Hernia Mesh Pain

Pain is a common complication following hernia mesh repair surgery. Hernia mesh, a medical device often made from polypropylene, can cause an inflammatory response, resulting in pain lasting three to six months following surgery.

Some people begin to experience chronic and debilitating hernia mesh pain years later. Dr. Robert Bendavid, a Shouldice Hospital surgeon who specializes in hernia repair, also noted that for some patients, pain may last for years.

Some patients may experience recurring or fluctuating pain over time. It’s not considered normal to experience persistent pain after hernia mesh surgery, so patients should consult with a doctor if their pain is chronic. This may indicate a reaction to or an issue with the mesh.

An injury to the skin, muscles or nerves can cause post-operative pain. Longer or more extensive surgeries can contribute to pain severity. Persistent pain years after hernia mesh surgery indicates something is wrong. Pain is a symptom of a problem and can be a sign of infections., reactions or other hernia mesh complications.

Some researchers maintain that as many as 10% to 12% of patients report moderate to severe chronic pain in the groin following inguinal mesh repair. This pain is often attributable to operational factors, such as nerve entrapment, or mesh-related factors, such as material, pore size and fixation method.

Bendavid explained that hernia mesh pain years later is often because of properties of the mesh, and that mesh manufacturers have downplayed the risks. He points out that hernia mesh lawsuits in U.S. courts are further evidence of mesh-related health problems or injuries.

Reactions to Mesh

Hernia mesh can cause inguinal pain because of irritation or inflammation. One 2023 study published in the Journal of Abdominal Wall Surgery found an increase in patients requiring mesh removal after a systemic reaction.

The synthetic materials composing the mesh can cause allergic reactions or trigger an immune reaction. However, not all individuals who undergo hernia repair surgery with mesh experience adverse reactions or have the same reaction.

Nerve Entrapment

Hernia nerve entrapment can occur if the nerves in the inguinal area become trapped or irritated. Factors that contribute to nerve entrapment include injury during surgery, the mesh fixation technique and mesh-related inflammatory responses or adhesions.

Nerves found in the inguinal region are the ilioinguinal, iliohypogastric, genitofemoral and lateral femoral cutaneous nerves. Nerves which come into contact with the mesh, or are stretched, irritated, damaged, or compressed, can cause neuropathic pain and are at risk of developing adhesions.

Mesh Erosion and Migration

If hernia mesh migrates, it can cause further complications impacting the testes, intestines, bladder and other vascular structures. One study explored how mesh migration into the bladder can lead to persistent lower urinary tract infection symptoms or urinalysis abnormalities.

Mesh erosion or migration into the spermatic cord and vas deferens can interfere with intercourse or cause painful ejaculation. According to Shouldice Hospital, “Since the general adoption of mesh in the 1990s, the incidence of dysejaculation has risen to 3.1%, a 7,750% increase from when natural-tissue repairs were the standard of care.”

Different complications that arise from hernia mesh surgeries can result in various types of pain. Hernia mesh pain can be abnormal or severe.

One 2022 case study, for example, presents a man who experienced right lower quadrant pain severe enough to be referred to the surgical department at the hospital. He’d had inguinal hernia repair 20 years prior and during laparoscopic abdominal exploration, it was determined his polypropylene hernia mesh had migrated to the intraperitoneal cavity and caused erosion of the small intestine. Surgery was required.

Locations of Hernia Mesh Pain

Symptoms vary from person to person and depend on the location of the surgery, type of surgery, type of mesh and any preexisting pain a patient may have had. For example, inguinal hernia repairs can result in groin or lower abdomen pain, while ventral hernia repair surgeries can cause pain around the abdominal wall.

It’s important that people experiencing hernia mesh pain communicate their symptoms and the location of pain to medical professionals. This allows for proper evaluation and treatment.

Impact of Chronic Hernia Mesh Pain

If postoperative pain gets in the way of daily activities and remains severe after six months, the patient may be experiencing chronic hernia mesh pain. Patients who have pain for longer than three months should speak to their surgeons about treatment options.

“Hernia mesh pain will vary in incidence depending on the definition of the pain,” Bendavid said. “The European Hernia Society and HerniaSurge have defined it as pain severe enough to interfere with daily activities.” He said the incidence of pain fitting this definition ranges from 13% to 15%.

According to Shouldice Hospital, some studies found the rates of pain can be as high as 60%. The pain was often “severe enough to bring a change in lifestyle, to cause a severe handicap in ordinary activities or make life unbearable.”

The goal of treatment for hernia mesh pain is to minimize discomfort. The first line of treatment is typically medication.

In some cases, patients’ pain will ease with time. However, if pain persists, there are several other treatment options available.

“The only definitive answer is as thorough a removal of the mesh as possible,” Bendavid said. “Certainly the best results have been obtained by mesh removal, but surgeons are loath to return to an area that has become scarred, has invaded adjacent tissues and can be a tricky and dangerous dissection.”

Patients should be proactive in discussing their symptoms with their doctor. If you’re in pain, don’t wait for your doctor to initiate a discussion. Medical professionals may ask you a series of questions to get more information about the specifics of your symptoms.

Health care providers must carefully monitor pain levels and address any concerns. Patients and doctors can work collaboratively to improve surgical outcomes and overall well-being.