It’s not about the mesh

When you read about the poor experience of some patients after a hernia repair, and this poor experience is ‘blamed’ on mesh you have to answer the following questions –

Do you believe that prior to the widespread use of mesh patients had no pain after a sutured inguinal hernia repair.   Be aware of this article from 1996, before the widespread use of mesh. So –this is 276 patients having one of three different non-mesh (including Shouldice) repairs.   At 1 year 62% of patients had groin or inguinal pain, in 11.9% it was moderate or severe.  And at 2 years the numbers were little changed.  To me this speaks of poor surgery.

The other very interesting finding of this study, which I have observed myself in patients coming to me from elsewhere with post-op pain, is that one of the predictors of long term pain was the  ABSENCE OF A VISIBLE BULGE BEFORE THE OPERATION.  Some patients with groin pain (for another reason) and no inguinal hernia, were having an inguinal hernia repair.

This is one of the groups reported as having pain after a hernia repair – they had pain before the operation that was not hernia related !