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  • Seeking advice

    Hello all. I stumbled across this site while doing some internet research and seems like a good place to hopefully find answers to some questions. My situation is this, I had bilateral inguinal hernia surgery in May 2018. The procedure performed was (and I'm quoting this directly from the operative report) transperitoneal laparoscopic repair of bilateral inguinal hernias with large light 3D mesh.
    My situation is at approximately 18 months after surgery I'm experiencing what I call a symphony of assorted pains and discomforts. Specifically strong pain in my abdomen, groin, and testicles. The abdominal pain is exacerbated when I lift my hands over my head (swimming really sucks). The groin pain is exacerbated by range of motion exercises (like stretching, yoga, bike riding). The testicular pain is acutely felt when my testicles ascend up into my abdomen (cold weather, vigorous exercise, ejaculation). I began experiencing these pains approximately one year post surgery. At that time I initially went to my PCP who diagnosed my problems as epididymitis. I took two different rounds of antibiotics and didn't have an improvement. So I went back to the surgeon who performed the operation. He ordered an ultrasound scan which didn't show anything abnormal.
    So, my first question is "what the hell is going on!?!" I'm confused why I'm experiencing greater pain now, a year and a half after surgery, than I did a year ago. What's even more disheartening is that I'm feeling pain in parts of my body that didn't hurt before I had the surgery.

  • #2
    The polypropylene fibers of the mesh do not have the same elasticity as body tissue. So when the tissue stretches and the fibers don't there is probably some tearing or debonding of the tissue from the fiber. This leads to more scarring/"healing", and possibly movement of the mesh over many tearing and healing cycles. This is my theory, based on the materials used and the symptoms and results from my own experience, and my limited understanding.

    I had the same problems with overhead movements. Only now, two years after removal, have I regained the ability to reach over my head, like, for example, trying to touch the ceiling, without feeling pain later.

    Are the areas of the mesh getting flatter (if they aren't perfectly flat already), and tighter? Does it feel like you have a thin plastic picnic plate in your abdomen? That's what mine felt like.

    You might find that your only choice is between certain activities and feeling comfortable. In other words, you have to give something up. In today's standard of care, if you are alive and don't have a hernia, the procedure was a success. The mesh is where it was placed, right or wrong, and that's just how things are done today.


    • #3
      Good intentions , the plastic plate analogy is spot on. What's strange is that I didn't have that feeling of a foreign object in my abdomen for the first six months or so, but each month it seems more noticeable.
      I haven't noticed any real external change in my abdomen. Mostly it's been a gradual progression: what started out as an irritant pain (2-3 on a scale of 10) became discomfort (4-5), and now is just straight-up pain (7-8). The abdominal pain is an annoyance, but the groin/testicular pain is giving me some concern because well... it's my groin, of course.
      Not terribly thrilled by the idea of giving up physical activities. In fact one of the first questions I asked the surgeon was whether this procedure would affect my ability to partake in all the things I love to do: bike riding, swimming, hiking, etc. and I was told that I'd be back to my old self after 6 months to a year of healing. Actually I felt pretty good at the six-month mark, but since then have had increasing issues. Ugh.


      • #4
        Good intentions . So I had a followup question. As I understand, based on your reply, you had your mesh removed. So my question is what were the events that led you to that decision? I'm trying to sift through all the information that surrounds this topic, and this particular forum is a fantastic resource as it allows people to discuss this situation with folks who are in the trenches so to speak, with real life experience. Thanks again for your time and info!


        • #5
          It was the insidious and persistent degradation of me, physically, mentally, and emotionally. I could not get out and be physically active without suffering, or "paying for it" afterward, for days at a time. I was spending so much time trying to define the very small cage that I was living in that I was neglecting personal relationships. I was no longer "available' to family members that had been used to my help in the past. They suffered too as a result. My whole life was revolving around trying to manage my messed up abdomen. Even though this was enough to warrant removing the mesh, to my thinking, more serious issues started to develop. My penis was affected physically, in ways more than just erectile. My digestive system did not work the way it had when I felt healthy. Physically, the degradation seemed to be getting worse.

          Overall, I felt like I was just waiting to die. Life was not enjoyable anymore. There was no hope of managing the mesh problem back to some sort of life worth living. the decison to have the mesh removed was easy. Ffinding the right person to do it still took a lot of work. It has been almost two years since the mesh was removed and the more time that goes by the more I realize that Dr. Billing is very skilled at mesh removal.

          Since having the mesh removed, all of those problems have resolved. I'm still damaged down there, my abdomen is still abnormally flat, but all of the normal bodily functions have come back. As a result I am also "back", involved in life, and looking forward to better things. Having mesh implanted to fix a hernia was the worst decision I ever made. Having it removed was the best.


          • #6
            T. Johnson- I had the standard weight Bard 3D Max placed via TEP (yours was TAPP method) in May of 2018 for left side. All is good so far, knock on wood. I had a medium size 3D Max Light put on right side with single point of fixation on 11/7/19. I'm 5'7" male and 150-155 pounds and very active). So far so good. From my extensive research and info on this forum, I have gathered that if you have immediate (or shortly after surgery) burning or stabbing types of pain, then most likely nerves or spermatic cord were affected. You did not experience any issues until approximately 6 momths to one year post op. SOME people who do experience issues like you is because of the mesh itself. As it contracts and tissue grows into it over the first year, it may fold over onto itself, or it migrated, or in rare cases got infected. This is ONLY speculation. The surgeons who contribute to this site may advise you get an an MRI without contrast and read by a knowledgeable person to help figure out what is going on. I'm kinda in the same boat in that although I'm doing well from my 11/7/19 surgery, I really have to wait a year or so to truly know that I'm out of the woods so to speak.

            Bard 3D Max light comes in several sizes and my surgeon said it is important to pick the right size for the body type. Too large a piece for the inguinal canal can possibly increase the chance of folding over (this is just my opinion).

            Two things: I would respectfully suggest you find out how many TAPP surgeries using this brand mesh your surgeon has done and did he use any fixation via suture of tack. The standard weight 3D Max is usually done with no fixation, the light with a single point of fixation, possibly 2 at most. Also, were you mainly sedentary or active in the first year?.

            You can also PM me if you prefer or just reply to post.


            • #7
              T. Johnson Find a surgeon who removes mesh to talk to. They will be open-minded and consider all of the possible causes and solutions to your problem.

              From my own experience and research I've found that most surgeons who repair hernias with mesh will go to extreme lengths, mentally, to believe in the mesh solution. They will waste your time and money sending you to various other specialists, who will not have experience with mesh problems. They will deny, deflect, and dissemble until eventually they give up and stop responding to you. The situation has been this way for many years. The hernia repair field is essentially owned by the mesh device makers. They sponsor the conferences and support the institutions that train future surgeons. They sponsor research designed to show the benefits of mesh but do not show the benefits of non-mesh solutions. The "International" "Guidelines" are the example of these things.

              Sicily and myself followed very similar paths. He, so far, has a good result. I had a bad result. My surgeon for the Bard Soft Mesh implantation is well-known and respected in the field. But he is still captured by the device makers' control of the hernia repair field. To his credit though, he was in the process of finding me a mesh removal surgeon when I found Dr. Billing instead.

              Good luck. Don't trust the "system". It is designed primarily for the masses, the average patient. You are outside of the norm so need to think that way.


              • #8
                T. Johnson
                You need to see a surgeon who has extensive experience removing mesh.
                He/she will carefully evaluate your situation and help you make decisions.
                Bill Brown MD


                • #9
                  So I'm going to take DrBrown s advice and meet with an experienced surgeon. I've identified two surgeons that are relatively close to me (Pacific NW), Dr Martindale in Portland and Dr Billing in Seattle. My next question is seeking comments from people who've been patients of either of these doctors.
                  Thanks again for input and advice, this has been very helpful as I wrap my mind around this increasingly troublesome situation.


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