Management Of Mesh Complications

The explosive use of different brands of nylon mesh for hernia repairs has been held out to the public as a “guaranteed” method to prevent the failure of a hernia repair.

Nothing could be further from the truth. The failure rate with mesh repaired hernias is reported in the range of 5% to 10%. Surgeons have for years recognized a number of severe complications caused by nylon mesh with the most common being chronic groin pain.

Numerous studies have documented rates of mesh related pain occurring in as many as 50% of patients implanted with this mesh with many experiencing debilitating, life altering pain. This is due to the inflammatory properties of nylon that can cause nerve entrapment, sexual dysfunction, and stiffness in the groin as well as a host of other severe problems.

Ultimately, many patients are forced to have the mesh surgically removed, which can be a challenging undertaking. Our treatment protocol for patients with mesh complications begins with a thorough history and physical exam by Dr. Grischkan, not a nurse, surgical trainee or physician assistant. Recommendations for either surgical intervention to remove the mesh or a conservative approach is individualized for each and every patient depending on the severity of symptoms, prior surgical procedure and the examination findings.

Our extensive experience in managing mesh complications is guided by the principles of minimizing any dissection, removing all or part of the mesh and avoiding tissue trauma. This means gently releasing nerve entrapment, excising mesh with minimal trauma to the host tissue and meticulously dissecting mesh off the spermatic cord, which carries the nerve and blood supply to the testicle.

Once the mesh is removed, the original hernia is unmasked and requires repair. Dr. Grischkan’s expertise with mesh removal often allows for a Shouldice, non-mesh repair. In select cases where the extent of damage from previous surgery is too great for a tissue repair, the Modified Shouldice Repair incorporates a Shouldice tissue repair with a small segment of GoreTex mesh to bridge any small gap that could not be closed. Unlike nylon, GoreTex mesh is relatively inert and is not associated with the host of complications reported with nylon mesh. This unique product is extremely well tolerated in the body has been used for over forty years.

If you are having symptoms following a nylon mesh hernia repair, it is important that you obtain a consultation with a hernia specialist so that you can avoid the progressive damage that can make future treatment more difficult.