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Post Hernia Mesh Issues - Looking for next steps, thoughts, feedback?

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  • Post Hernia Mesh Issues - Looking for next steps, thoughts, feedback?

    Hello, This is my first time posting and reaching out about my issues following my Hernia Inguinal right side repair roughly 14 months ago. I don't want to go into a ton of detail on my reasons for getting mesh repair vs. talking about where I am at today. Let's just say I had the right side hernia pop over a weekend, spent two weeks still not knowing what it was, running and exercising with it pushing out etc. Ended up in the ER after having the hernia push through more than I had experienced since it started, then the ER Dr.. telling me I needed to get it fixed asap, then onto hernia Dr.'s who argued that it was such a small hernia that it could wait, but after explaining I had an international trip coming up in 2-3 months, they directed me to take the mesh repair option.

    Not knowing what I know now about mesh, I opted to take the mesh repair surgery. Post surgery 14 months ago while I was in the recovery room, I woke up to excruciating pain. The Dr.'s at the time said they had to do more irrigation than expected, then finally when my Dr. that did the actual surgery showed up he indicated that he had to apply a much larger area of mesh due to the hernia being significantly larger than expected. (Imaging indicated a 50 cent piece size hernia) turns out it was much larger when they got in there to do the work. They communicated to me that my immediate pain was due to the larger mesh used.

    Mesh used was 3D Max Light.

    Issues following Mesh repair (Post Op 14 Months and still ongoing):

    - It took me roughly 3-4 weeks to get to a point where the post op pain was tolerable and I wasn't heavy on pain meds and could go back to work. (It was "marketed" to me heavily that I would only need about two weeks, before I would be back to aka "normal". Riding bikes, running, etc.) - back to normal hasn't really happened for me. A follow up ultrasound showed no issues...(According to my Hernia Dr.)

    - I spent the next 6 months doing follow ups with my Dr. and his sub Dr.'s, asking about my following issues: Right side area where the mesh and hernia was located continued to have spasm type pain, having pressure from needing to go to the bathroom 1 or 2 caused pain and tenderness in the area, pressure or stretching of the area has caused sharp to dull pains, tightness, etc. Pain does radiate down into my right testicle.

    - Each time I did my monthly follow up sessions the Dr.s continued to classify my healing into "6 months needed to recover" to eventually "It's going to take up to a year or more". The Dr.s started discussing nerve numbing options with me, but I respectfully have declined this as a option.

    - At this time I'm continuing to have discomfort in the area of the mesh implant. After ~3 months post op I developed a rash like issue on my skin, in the exact area of the mesh and around my lower torso. I've returned to my hernia Dr. who indicated he had never seen anything like it before, then also to my family Dr. who just prescribed steroid cream that never fixed it. I have reddish & spots and almost bruise like skin over the mesh area. No Dr. to date has been able to explain this to me and has not indicated that it could be a mesh allergic reaction.

    - My last issues which is difficult to discuss. I have no sexual issues and can perform, the problem I'm having is what I believe is called "painful ejaculation". My issue during ejaculation is my right side literally feels like it's backed up and a ton of pressure is pushing on the right side and or backing up my release. I then immediately have spasms in the right side inguinal area that come up into my right obliques. This pain basically has me on the floor until the spasms stop. I then have 1-2 days of soreness and what feels like post injury healing time before the pain fully subsides.

    I've been reading a lot about mesh removal. However I'm also aware there can be down sides to this. My issues are that no one has explained my skin condition following the operation, when I'm not having discomfort or any paid radiating down to my right testicle I feel pretty good, good enough to do a light run etc. However this is only 10% or less of the time. I live in WA state and just recently started to look for Dr.s that would or could take out the mesh, so I'm just starting. I feel as if my issues are not 100% enough to push mesh removal, however after 14 months of still having pain, discomfort, sexual issues, and this rash type issue, it does not appear to be getting better and I do not feel as if it's something I should or can continue to just live with.

    Any thoughts or feedback is appreciated. Thanks!

  • Chaunce1234
    replied
    I'm sorry you're going through this.

    LeviProcter makes a strong point that a re-do surgery is a big deal. Thus if you even are to consider it, be sure you seek out an expert in that particular specialty, including mesh removal, who has done it many times before. Unfortunately that may involve traveling.

    Two names in the northwest that have been recommended on these forums before are the heads of the hernia departments at UW and OHSU:

    - Dr Andrew Wright at UW Washington

    - Dr Robert Martindale at OHSU Oregon

    I have also seen Dr Peter Billings recommended here and on other forums.

    I am not sure what experience these doctors have with mesh removal specifically, but it wouldn't hurt to ask them, and presumably they could be helpful resources.

    And if you happen to be interested in visiting Los Angeles, California, then Dr Shirin Towfigh who runs these forums has notable experience with this topic and would be a great resource.

    Anyway, good luck, stay positive, and keep us updated on your progress and decision making.


    Leave a comment:


  • LeviProcter
    replied
    Mesh removal is a big deal. It can carries serious complications.

    I appreciate your symptoms. You will require a very thorough workup to determine if the risk vs benefit of mesh removal is appropriate.

    I agree that you should be seen by hernia surgeons that explant/remove mesh as they have a dedicated expertise to determine if this is needed.

    Typically start with:
    1. History and physical exam
    2. Dermatome map testing in the office
    3. Review operative report from initial surgery
    4. MRI to look for recurrent and/or unrecognized hernia(S)
    5. Then go from there....

    Leave a comment:


  • McD41
    replied
    Appreciate the follow up information Jnomesh & Momof4. I'm doing my foot work on this one giving it time to review the options etc. I did leave out that I have been going through muscle therapy work efforts in the groin and abdominal areas down into my right leg as well for the past 6 months. This does help with the pulling, stretching, aching pains a bit, but does not last. If I exercise, lift anything, or have any sexual interaction my spasms and pain in the right inguinal area comes right back I'll be pursing the Dr's here in WA and also already have e-mail contact happening with Dr. Towfigh's folks. I'm open to try to make a consult with her if possible / timing works out with everything.

    I'm grateful for this forum and all of the information on it as of course all the great members who are posting. Our unfortunate medical system at times makes you feel like you are the only one having issues and or "it's just your case" etc.

    Thanks again for all the information and great feedback thus far. I'll keep updates on progress.

    Leave a comment:


  • Momof4
    replied
    Sorry to hear of your pain issues after mesh hernia repair. I’ve been there done that! You need to be patient and seek second and third opinions from a hernia expert that deals with post surgery problems. Dr. Towfigh, in Beverly Hills that runs this forum, is the best in that area. She has the most experience reading imaging looking for hernias and mesh related issues. The rash you describe sounds like an allergic reaction. A true mesh reaction is rare but can happen, I know because it happened to me. I was mesh patch tested and had reactions to polypropelene mesh and sutures, which was the material that had been implanted across my entire pelvis for 2 years. I was having several systemic reactions and Dr. Towfigh recognized that the mesh was most likely causing my problems. Besides the rashes and itching, I was having nausea and weight loss and strange bruising, also constant pulling feeling and debilitating pain. It was also causing lots of inflammation. If you are having a true mesh reaction then the mesh needs to be removed. Once again, this needs to be done by an expert with lots of experience. Mesh removal has many risks and the benefit needs to outweigh the risks. I am still recovering from mesh removal, a nerve problem and all of the inflammation. I am remaining hopeful for a good recovery. This forum is certainly a good place to start to find answers to your questions. We are very fortunate that Dr. Towfigh and others share their expertise!

    Leave a comment:


  • Jnomesh
    replied
    Dr. Igor Belyanski in MD has expertise in removing hernia mesh . The way your mesh was out in is the way it should be removed ie open BS laparoscopically. Belyanski specializes in robotic assisted lapro removals but is also doing more
    open removals of mesh placed openly too. He still prefers to replace the removed mesh with more mesh but definitely will not do so if you don't want that.
    my logic is to first see if there is anything wrong with the mesh itself: i.e. Is it folded or migrated. Dr. Belyanski is an expert at reading catscans and in many cases can see if the mesh is folded or migrated or if the mesh looks to he in the proper place. Contrary to many voices out there this can be done. The problem is most surgeons and radiologist don't know what to look for or how to see mesh on the cat scan.
    So id get a cat scan and send it to dr. Igor Belyanski even if you don't intend to use homebfor removal this way you can here what he has to say as looks at your cat scan. You can send the scan to his office for review.
    if he says all looks well my advice would be then to try everything else you can (nerve blocks, medicine, PT etc) before considering havekng the mesh removed-Unless it is at a point where you can't function.
    if there is something wrong with the mesh itself however, it should be removed.
    hope this helps-

    Leave a comment:


  • McD41
    replied
    Thank you Good intentions, I will start with Dr. Billing and get the ball rolling. Appreciate the follow up and information!

    Leave a comment:


  • Good intentions
    replied
    Dr. Peter S. Billing in Edmonds WA might be close to you, a surgeon with experience in removing mesh. He knows the signs and can offer good advice. There are many others listed on this site, that you could talk to via phone or email. You just have to take the step of calling or writing a letter and initiating a discussion with someone who has the proper knowledge. The hardest part might be accepting that they might recommend what you already suspect. That the mesh needs removal. Another surgery.

    There are very few surgeons who understand mesh problems and/or will remove mesh to solve the problems. There are several posts about the issue, within the last few months, and one just a day or two ago.

    Leave a comment:

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