Five things you need to know about Mesh
If you have a hernia, and are considering undergoing a hernia repair, you might wonder about the safety of using “mesh”. While there have been isolated recalls and complications from a few specific mesh products in the past, the overwhelming majority of hernias are safely and effectively repaired with mesh today. There are 2 main factors to consider when talking about a mesh hernia repair: Recurrence and Recovery.
Using mesh for hernia repairs significantly decreases the risk of the hernia coming back (recurrence). In groin hernias, placing mesh to strengthen the inguinal area is the standard of care. Non-mesh repairs have a recurrence rate 2 to 4 times that of mesh repairs (up to 15% risk of recurrence). In hernias of the mid- and upper- abdomen recurrence rates without mesh are even higher (up to 20-30%). These hernias are almost always repaired laparoscopically (just a few small incisions) which requires the use of mesh to cover the hernia opening. There are unique situations where non-mesh, open (bigger incision) repairs are appropriate. Dr. Farrow can discuss these specific options with you.
Pain after a hernia repair can be short-term (post-operative pain) or long-term (chronic). Post-operative pain is reduced by performing laparoscopic hernia repairs. These minimally invasive repairs require the use of mesh to cover the hernia opening. By patching the opening (with mesh) instead of pulling the hernia edges together (non-mesh) there is less tension on the wound and less pain in the early post-operative period. Chronic pain that interferes with work or daily activities can occur in up to 5% of patients with a mesh hernia repair in the groin. The risk of this pain in other hernias (umbilical, ventral, or incisional) is even lower (less than 5%). Furthermore the risk of chronic pain is lower in laparoscopic groin hernia repairs compared to open repairs.
So why all the commercials? Three reasons:
- A specific type of lightweight polypropylene mesh (Proceed) was found to result in a high rate of recurrence. This mesh has been removed from the market, however lawyers are seeking patients who have the mesh in case they have a recurrent hernia. Dr Farrow has never used this type of mesh
- Mesh is still used to repair the pelvic floor of women in case of severe bladder, uterine, or rectal prolapse. These are not considered hernia repairs and the surgeries are performed by highly specialized urologic or gynecologic surgeons. The proximity of the mesh to the bladder, rectum or vagina makes these procedures at high risk for complications such as erosion and infection. Dr Farrow does not perform these types of operations.
- Pain after a hernia repair can be caused by other factors not related to the mesh, such as complications from infection, fixation, or recurrence. These can all occur in rare circumstances. Only a detailed discussion and examination with your doctor can determine if someone has a problem after a mesh hernia repair.
In summary, mesh hernia repairs are still the best option for most patients because of a lower risk of recurrence and a better recovery. Please schedule a consultation with Dr. Farrow today to determine what type of hernia repair is best for your situation. Let Dr Farrow get you back to being you!