Good intentions
Forum Replies Created
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Do you know what type of mesh was used, and how much? All types of mesh tend to get lumped in to the one small descriptor of “mesh” even though there are many many different types. And surgeons use different amounts, some only treat the existing hernia, others will fill as much space as possible, to avoid future recurrence.
The poorly defined materials and procedures used around the world is one of the big problems with solving the chronic pain issue with “mesh”.
Good luck. You’ll probably experience changes at the repair for at least a year, maybe longer.
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quote clbear:My replies on my other thread are unapproved ?
This happens on the site occasionally. If you send a message to Dr. Towfigh she might have time to fix it. It has happened to me several times. It’s a problem with the site’s anti-spam software, apparently.
The SAGES conference is coming up in two days, so she might not be as responsive as usual. Professionals often meet up before the actual meetings to conduct business. Hopefully some progress will be made on this mesh travesty.
Good luck. Keep posting here. Don’t forget that there are many people who probably see what is written but don’t participate n the conversation. It is still useful to share your experiences.
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Do you know what type of mesh was used? There are many different kinds, and it’s unclear if they have real differences in performance. And was the original hernia direct or indirect? Did you get your surgical records?
Is the surgeon famous for hernia repair or just generally famous? Have you told him or her about the failure? Maybe they can use their fame for some good.
After a TEP surgery most subsequent hernia repairs are done via the open procedure. Some surgeons will try TAPP, depending on what they are trying to fix. TAPP leaves more and bigger scars than TEP.
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It sounds like the very common dissembling answer, avoiding saying what needs to be said. Mesh-induced pain.
You’ve probably seen my recommendation about getting your medical records soon. Many organizations purge their records after just a short time. Get your records, write up a good description of what you feel and when you feel it and send it and your records to surgeons who do mesh removal.
I think that the surgical field is divided in to two basic camps, regarding hernia repair – one that denies, refuses to believe, that mesh-induced pain exists and structures all of their diagnoses around that presumption. “It must be something inherent to the patient, not the mesh prosthetic”. And another camp, composed of true physicians, that accept that mesh-induced pain is real and needs to be treated as mesh-induced pain.
It’s a sad situation that is turning many honest well-intentioned doctors in to less than they could be. Like their patients with mesh problems. Everybody loses.
Get your records and find a doctor who does mesh removal. The ones who don’t will not “see” what needs to be done. I’m not saying that you will need it removed, but the doctor has to accept that mesh might be the cause before they can create a proper treatment plan. If they avoid the mesh as a cause, they will be treating other conditions and wasting your time, along with the time of the all of the other professionals involved. It’s incredible how much time and money was spent on my problem, all wasted.
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I just posted in your other thread. But forgot to say that one advantage to talking to a doctor who has removed mesh for a while is that they will recognize your symptoms and might also have experience with your specific type of mesh, maybe even your surgeon.
I wasted a lot of time working with a surgeon who did not remove mesh. He was trying learn as he went, on a topic he really wanted to avoid since he had implanted the mesh. I got an MRI, and saw a urologist, and did some blood testing. Even though it was obvious that the mesh was the problem.
A surgeon with experience removing mesh will have seen all of the signs before.
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Sorry, I misread your post. I see the part about neurectomy. I did not have any neurectomy done when my mesh was removed. I also did not have any referred pain, or pain typical of nerve pressure, like shooting pains, or sharp pains. Mine was just dull soreness, pressure, and swelling caused by normal activities like running, biking, physical labor, etc. There were also side effects for other body functions, in that area, due to large scale inflammation. They all disappeared or diminished dramatically after the mesh was removed. I am now more like a person who just got stabbed in the abdomen several times. Slowly working through stretching out the scar tissue.
I have seen accounts of surgeons who cut nerves “just in case”. Nerves do grow back but the nerves they are cutting are large. You probably want to get very clear advice on what they plan to do, before you choose a doctor.
It seems that, because there is not a clear acceptance of what causes the pain, that there is also no clear acceptant of what to do when removing it. Nobody wants to accept that it’s just the mesh. So they cut nerves.
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The self-adhering nature of the mesh is more of a short-term adhesion. To hold it in place while tissue “ingrowth” occurs. Once ingrowth occurs it is probably just like a common mesh. After a few months they all look the same.
The reason for the development of self-adhering mesh is because one of the original causes proposed for mesh pain was the tacks, staples, or sutures, used to hold it in place. But, it’s becoming more clear now that is it the mesh itself that causes pain.
Beware of the gimmicky nature of some of the newly developed mesh products. The sales literature is for selling. And these products are actively sold, by professional marketing and sales people.
The surgeon you choose should be able to tell you about patients he or she repaired years ago that are very happy with their decision. If they can’t tell you about them they probably don’t exist.
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quote SighFigh:Good Intentions,
Would you mind telling me what surgeon you used for the last repair? You can send it me by private message if you don’t mind.
thanks in advance!
There was not actually a repair, just removal of the mesh. The tissue around the mesh has become stiff and leathery, so the hernia is gone. In the big picture, I traded one type of damage for another. And paid for it with three years of life quality and a lot of money.
Sorry. It looks like you’re seeking a solution to a hernia problem. I think that the surgeon who removed my mesh also uses mesh for repair. We did not talk much about his hernia repairs, only my mesh removal.
I still recommend trying to find a surgeon who knows of at least a few of his or her patients that have returned to their former activity levels, and can describe them to you. And make sure that they are using the same method that worked for those patients. Many surgeons are getting drawn in to changing to laparscopic large area implantation, covering all of the lower abdomen with mesh, for the speed of surgery and the prophylactic aspect of covering a large area. They’re changing from what used to work, but with a low level of recurrence, to untested methods that cause new unexpected problems.
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quote miner:Keep in mind most professional athletes have whatever surgery gets them back on the field fastest not what might cause chronic pain. As they can play through chronic pain with medication.
I don’t think that this is true. I’ve thought of the difference between professionals and athletic people and the effort expended by each can be similar. The skill levels are different but the work on the body is about the same. The damage that the mesh does is not just pain, that can be disappeared with drugs. It’s real damage, with swelling, and inflammation, followed by healing efforts. There are also real effects on physical function in that area. Constant inflammation causes other problems. You would expect professional athletes to be even more sensitive to the physical damage that the mesh causes.
When the meshes are removed they are always smaller than when they were put in. They’re not flexible anymore, not soft, not pliable. Often the tissue around the mesh is inflamed.
Once a procedure has been shown to actually delay getting back to performance levels for pro athletes, it is avoided. The managers, agents, and support people behind the athletes know what will work long-term. I doubt that the athletes themselves have much to say about the procedure used. It’s a financial decision. You can find old literature where they tried to use mesh to repair athletic pubalgia, aka sports hernias. They don’t do that anymore, it didn’t work.
I didn’t mean to write so much, rejecting your idea. Sorry. The short answer is, actually, that laparoscopic mesh implantation is a one hour outpatient procedure. And because the incisions are smaller, the healing is faster. Rapid return to work is one of the main selling points for laparoscopic mesh implantation. It should be the fastest way for a pro to get back on the field, and they don’t use it.
You’ve actually helped form another argument against mesh implantation. If it really was what they say it is, professional athletes would be using it.
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quote SighFigh:Good Intentions, and Dr. Kang, thank you both for the info.
Good Intentions, did you have the mesh removed?
I did have it removed and I’m doing well. I had immediate benefit after the removal, but the full recovery is taking longer. Three years of constant irritation seems to have thickened the tissue of my lower abdomen to a leathery, less flexible quality. It’s taking a while to loosen up but progress is consistent.
There was someone on the forum recently, ajm22 I think, asking about the best surgery to have and I recommended waiting, if possible. There are some interesting things happening in the field. The “standard of care” seems like it must change relatively soon. Things seem to be getting more clear about what works and what doesn’t. Mesh has many problems.
ajm22 was about to have mesh implantation not long ago but he has not been back. I’ve found that this is fairly common on the forums, which is somewhat disturbing. People are usually happy to tell about their successful journey through a traumatic experience, especially after they’ve received helpful advice. I’ve only seen two people, on a different forum, actually come back and describe successful mesh implantation results. I think that most just don’t want to talk about it, which is telling.
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quote Milo:Hi, currently 6 hours post-op;
I think that 6 hours is way too early to be trying to asses much about the surgery. The tissues that were damaged during surgery all leak a small amount of fluid, which builds up and takes time to get reabsorbed by the body. I had a bowling ball of jello in my lower abdomen for about two days. I think it took about 5 days before it was close to normal, and a week before it felt tight/flat again.
I don’t know if a week is a long time, but I think that 6 hours is definitely a short time. Milo, you didn’t say what type of surgery you had. Mine was laparoscopic TEP.
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I forgot to add – get your medical records as soon as you can. Many organizations only hold them for a few years.
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Read my recent posts if you want some thoughts on better surgeons to see. Most surgeons are not trained or mentally equipped to deal with mesh problems, they only know how to put it in. Dr. Billing, Dr. Brown, and Dr. Towfigh are all on the west coast, and all will deal with mesh problems.
Post your general location and people will offer more specific advice. Information from you on the type of mesh, and type of hernia would help also. Good luck.
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It didn’t work. You’ll have to click through from here.
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Here is a link to their English language sales literature.
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Here is an excerpt from the DynaMesh literature.
“However, the thread first has to be warp-knitted into a textile structure. Not just anyhow but tailor-made for the relevant indication. The right stitch makes the difference. Only through the right stitch can we achieve the “inner values” required, such as stability, elasticity and porosity. So the end result is not a “one fits all” implant but a specifically created DynaMesh® high-tech product. A product which enables doctors to perform their duties as effectively as possible – and which gives patients many symptom-free and safe years.”
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I recommend contacting Dr. Towfigh directly, either via message on this site, or through her practice web site. She has worked with many of the different types of membranes, meshes, and materials. You can find her presentations on the internet. Many surgeons really don’t know much about other materials, and they know little about the materials that they use for their hernia repairs. They trust that the medical device maker is supplying them with something that works. They trust the literature that is provided.
Your surgeon chose a somewhat new and unusual mesh, made from PVDF. The marketing literature is almost directly aimed at Bard and other competitive meshes. They even mention Bard’s standard sales line of “one size fits all”. But it is still a woven mesh, which Dr. Bendavid has proposed causes edema and inflammation, due to the small pores remaining, even though large pores are the goal of the weave design. It’s basically the same old mesh, just a different type of polymer and a different weave. The idea that large pores, or softer mesh, will be more comfortable is just a thought that softer and flexible has to be “more comfortable”. Like the mesh is an article of clothing. The meme is sued to make people comfortable with a new product. After the meshes are implanted, they all shrink and become boardy or leathery, nothing like when they were taken from the package.
Good luck. You have an unusual mesh, and your surgery seems unusual also, in that you had two nerves cut. You need to find somebody that is very knowledgeable, in more than just mesh implantation.
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Here is a link. Hope it makes it through.
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Hello Mbs. I think that you meant “neuritis”, not neurosis.
You’ll probably have to give more detail to get any kind of answer. It’s not even clear that a hernia is involved.
Good luck.
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quote Baris:In august 2017 i had bilateral hernia surgery in germany. The method used was the shouldice method
I believe i caused my firrst hernias by doing too much heavy work both in the gym and as an occupation whilst also playing football.
Dr. Ulrike Muschawek is known for working on athletic people and will also remove mesh. Have you considered her? She is in Germany.
Dr. William Meyers works on athletes also, although, apparently, he will not remove mesh if it is attached to healthy tissue. I’m not sure what that means but that’s what I was told.
Dr. Peter Billing in Shoreline WA will remove mesh, and does hernia repair. He might have good advice and a solution.
Dr. William Brown also works on athletes. I’m not sure of his opinion on removing mesh.
Dr. Towfigh is also a known expert in both hernia repair and mesh removal.
I don’t think that you’ll get specific advice over the internet. My best results have come from collecting my medical records in paper form, or on CD, writing a clear and concise letter, then sending it all to the doctor themselves.
Your story has many questions unanswered. It looks like you went right back to full activity within weeks or months. It doesn’t sound like the first surgery was “Shouldice approved”. You don’t say whether the mesh implantation was done via open or laparoscopic surgery. What type of mesh was used? Your medical records and a letter should explain all of that.