[Herniator]

Every time you have an operation you create scar tissue. The best way to deal with this is to break down scar tissue manually so it can remodel and hopefully not give you as much in the way of contractual pain. So your answer lies with physiotherapy

[Herniator]

We will have some answers to autoimmune responses and possibility of ASIA syndrome soon enough. My study Tackomesh is investigating patients after hernia repair by measuring the presence of at least 20-30 autoimmune markers or not from blood samples already taken before and at certain time points after surgery. Surgery involves mesh implantation. So watch this space
And I concur with my colleagues that you will not have a problem with erectile dysfunction, those nerves are very deep indeed.
H

[Herniator]

all hernia repairs have a risk of chronic pain and most operations that involve an incision will have a risk of chronic pain – in addition whether you have mesh or not the incidence of you having chronic pain is the same. But will it effect you and your sports – it is unlikely, rare but possible (now I sound like a lawyer). The caveat here though is that any non-mesh repair has a much higher chance of recurrence – so back to the OR you go!
I would ask that you choose your surgeon, one that undertakes a lot of hernia repairs will be the one to go for.
Good luck
H

[Herniator]

I can help and see you – please email me thorough my website Manchestergeneralsurgery.com

[Herniator]

You need both 🙂 http://bjsm.bmj.com/content/early/2013/12/10/bjsports-2013-092872

[Herniator]

Thanks for sharing your experience: Hernia surgery will not address your period pain, the findings on the scan are incidental ? I would investigate the period pain first, then hernias can be operated on especially if symptomatic, but may not cure this pain

[Herniator]

I’d go with Dr Towfigh’s suggestions

[Herniator]

Thanks for clarification – I would inject your groin nerves with anaesthetic and steroid in the first instance under ultrasound guidance – if the pain is resolved (usually lasts a few days only) then I would consider nerve division with mesh removal – however a course of nerve pain killers is still worth a shot ?

[Herniator]

Hi

Did you have pain before the mesh was used to repair your hernia? you will need a thorough assessment with nerve mapping, magnetic scans and also an XR – do you know if tacks were used to fixated the mesh and is your pain more of a discomfort or sharp irritation when you touch the sensitive area (latter related to nerve pain, former maybe mesh related?) You must be aware that mesh removal may not make the pain better?

[Herniator]

Hi – your original hernia repair was method was used please? how big was it and was mesh used ? – if open, +/- mesh then Lap repair is best way for you in any attempted recurrent repair – it is more painful in the first 24 hours and will utilise mesh – Dr Towfigh’s recommendations are excellent

[Herniator]

Its good to hear experiences of patients as it helps us learn more – much obliged and have a hernia free life 🙂

[Herniator]

Best if we wait the full three months post op to see where you are up to, physio with careful stretching your groin area + gentle massage therapy in the meantime may help – if the pain/ discomfort continues you ideally should have an MR scan to see if there are any mesh related factors and a pelvic XR may help – Most patients that I see with your symptoms do get better in 3 months but I have never used tacks so I am inclined to feel that this is most likely tack related pain until proven otherwise, here is one my papers https://www.ncbi.nlm.nih.gov/pubmed/24770891

Best Wishes
A

[Herniator]

1) Mesh shrinkage occurs to about 30% – it incorporates into the normal body tissues and creates neo (new) collagen, but will remain. The mesh composition will decide on amount and degree of new collagen – most data is from animal studies, but overall the risk is very small for you to experience an immunological reaction – https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3895198/ https://www.ncbi.nlm.nih.gov/pubmed/22575883
2) Chronic groin pain is defined as pain after three months and if neuropathic (pin point sharp pain) then the nerve can be damaged/intertwined or irritated by the mesh or by surgery itself – in lap, mesh will lie in contact with the nerves and can present commonly with pain in the front of the thigh and open will present with groin pain around the groin crease and pubic bone – if you have no pain then the likelihood is that the mesh is not causing you any problems and this is the case for at least 94% of persons as shown in most large hernia registries and randomised controlled trials.
3) If you are young, have prior pain and elect for an open repair then you are more likely to have pain post op – but the incidence remains low around 2-5% – risk of complications is also low and I would seek out a surgeon with relevant experience in this area – all surgery has risks but leaving your hernia and having a later repair increases the chances of you having potential complications from surgery.
4) 30 years is a long time and most long term follow up data is usually up to 3 years – for longer term data I would examine the Danish Hernia registry which has the largest outcome data collected over many years with 10000s of patients. If your mesh has caused you no problems in the first three months then the likelihood of it causing you problems in the future reduce over time although like everything in our profession nothing is absolute https://www.ncbi.nlm.nih.gov/pubmed/11597665

Hope this helps
Good luck
A

[Herniator]

Need to exclude Ehlers-Danlos or any other such collagen disorder (you would know if you have Marfans bby now) – biological mesh eventually disappears but is designed to be safe – so no need to blame the poor pig ! I would not have another repair just yet unless collagen disorders are excluded first – then I would suggest you will need a synthetic mesh

[Herniator]

where were your other surgeries please – itching albeit rare could have been caused by the occurrence of the hernia – any abnormal or new sensation will suffice

[Herniator]

I’d go back and see the hernia specialist and your GP should authorise this OK especially as you have pain and need a stress ultrasound – please make sure a musculoskeletal radiologist undertakes the scan

[Herniator]

I’m pleased that you are better – but mesh overall is very safe as well as recommended
http://mailchi.mp/23a275fbe343/j114lk1gnu

[Herniator]

Hi Tacks cause pain regardless of whether an absorbable or permanent tacker – the most common nerve damaged in Lap groin surgery is the lateral cutaneous nerve (pain on side of hip) and femoral branch of genitofemoral nerve (pain in the front of the thigh). Where exactly is your pain please – Tack should ideally be removed as nerve is irritated, but you may find that it will burn out in three months or so