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Dr recommended mesh removal......


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  • Dr recommended mesh removal......

    Looking for opinions or advice. Had bilateral inguinal (indirect) hernia repair (laproscopic) in 2014. 4 months ago, something went wrong and I felt a tear. Now, I have severe muscle spasms and sharp pains regularly. After a CT Scan and two MRIs, and Dr recommended mesh removal. He said the second MRI showed some fluid built up near my pubic bone, suggesting some sort of irritation.

    A brief timeline of my current injury/history:
    Nov 2014, bilateral inguinal hernia repair w/mesh. Healed and was more or less problem-free w/ occasional discomfort. Maintained a generally active lifestyle (jogging, limited weight lifting, rowing, caving, etc).

    Dec 2018- started an intense stair-running workout routine which I did for several weeks. One night I crossed my legs on the couch and felt a lower abdominal “tearing” sensation, near my pubic bone / surgical site. However, there was no immediate pain at that time. Several weeks went by with no real issues.

    Jan 2019- I did tricep rope pulldowns for the first time in ages, including some that stressed my stomach. Pain began the next morning.
    Pain was near the pubic bone (right side) and hurt to touch. Most activities (pushups, etc) did not hurt, but it did hurt to cough vigorously. I was obviously fearful of a hernia recurrence .Local doctors said they could not detect a recurrence, but none of the exams were very thorough. CT and MRI imaging of the pelvis (which I brought with me) were said to be unremarkable. Doctors were unable to offer a diagnosis and suggested rest and NSAIDs, which did not work at all.

    Feb, March 2019 – The problematic spot no longer hurt to touch, but initiating motion (even just getting up from sitting and walking around the office) often caused a sharp pain above my pubic bone, and spasms became constant (which is a major issue to this day). After several weeks, there was also a burning/irritating pain that affected the whole region between belly button and pubic bone, especially when bending.

    April 2019 - Sharp, focused pains above my pubic bone persist, even with minor activities such as walking, pushing open a heavy door with foot, and mowing the lawn with heavy boots on. Even shifting my posture in the chair can send a jolt of pain. One day, I did some pushups and felt fine, but immediately afterwards, I lifted the hinged cover on my grill (5 lbs) and felt like I had been stabbed. Straining in general causes pain, although situps don’t hurt and neither do pushups. Light jogs are ok. Any sort of weight-based exertion tends to intensify the pain. I usually get hit with several sharp “jabs” of this pain per day and ceaseless spasms – the spasms are just never ending. Sometimes, bending to lift things off the floor will be painful (like a garden hose). Spasms are on both sides of my abdomen. They have been going on endlessly for months. The spasms are near-constant and are very, very distracting. Muscle relaxers are ineffective. Second MRI ordered which shows the moderate amount of fluid near the pubic bone.

    I have a one year old baby, and carry him against my stomach, the increased pressure can cause significant pain in my lower abs/groin. This is usually followed by an increased amount of spasming. Sometimes, when we are reading bedtime books, if he leans back against my belly it can be painful. Once or twice, it has been mildly painful to take a deep breath. Hugs can sometimes cause discomfort as well. I am having to get my wife to do basic activities, such as lifting our baby and doing things such as yard work and taking out the trash. Multiple people have commented on how I “look like I’ve lost weight”.

    I thank anyone who can offer opinioins/guidance/assistance as I try to overcome this difficult issue.

    1. Spasms
    2. Sharp, localized pain above pubic bone when I initiate movement/shift posture/lift things up
    3. Irritation/burn pain with certain postures/movements near crease in belly
    4. Pain near pubic bone w/ belly compression

  • #2
    Sounds like a recurrence.
    It’s not uncommon for imaging to be misread by the way.
    Last edited by drtowfigh; 05-12-2019, 11:25 AM. Reason: Typo


    • #3
      Be prepared to travel and potentially pay out of pocket to seek the top (very few) surgeons who specialize in mesh complications and mesh removal. Since you were implanted lapro the bed t way to remove mesh of indicates is by the same method it was put in so you will want to find a surgeon who specializes in lapro removal

      there are threads on this site that list removal surgeons .

      There is dr. Towfigh CA
      dr. Igor Belyanski in MD
      dr. Brian Jacobs in NYC
      and others
      I had my mesh removed by dr. Igor Belyanski and and am doing very well. Recover can be slow and non linear and you can notice improvements at intervals all the way into the year and year and half marks. I can also Dr. Belyanski is doing many removals these days and as someone who has been in touch with many of his patients I personally haven’tt met anyone who is worse off after removal of that was what was decided on.
      Some are 100% some 90% and so on. You are welcome to PM me if you have any specific questions and I am happy to put you in touch with other people who have had their mesh removed.
      it is a big decision and not one to take likely and I always rx people consult with at least 2-3 removal surgeons get as much info as you can and make the best decision.
      Dr. Towfigh this forum is great and your personal professional opinions are great. One point I would disagree on from personal experience and from speaking to so many other people is that mesh issues can occur way down the line without having any major initial issues in the first year.
      For me personally my major issues started 6 1/3 year after implantation and became quite debilitating.
      All tests normal (cat scans multiple MRI’s of groin back and hip-GI doctor, Urologist etc all “normal” findings.
      After a exhaustive 5 month search I found dr. Jacobs whose best educational guess after seeing some weird abnormalities on one of MRI’s was that it was something wrong with the mesh and he would perform diagnostic lapro explorato
      ry surgery. I wanted a second opinion and sent my CT scan to dr. Belyansk as that is what he specializes in reading and he saw that the mesh was bent and shifted.
      I ended up having removal with Belyansk and traveled to Maryland. It was a 3 hour surgery and he found my mesh was completely balled up and rock hard and attached to all sorts of structures it shouldn’t of been.
      We know ourselves the best. The majority of the medical community is clueless when it comes to mesh issues. If you are having issues in the area where the mean was inserted and have had test after rest doctor aftter doctor tell you that you are fine then there is a good chance that your issue is due to the mesh or related to the mesh repair.
      seek out the best surgeons and make the best decision you can!
      bedt wishes


      • #4
        Jnomesh of course dr. Igor Belyanski is a great doctor ..does he do excellent no mesh repair as well ?


        • #5
          Jnomesh dr. Igor Belyanski is a great doctor ..does he do excellent no mesh repair as well ?


          • #6
            Thank you all for the kind words and follow up. I apologize for posting 4 times, there must have a been a time delay with my initial post.

            I am going to see Dr. Belyansky next month. I wish I could see him sooner but logistically that will not be possible.

            To answer some questions - the surgeons I visited did a brief "cough" test and pressed to the side of my pubic bone while I did so. They said it felt good and tight, but my initial surgeon didn't put much stock in that test, saying it's not really a good way of detecting a small hernia. She said that a CT scan is required to really know.

            CT Scan was negative.

            Second doctor I visited told me before he even did the cough test that he didn't think it was a hernia. Then he, too, said all felt good and tight and suggested NSAIDs. He did order a pelvic MRI to confirm/rule out hernia which also came back negative.

            Interestingly, when I was first diagnosed with inguinal hernia in 2014, they did a rather uncomfortable evaluation where they put a finger "up my scrotum" and felt around that way, which is how they detected it. Nobody has repeated that test this time, which makes me feel like they aren't being as thorough as they were at first.

            A third doctor I saw ordered another MRI with his own, special protocol. Nothing definitive still, but he did say there was a modest amount of fluid built up near the pubic bone.

            In any case, I was very active after my first repair. They only thing I didn't really do was lower body weights or pullups. I did just about everything else, including rowing. A recurrence was always a fear of mine and I didn't want to risk it. When I started my stair running routine 4.5 years later (so foolishly), it was probably the most lower body exertion I had done in years. I was running up the stairwell of high-rise office building every morning, and then started doing it twice a day (18 stories up each time). I felt great at first. But after 3 weeks of this routine, there was a small tender spot halfway between my belly button and pubic bone. I called of the stairs after that. Things felt just a little bit off. A few weeks later I felt a ripping sensation in my groin when I crossed my legs on the couch, and I knew something was very wrong. I wonder what ripped - my mesh? My tissue? Who knows. Then the pain/complications took over.

            I really have been devastated by this and I am not handling it well. 6 months ago I had it all. Great new job, 1 year old baby, happy with life, active lifestyle. Now it is considered a good day if I can manage to mow the lawn without complication or roll over in bed without waking up due to the pain. Spasms, spasms, spasms have come to define my days. Now in the 5th month, it has been very trying on me and my wife. 90% of the pain is on the right but I do get left sided spasms that make me wonder if this issue is bilateral, even though that is statistically unlikely. I would give almost anything to go back in time and avoid those stairs.


            • #7
              Hi mitchtom6, thanks for sharing your experience I hope you can recover soon and it is not something serious.

              I have been diagnosed by a bilateral inguinal hernia, I am very active, and I haven't had my repair yet, here most of people are having issues with mesh repairs, and some of them claim a pure tissue repair as the best way to do it.
              In my opinion I think no matter which route you take you will never be the same person and probably after any surgery (mesh or no-mesh) I would give up activities like running, cycling and all sport activities, and just be careful with anything that you lift, unfortunately this is our fate.

              I wish you my best for you!


              • #8
                Originally posted by mitchtom6 View Post
                Thank you all for the kind words and follow up. I apologize for posting 4 times, there must have a been a time delay with my initial post.

                A few weeks later I felt a ripping sensation in my groin when I crossed my legs on the couch, and I knew something was very wrong. I wonder what ripped - my mesh? My tissue?
                I've had that happen to me. The ripping is the sense you feel when the mesh detaches from where it's attached. Like a zipper. It's not painful. The pain comes later as your hernia reopens.


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