[JR]

Dear Dr. Towfigh,
I have a questions in regards to the topic of fertility in which I relates to sex and masturbation after mesh removal surgery. How long after abdominal mesh removal do you tell your patients that it is ok to engage in sex or masturbation? Can it effect healing at all?

[JR]

Hello Dr Towfigh,
Thank you so much for the reply. So the small hernia which he found through the open incision was apparently sutured with PDS dissolvable sutures but I don’t know how good this will be long term? I also didn’t question but wondered why he was not able to detect the hernia with the robot when the doctor was inside in the first place when he removed the mesh. Perhaps he only sliced the mesh off and lysed the adhesions but then decided to repair the mesh from the open cut on top? But then the question stands as to why you wouldn’t address the hernia robotically if you are already in there, and is it possible that the sutures of the abdomen were all done via open as well since the hernia was sutured that way using my own tissues. The third thing is at what point do I investigate the ongoing soreness area and what options would I then I have to deal with it? Would it require more surgery to explore nerves at that time? Does pain scar tissue resolve over 3 months? 6 months in your experience and hopefully the nerves settle? Or is it also likely that he inserted the trocar going parallel to the sore areas possibly re-injuring or re-activating the sore muscles? Finally, can’t the lights from the robot show the areas under large visualization of the whole abdominal wall to look for nerve entrapment and possible other causes of pain? I’m just trying to understand it more since my doctor said he couldn’t see nerve entrapment from the small incision that he made. But I thought you can see the whole anterior wall with the robotic inserts in the abdominal cavity?

[JR]

Hello ajm222

I am having the same exact issues as you although I also had vertical cut above the belly over old incision which was causing pain. Although my mesh was put in both openly, the doctor who removed it said he felt comfortable removing it robotically. From the open above incision he saw a small hernia that he sutures with dissolvable sutures but I continue to have these sharp soreness along the left lines of the incision. I don’t know if this is nerves from the new scar tissue? Old? If it’s going to get better or not because work was done at the belly and nerves are all connected? I just don’t want to continue having the same soreness because that was the major reason I had mesh removed. This seems like a never ending nightmare. I also don’t know why the doctor didn’t close the hernia robotically when he was in there? I am so confused what he did exactly robotically vs what he did openly and why he is telling me he couldn’t see anything? He also mentions in the op report that he removed the meshes from the incision he made. So now I am not sure if he just made 4 trocar sites and just did the removal but pulled the meshes out from the open incision only? I asked if the extra incision served a purpose and he said yes because he was able to see the small hernia. But then I am like hmm 🤔 why weren’t you able to see the hernia robotically from the inside? He is a very skilled surgeon who came highly recommended so I am confused 🤷‍♂️

[JR]

And I know others have always said mesh should be removed the same way it was put in, but my doctor felt to remove it /Laprascopic/robotically and on op report it says he removed scar tissue but he did not think it was related to the mesh (which I respectfully want to disagree because I only developed the adhesions due to all the scar tissue that the mesh caused since I never had any scar tissue or adhesions from before the mesh). I don’t know why he thought it was better to remove the mesh robotically and when I asked him he said because he knows where the mesh is and felt comfortable removing it that way)but in the op report he also mentions that he removed the meshes from the incision that he made to explore and clear scar tissue from old incision. I am very confused with the op report because it’s inconsistent. What do you suspect happened and when I asked him why he made 4 trocar incisions instead of the 3 he said because the trocar was too close and he had to make one more that farther away. I don’t know what to think of all this 🤔 which is why I joined this forum in hopes that someone else can chime in. Thank you.