Understanding Chronic Pain after Inguinal Hernia Surgery
As you research inguinal hernia repair, you will undoubtedly come across the topic of chronic pain after a mesh-based hernia repair. There is a great deal of discussion and controversy surrounding this phenomenon. We know that this pain does exist, but there’re still some question as to why it occurs, and why most patients have no pain whatsoever. Let’s first dive into the potential causes of post-hernia, chronic pain:
- Damage to the nerves in the surgical area. Of course, damage to nerves will cause some sort of sensation or lack thereof. For many, this is pain. When open surgery is performed for a hernia, sharp tools are used to cut into the abdomen. This can sever nerve endings and cause long-term pain. Laparoscopic and robotic surgeries uses blunt dissection, which significantly reduces the chance that an important nerve is severed. Also, visualization is magnified so vital nerves are identified and protected.
- Hernia mesh considerations. It is possible for hernia mesh to cause chronic pain after an inguinal hernia repair. Many complaints originated from counterfeit hernia mesh that was discovered and taken off market many years ago. Further, today’s hernia mesh is lighter and more advanced than ever before. The different characteristics of mesh, and an experienced surgeon to carefully select which option is best for the patient, minimizes the potential for chronic pain.
- In past, hernia mesh had to be mechanically affixed to the surrounding musculature in order to stay in place after surgery. Originally, titanium tacks were used to hold it in place. Technology then allowed for these tacks to be absorbable. Occasionally, placement of these tacks irritated nerve bundles, causing chronic pain. Today, however, almost all hernia meshes are affixed with adhesive, thereby eliminating this possible cause of pain.
- Clinical data has shown that patients who wait to have their hernia repaired, and in doing so develop a strangulated hernia, have a higher risk of chronic pain. Emergency hernia surgery has shown to be less successful, with greater potential for complications, than elective hernia procedure.
- We have also seen evidence that pain prior to hernia repair often translates to a higher chance of chronic pain after the hernia is repaired.
- Our surgeons will discuss the choice of meshes available on an individual case. They will discuss the properties of each mesh and why they think it will serve you
Chronic pain after hernia surgery, especially in the case of an inguinal hernia, is a real possibility after surgery. The rate and intensity varies from 1-30 % and the vast majority of people improve in 3-6 months.There are so many confounding factors that it is hard to tell what percentage of patients would be expected to have pain after surgery. Further, most cases of pain after surgery spontaneously resolve themselves up to a year after the procedure. For those experiencing significant long-term pain, the possibility of mesh removal may be considered, however this is a complicated procedure and should not be undertaken lightly.
Please contact our office to learn more about hernia surgery and chronic pain as it relates to the repair. We will be more than happy to discuss the potential risks associated with hernia surgery.