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Severe pain 14 months after TEP-repair

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  • Severe pain 14 months after TEP-repair

    Hi,



    I had a laparoscopic TEP inguinal hernia surgery in september 2014, for a small hernia on the left side. I think it was a ProGrip mesh, it was 15x12 cm with no tacks or sutures. 4 weeks later I got severe pain in my left abdomen and groin when I sat down and my belt put pressure to the area. The pain calmed down after a few days. I've had some discomfort and pain around five times the next year, but it only lasted hours or couple of days. So been pretty much pain free until november 2015. In november 2015 the pain returned, and only got worse for each day. I was at the hospital for two weeks in december, before they went in for a diagnostic laparoscopy. They found out that the mesh had folded a little bit in the exact same spot for maximum pain, upper edge of the mesh. They cut out this little piece, and didn't find any new hernias or something else that would explain my pain. One week before this surgery I woke up with severe pain because I was sleeping on the left side, and the madrass put pressure to my abdomen. When I was turning and the pressure released it felt like my whole left lower abdomen exploded for a few seconds.


    After the surgery it felt promising the first few days, but it was this extreme tightness and pulling from the area where my mesh is. And when I started to walk more,the pain returned from the same area. The next days the pain only got worse and I see no improvement till this day. It felt like the problem was resolved, but the area where the mesh is felt tighter and was pulling the upper edge. Most days i am almost pain free when I wake up or are in bed without clothes, but if I put my underwear on and start moving the pain gets more severe for each minute. My doctor told me to try excercising and stretching the hip-flexors, but this has made my pain much worse. I had no pain on my right side, but after I started stretching, I also got pain around my key-whole scar on the right side and down towards the groin. It now feels like the mesh is pulling the edges of the mesh and this is causing irritation to the whole lower abdomen. It feels like my muscles are being pulled / stretched towards the place where my mesh is, and the result is a gnawing or burning pain on both sides of my lower abdomen, and sometimes intense stabbing pain from what I think is the upper edge of the mesh. The whole area where my mesh and the pulling pain come from feels inflamed, with soreness around.
    Five months ago I was studying, working and had a normal life. Now I sometimes doesn't manage to get out of bed, can't work, and dropped out of my studies. The pain is so severe, that I can't imaging living like this for the rest of my life.

    I get good help from an very experienced surgeon now, and he is currently trying injections with local anestethic, but this has until now only had short time relief with three injections, and none relief with two. I also started today with Naproxen, ginger, turmeric and Arnica Montana C30, other than that I take Gabapentin.



    - Is there anything I can do if the mesh is too tight and cause pulling and chronic inflammation? Or is mesh removal my only option?

    Dr Towfigh: I saw you recomended Botox in a different thread if the mesh was to tight, but didn't find so much information about this other than this success story( http://www.ncbi.nlm.nih.gov/pubmed/21668748 ).Is it safe to use botox here or can it damage some nerves?

    - How can I suddenly get this severe pain, after being almost pain free in my groin for a year? I've had some back and hip pain prior to the first surgery, and still have it. Can these problems play a role?

  • #2
    Severe pain 14 months after TEP-repair

    Interesting story.

    If pain is due to mesh related inflammation, I typically start with local injections which includes steroids. The injection is at the level of the mesh:muscle interface. I use ultrasound guidance. This helps treat pain and buys time until the inflammation dissipates. Injections need to be repeated.

    I have not seen much inflammation-related pain with the Parietex polyester mesh.

    If pain is due to too tight a repair, one option is neurotoxin injection. A few Pain specialists perform this. I do it under ultrasound guidance. It really helps.
    #ItsNotJustAHernia
    www.BeverlyHillsHerniaCenter.com

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    • #3
      Severe pain 14 months after TEP-repair

      Thank you for your answer Dr Towfigh.

      I'm not sure if it was ProGrip mesh or some other starting with P, my first surgery report got lost at the other hospital.

      The strange thing is the first three days after I woke up after my second surgery, I just had normal postoperative pain. But it was so much tighter, and I think it is this "pulling" from where the mesh is that are causing this pain and inflammation response I have now.


      Is it possible to see the mesh with Ultrasound?

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      • #4
        In pain how are you doing now

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