Good intentions]

There is a new “sticky” at the top of the forum’s main page, about sports hernias.

[Good intentions]

Jim82, if you could come back every few months, good or bad, that would be fantastic. Despite the huge number of hernia repairs, it’s very difficult to find any real-life success stories. There’s no way to tell why, if it’s something people don’t want to talk about, or if things are so good that they’ve forgotten they ever had a hernia.

I started a thread to try to collect some, hoping that something positive might show up. If the bad can’t be weeded out, maybe the good can be identified.

https://www.herniatalk.com/6883-successful-good-mesh-stories

[Good intentions]

Dr. Towfigh has written quite a bit about “hidden”, or occult, hernias. You can find a lot on this forum, and on the internet if you search those words and her name. Send her a message or contact her office directly.

Here is some information from her practice’s web site –

https://www.nytimes.com/2011/05/17/health/17brody.html

http://www.beverlyhillsherniacenter.com/hernia-education/types-of-hernias/