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Hernia Mesh Complications

Hernia mesh complications can be life-threatening. Surgery is almost always necessary to fix hernia mesh complications. Recalled mesh has been responsible for some of the most serious complications. Complications of hernia mesh include adhesion, bowel obstruction, bowel perforation and migration. People have also reported infection, rejection and hernia recurrence after being implanted with hernia mesh. Hernia mesh complications can occur soon after surgery or years later. It is important to know what symptoms to look for.

The most serious complications after hernia mesh surgery can be deadly.

At the very least, they can cause severe pain. They almost always need revision surgery to correct.

The most serious complications of hernia mesh are also some of the most common.

Hernia mesh complications include adhesion, bowel obstruction or perforation, infection, rejection and migration.

More than 90 percent of the 1-million-plus hernia surgeries performed every year in the U.S. rely on hernia mesh for repairs.

Nearly one-third of people who undergo hernia surgeries experience some sort of complication, with excessive pain being the most frequent complaint, according to one study.

Hernia Mesh Adhesion

The U.S. Food and Drug Administration describes adhesions as “scar-like tissue that sticks tissues together.”

Chronic, often severe, pain may be a patient’s only symptom of a mesh adhesion. The condition can also lead to life-threatening bowel obstructions.

 
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Replay Video
Madris Tomes, founder of adverse event reporting group Device Events, details the most frequently reported hernia mesh complications
Complication Reported to FDA
An Atrium C-QUR TacShield became attached to the patient's small intestine. Doctors had to remove it 12 days after it was first implanted.

Intraperitoneal surgery is a technique that leaves mesh in contact with the intestines. The intestines and the repair stick together around the mesh.

Manufacturers have developed different materials or coatings to prevent adhesion. But the problem still occurs in some surgeries.

A 2009 study in the British Journal of Surgery found that the body absorbs the coating over time. The mesh then comes in contact with the intestines.

Researchers found that the coating reduced adhesions for up to a week. But after a month, there was no advantage in preventing them.

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Bowel Obstruction from Hernia Mesh

Hernia mesh can cause a bowel obstruction if it adheres to the intestines. Mesh sometimes creates obstructions when it migrates in the body. If it moves, mesh can entrap loops of the intestines.

Bowel Obstruction Symptoms
  • Nausea
  • Vomiting
  • Inability to pass gas or stool

Bowel obstructions are a dangerous condition. They need immediate treatment.

Left untreated, an obstruction can cut off blood flow, causing part of the intestine to die.

Surgeons may have to remove part of the intestine if mesh causes a bowel obstruction.

The FDA cites recalled mesh as a major cause of bowel perforation and obstruction.

Hernia Mesh and Bowel Perforation

Bowel perforation happens when hernia mesh punctures or erodes into the bowel.

Mesh may also perforate the abdominal wall or another organ in the abdomen.

Bowel Perforation Symptoms
  • Nausea
  • Vomiting
  • Severe abdominal pain
  • Abdominal rigidity

A bowel perforation allows fecal matter and bacteria into the abdominal cavity. This can cause peritonitis.

Peritonitis is a dangerous form of inflammation.

Perforation can also cause sepsis, a sometimes fatal bloodstream infection.

People should consider any bowel perforation a life-threatening medical emergency.

Complications from Infection

Antibiotics can treat minor infections around the suture site on the skin.

Deep, chronic infections around hernia mesh are harder to treat.

Patients often need surgery to remove the mesh.

This is usually accompanied with intravenous antimicrobial treatments.

Chronic infection symptoms may not occur until years after hernia mesh surgery.

Symptoms of Chronic Mesh Infections
  • Inflammation
  • Fever
  • Other flu-like symptoms

Hernia Mesh Rejection

Materials in hernia surgical mesh may sometimes trigger the body’s immune response.

This can cause the body to reject the mesh.

Patients should seek medical attention if they experience mesh rejection symptoms.

Mesh Rejection Symptoms
  • Extreme swelling at the surgical site
  • Tenderness or pain
  • Redness
  • Flu-like symptoms

Hernia Mesh Migration

If hernia mesh detaches after surgery, there is a risk it can migrate through the abdomen.

It can lead to adhesions, fistulas, abscesses and bowel obstruction or perforation.

Complication Reported to the FDA
An Ethicon Physiomesh implant detached and migrated. It attached to the patient's intestine and the skin. Doctors had to remove the mesh and part of the patient's intestine.

Detachment is more likely to happen in laparoscopic (minimally invasive) hernia surgery techniques.

Migration may result in excess pain, or it may be symptom-free until it causes more severe damage.

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Hernia Recurrence After Hernia Mesh Surgery

One of the most common complications of hernia surgery is that hernias can come back.

Doctors call this “recurrence.”

Surgeons began using hernia mesh to overcome this problem. The idea is that mesh can further reinforce weakened tissue.

But using mesh is no guarantee against recurrence.

“A study of 3,200 patients found hernias were less likely to return if repaired with hernia mesh. But the study also found the risk of long-term complications off-set that benefit.”

Mesh detachment or migration can let a hernia return. A patient’s health and lifestyle can also affect the chances of recurrence.

How to Tell if Hernia Mesh Ripped

Pain or a hernia coming back may be signs that hernia mesh ripped. But these symptoms may be related to other complications, too. In some cases, surgery may be the only way to tell for certain if hernia mesh ripped or tore.

Hernia mesh may rip from the sutures or tacks holding it in place in the days immediately after surgery. This is rare and most likely to happen if the patient lifts a heavy weight or overexerts him or herself physically. If this happens, it can cause hernia recurrence.

Surgeons will set limits on physical activity for patients in the weeks during their first few weeks of recovery from hernia mesh surgery. This gives time for scar tissue to form around the mesh. This helps to strengthen the hernia repair.

If mesh shrinks, it may also rip lose from sutures or tacks. This can result in mesh migration.

Over time, mesh may erode in the body. If this happens, it may break into pieces. The edges can cut or perforate tissue.

When Can Hernia Mesh Complications Occur?

Hernia mesh complications can happen shortly after surgery or years later.

A 2016 study found that the number of complications increased over the course of five years.

Out of 3,242 study participants, 1,050 required another abdominal surgery.

“This [study] calls into question the current practice of liberal use of mesh, even for repair of small hernias, when mesh is the norm for all incisional hernia repairs of any size.”

Dr. Kamal Itani, JAMA Surgery commentary, Oct. 18, 2016

How to Tell If Hernia Mesh Failed

Typically, when hernia mesh fails, people experience symptoms. Some hernia mesh complications share symptoms. But some symptoms are unique to a particular complication.

Contact a Doctor Immediately If You Experience These Symptoms
  • Difficulty urinating or passing gas and stool
  • Excessive pain, bruising, or swelling
  • High fever (101 degrees)
  • Increased redness or drainage from the incision
  • Nausea, vomiting or other flu-like symptoms
  • Stiffness in the abdomen

Hernia mesh complications can be hard to diagnose. People who experience these symptoms should tell their doctors that they have hernia mesh.

Diagnosing Hernia Mesh Complications

There are several diagnostic tests doctors can use to detect hernia mesh complications.

These include X-rays, CT scans and blood tests.

Treatment for Hernia Mesh Complications

Depending on the complication, a surgeon may decide to perform surgery to remove the mesh.

Doctors may rely on surgery, medication or a combination of both to treat an adhesion or fistula.

Surgery may be the only option for patients with bowel or abdominal perforation.

Surgeons will have to remove the mesh and repair the hole.

They may also remove the damaged section of the bowel.

Please seek the advice of a medical professional before making health care decisions.

Terry Turner
Written By Terry Turner Writer

Terry Turner has been writing articles and producing news broadcasts for more than 25 years. He covers FDA policy, proton pump inhibitors, and medical devices such as hernia mesh, IVC filters, and hip and knee implants. An Emmy-winning journalist, he has reported on health and medical policy issues before Congress, the FDA and other federal agencies. Some of his qualifications include:

  • American Medical Writers Association (AMWA) and The Alliance of Professional Health Advocates member
  • Centers for Disease Control and Prevention Health Literacy certificates
  • Original works published or cited in Washington Examiner, MedPage Today and The New York Times
  • Appeared as an expert panelist on hernia mesh lawsuits on the BBC
Edited By
Medically Reviewed By
Dr. John A. Daller
Dr. John A. Daller American Board of Surgery

20 Cited Research Articles

  1. Kokotovic, D. et al. (2016, October 18). Long-term Recurrence and Complications Associated With Elective Incisional Hernia Repair. JAMA Surgery. Retrieved from https://jamanetwork.com/journals/jama/fullarticle/2565771
  2. Itani, K.M.F. (2016, October 18). New Findings in Ventral Incisional Hernia Repair. JAMA Surgery. Retrieved from https://jamanetwork.com/journals/jama/article-abstract/2569750?redirect=true
  3. Science Daily. (2016, October 18). Study finds mixed results for use of mesh for hernia repair. Retrieved from https://www.sciencedaily.com/releases/2016/10/161018094928.htm
  4. Fränneby, U. et al. (2006, August). Risk Factors for Long-term Pain After Hernia Surgery. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1602172/
  5. FDA.gov. (2018, February 4). Hernia Surgical Mesh Implants. Retrieved from https://www.fda.gov/MedicalDevices/ProductsandMedicalProcedures/ImplantsandProsthetics/HerniaSurgicalMesh/default.htm
  6. FDA.gov. (2016, July 11). MAUDE Adverse Event Report: Ethicon Inc. Physiomesh Mesh, Surgical. Retrieved from https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfmaude/detail.cfm?mdrfoi__id=5782201
  7. University of California, San Francisco Medical Center. (n.d.). Enterocutaneous Fistula. Retrieved from https://www.ucsfhealth.org/conditions/enterocutaneous_fistula/
  8. FDA.gov. (2014, August 13). MAUDE Adverse Event Report: Atrium Medical Corp. C-QUR TacShield Mesh, Surgical, Polymeric. Retrieved from http://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfMAUDE/detail.cfm?mdrfoi__id=4107017
  9. FDA.gov. (2014, June 29). MAUDE Adverse Event Report: Atrium Medical Corp, Atrium C-QUR Mesh, Hernia Mesh 8.9cm x 8.9 cm 3 1/2in X 3 ½ in. Retrieved from http://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfMAUDE/detail.cfm?mdrfoi__id=2639496
  10. Schreinemacher, M.H.F. (n.d.). Abdominal Wall Hernia Repair; Intraperitoneal Mesh and Adhesions. Retrieved from http://www.nvec.nl/wp-content/uploads/2015/05/Commissie-Abdominal-Wall-Hernia-Repair1-M.-Schreinemacher.pdf
  11. University of California, San Francisco Medical Center. (n.d.). Overview of Hernias. Retrieved from http://surgery.ucsf.edu/conditions--procedures/hernia-overview.aspx
  12. Medical University of South Carolina. (n.d.). Small Bowel Obstruction. Retrieved from http://ddc.musc.edu/public/diseases/small-intestine/small-bowel-obstruction.html
  13. Akyol, C. et al. (2013, April 24). Outcome of the Patients with Chronic Mesh Infection Following Open Inguinal Hernia Repair. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3641368/
  14. Banasiewicz, T. (2013). Migration of Biomaterials Used in Gastroenterological Surgery. Retrieved from https://www.academia.edu/22543708/Migration_of_biomaterials_used_in_gastroenterological_surgery
  15. Haninec, P., Horak, L. & Kaiser, R. (2012, July 12). Obturator Nerve Injury in Laparoscopic Inguinal Hernia Mesh Repair. Retrieved from https://www.academia.edu/23580303/Obturator_nerve_injury_in_laparoscopic_inguinal_hernia_mesh_repair
  16. Zogbi, L. (2011). The Use of Biomaterials to Treat Abdominal Hernias. Retrieved from http://www.intechopen.com/books/biomaterials-applications-for-nanomedicine/the-use-of-biomaterials-to-treat-abdominal-hernias
  17. Sherwinter, D.A. et al. (2016). Laparoscopic Inguinal Hernia Repair. Retrieved from http://emedicine.medscape.com/article/1534321-overview
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  19. Kong, C.Y. et al. (2016). Inflammatory reaction to fish oil coated polypropylene mesh used for laparoscopic incisional hernia repair: a case report. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4750192/
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