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Mesh removal triple neurectomy rehab

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  • Mesh removal triple neurectomy rehab

    Hi All,

    For those who are experiencing inguinal hernia mesh complication and has had removal with triple neurectomy or is planning on having one. Here’s a recovery pointer from a patient (not me) who had right inguinial hernia mesh removal due to meshoma and infection of the mesh, this patient had a triple neurectomy of the illio inguinial, illio hypergrastic and branches of genital.

    This was all brought about as the removal and division of nerves has not been without its problems, as anybody who has had a mesh removal or is planning to have one, understands that alone is a major operation as the surgeon has to cut through the abdominal wall/muscles and the peal off the mesh leaving the muscle wall stripped and raw, this alone will take months to recover from and only time, anti inflammatories and physio will sort this.

    The nerve division itself is something different as with any nerve they stem from the spinal cord out into branches, now when you have the nerve cut no one tell the spinal cord that a particular branch is cut and so it will keep firing, hence the pain.

    Surgeons will normally burry the nerve ending into muscle or fat which is not as conductive so in theory pain should be less but this isn't always the case.

    What you don't read and what you don't get told is that lucky people will be perfectly fine with nerve division but others won't be.

    This is due to four factors that combine to almost create a perfect storm, the first is the fact the nerves that are cut are still firing so the impulse from the cut nerve is returning a lot quicker back to the spinal cord as the nerves shorter, which in turn forms a back up or overload at the branch connection to the spinal cord which causes pain, for this it's wise to seek a pt who can work on opening the gaps in the vertebra and has a tens machine which they can work around the l2 and l3 sections of your back.

    The next problems is that the branches of the nerves which are higher up than the division also become overloaded so you now have an increased or hypersensitive of the bowel, bladder or genitalia.

    This problem is also linked to the third problem of the actual end of the cut nerve, due to the trauma of the cut nerve our bodies reaction is to supply the area with sodium which is highly conductive thus making the pain worse, the added sodium in the area means that areas of the body which rely on sodium such as the bowel and bladder to keep a healthy ph balance now suffer causing bladder like infections and a stomach which is all over the place.

    There is away you can combat both of these problems, the first being lidocaine patches 5mg which work at dispersion the sodium build up and making the cut nerves less conductive, the seconds a home remedy of adding half a teaspoon of Bicorbonate of soda to a glass of water for a week to reset the ph levels in your stomach and bladder as they will have become acidic.

    And finally the 4th problem is the actual trauma of the surgery and scar tissue, which will be significant and only time and help from a pt who has an ultrasound machine will help, if the scaring is chronic and serve a direct steroid injection into this will speed the process up.

    I hope people have found this informative as I have.

  • #2
    jerome848
    I agree with Jerome. The removal of mesh is complicated and technically difficult. The results from surgery are mixed.
    I encourage patients to ask their surgeon about pure tissue repair options.
    Regards.
    Bill Brown MD

    Comment


    • #3
      Dear
      DrBrown

      for the permanent sutures is the same reasoning as the prosthesis, or do they have less risk?

      Comment


      • #4
        saro
        The suture material can be chosen so that it will dissolve in 6 months to a year.
        Also, sutures are placed about 1 cm apart, so that scar tissue can not bridge from one suture to the next and cause contraction of the wound.
        The sutures are not placed next to the nerves or other sensitive structures as is done in mesh repairs.
        Regards
        Bill Brown MD

        Comment

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