This will be my only post here but I am surprised that no-one has offered a similar point of view:

1. The repair of a hernia is a very common procedure.

2. Complications arise in a minority of cases.

3. That means that most people who have experienced successful hernia surgery will probably not be posting in this kind of forum.

4. Therefore many of the threads you will find here are probably not representative of the experiences of the overwhelming majority of people, like myself, who have undergone hernia repair and are doing well.

5. For people who are experiencing chronic pain/other complications as a result of your surgery please bear in mind that I am not wishing to question the reality of what you are going through. I suffer from another chronic condition myself and have therefore had to reluctantly acquaint myself with the literature on chronic pain management such as John Kabat-Zinn's 'Full Catastrophe Living' and the writings of Darlene Cohen. Both of these authors have proved to be invaluable in helping me to adjust to this additional, debilitating condition.

6. For the record I had an umbilical hernia repaired with a Vypro mesh just over two weeks ago. I would rate my present discomfort level as 1 (on a scale of 1 to 10). I also thought my surgeon was amazing and I cannot believe that he would have performed this procedure if it wasn't safe.

7. My surgery was carried out in the UK where there is seemingly no viable alternative to the insertion of a mesh. But I would rather have this mesh inside me than live with an incarcerated hernia which might have eventually become strangulated, requiring emergency surgery and the insertion of....a mesh.

8. To reiterate,this is both my first and last post here. This is because I spend time posting in Forums devoted to my chronic condition supporting people there as and when I am able or getting support myself from time to time.

Best wishes to you all.
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replied April 24th, 2010
Hi,

Thanks for the post. Your post shall be really useful for people who are suffering from hernia, postponing the treatment due to apprehension about surgery and other issues. You have rightly mentioned that is better to live with the mesh rather than suffering due to the constant pain, swelling and complications at times.

I appreciate your concern.


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replied April 25th, 2010
Any surgery should NEVER be considered lightly, and true risk reward needs to be evaluated. In 2006 the journal of the American Medical Association considered watchful waiting a prudent option:

http://jama.ama-assn.org/cgi/content/short /295/3/285

For that study to even be considered yet alone done demonstrates the failure of the medical community to adequately address or understand the chronic pain sometimes associated with hernia repair.

"Post surgical chronic pain represents a major, largely unrecognized clinical problem. Incidences after inguinal hernia repair up to 54% have been reported (Kalliomaki 2009; Nienhuijs, Staal 2007; Poobalan 2003"

"Persistent pain after groin hernia surgery: a qualitative analysis of pain and its consequences for quality of life."

http://www.ncbi.nlm.nih.gov/pubmed/1909417 5

I also find it interesting that you choose to post an opinion, but at the same time do not wish to defend that opinion if others should question it:

"This will be my only post here but I am surprised that no-one has offered a similar point of view"

There are REAL issues with hernia repair associated with chronic pain, and by even taking the low end of some studies which say 5% will get have chronic pain after hernia repair, that represents 5 out of a hundred.

A lot of doctors who perform hernia repair do not even consider chronic pain a complication, and even you imply it in your post by saying there are many techniques one can use for pain. I hate to tell you but most of those chronic pain techniques that you refer to are not that effective

As I said before NO surgery should be taken lightly, a careful evaluation of risk verses reward need to be made
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replied May 20th, 2010
I wanted to come on here to fully support the OP's comments.

I had a very large inguinal hernia on the right side. Once I was diagnosed, I spent some time researching repair options online. This site, among with others, concerned me about the repair techniques currently deployed.

I read all about the chronic pain people are feeling, etc. I read about the Shouldice technique and if that was for me. I read about open vs Laparoscopic. This board, among others, terrified me that I was definitely doomed to have chronic pain.

Then it hit me. There are over 800,000 hernia repairs in THIS COUNTRY EVERY YEAR. If chronic, long-term pain was really as high as the 20% or so that some claim on this board, we would be hearing A LOT more about it. So, using this knowledge, I went ahead with the procedure.

Today marks two weeks from surgery. Obviously, I cannot speak on the future, but I almost feel 100% recovered at this point. I had laparoscopic repair and my hernia was huge. I was in surgery for over 5 hours. My incisions are almost completely gone and the only pain I have is slight soreness where the mesh is and in my groin/scrotum area due to swelling.

Other than that? I'm having trouble with this whole "no strenuous activity for 6 weeks" thing. I feel well enough to do everything I want to do but I have to hold off for now.

So all I am trying to say is those of you who recently discovered you had an inguinal hernia, don't let this board scare you into drastic measures for your repair. Sure, some people will have problems, but the reality is, only those with problems will come on here to post. The VAST majority of people who have completely trouble-free hernia repairs don't come on here to talk about it. So don't be afraid!
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replied May 20th, 2010
I am glad your experience was good, but your statement

"There are over 800,000 hernia repairs in THIS COUNTRY EVERY YEAR. If chronic, long-term pain was really as high as the 20% or so that some claim on this board, we would be hearing A LOT more about it. "

is flawed. For one thing there is very little long term follow up on patients after hernia repairs. Within the last couple of years tthose studies are now underway.

In addition, there are numerous recalls or adverse effects the public never hears about. If you had your repair done several years ago, with a Bard Composix® Kugel Mesh I doubt you would be so positive. In fact, even after the problems were recognized with that, it took several years to get it off the market, and notify the affected patients

When the AMA and other reputable medical groups makes a statement that watchful waiting is an appropriate course, if their are no symptoms, that is recognition in itself that they recognize the problem of chronic pain

It appears in your particular situation you were experiencing symptoms and pain, which are indicative for having the repair done.

No surgery should be taken lightly.
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replied May 20th, 2010
I am glad your experience was good, but your statement

"There are over 800,000 hernia repairs in THIS COUNTRY EVERY YEAR. If chronic, long-term pain was really as high as the 20% or so that some claim on this board, we would be hearing A LOT more about it. "

is flawed. For one thing there is very little long term follow up on patients after hernia repairs. Within the last couple of years they are now those studies underway.

In addition, there are numerous recalls or adverse effects the public never hears about. If you had your repair done several years ago, with a Bard Composix® Kugel Mesh I doubt you would be so positive. In fact, even after the problems were recognized with it, it took several years to get it off the market, and notify the affected patients

When the AMA and other reputable medical groups makes a statement that watchful waiting is an appropriate course, if their are no symptoms, that is recognition in itself that they recognize the problem of chronic pain

It appears in your particular situation you were experiencing symptoms and pain, which are indicative for having the repair done.

No surgery should be taken lightly.
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replied May 20th, 2010
I agree with johnl’s post.

I was recently (Sept 09) diagnosed with an inguinal hernia. The bulge is very small, painless and is fully reducible. After I was diagnosed, I was told that surgery was the only avenue to pursue, this reply prompted to dive into the literature to study up before committing to any form of surgery.

After reviewing the medical literature I have come to the conclusion that hernia surgery (open or Lap, using the polypropylene mesh implant or not), has a significant probability that the procedure itself could result in a series of complications the medical field has only started to recognize. Clearly I see that the historic metric for the success of the “repair” has been recurrence, not postoperative pain, which has been recently reported between at 2-10% of the cases for disabling chronic pain and at least 30% of the cases for mild chronic pain. It’s almost like the Docs consider numbness, immobility and pain as an expected outcome. With the large numbers of people going for hernia surgery each year (upwards of 800,000 in the US), and factoring in the reported rate of occurrence of chronic postoperative pain, the result is thousands suffering postoperative pain. Do they all post here? No they don't. But they are still out there suffering. I don't see the medical community doing much in terms of followup or tracking post surgery, after all in their mind the hernia is "fixed" so what's your problem?

Don't commit to anything without doing your homework first. Review the literature, become informed, and make your own informed choice on the question of surgery.

No matter what the Doc’s tell you this procedure is anything but routine surgery, and if the Docs insist that it is routine, I would be willing to ask the Doc “how many implants have been placed in YOUR body?” Always keep in mind that it's your body, and you are the one making the ultimate commitment.

The big question that you need to answer is; after getting the surgery & implant, to what degree would you be able to tolerate and accept being disabled (regarding testicle pain and swelling, numbness, tightness, sensitivity around the incision etc) and not being able to participate in everyday living for a period of up to 6-8 weeks? Would you have to go on pain meds for long-term, and if so would this cause other health complications? Plan for the worse, and hope for the best?

In my case I have decided for the watch and wait option, my hernia was originally diagnosed in Sept 09, now some 9 months later I’m still OK, and I don’t have any cause for concern at this point. Please keep in mind that my hernia is small, I am healthy, not overweight, and no other medical problems. Everyone is different, so their course of action will be different.
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