Hernia Mesh

Many patients request medical information regarding hernia mesh. Below are some of the commonly asked questions during a consultation and discussion.

Is hernia mesh safe?

Over the last few years there has been increasing media coverage of mesh problems. This has raised the public awareness of the potential risk of using mesh. Unfortunately, some reports are over stated or misleading, and in the age of electronic information, many “expert” opinions might be quoted as fact.  As with many operations, good outcomes are dependent on an appropriate surgeon, the correct technique and patient factors – in summary, the right operation performed by the right surgeon on the right patient at the right time, and done properly!

How did the mesh hernia issue start?

Possible problems with meshes were first reported regarding the mesh used in gynaecological procedures with a trans-vaginal tape. Many women have suffered serious complications and side effects from this procedure. However, apart from the mesh material used, there are absolutely no similarities between these troublesome gynaecological mesh operations and groin hernia surgery.

What are meshes made of?

Most groin hernia mesh repairs use a mesh manufactured from polypropylene or polyester. These materials are strong, stable and non-toxic, but the presence of a “foreign material” in the body can elicit a “foreign body reaction” with tough scar tissue. The mesh acts as a scaffold allowing the body’s scar tissue to grow into the mesh, fixing it in place.

Do groin hernia meshes cause pain?

As a surgeon a strong repair using mesh means a lower risk of the hernia recurring. However, excessive scar tissue growing into the mesh can cause thickening in the groin. If nerves are caught, then this can provoke persistent pain. Placement of the mesh “deeper” behind the muscle using a laparoscopic (keyhole) technique reduces the risk of persistent pain as the mesh is placed away from any nerves.

Is mesh the best method of hernia repair?

All of the clinical trials show that the use of mesh in groin hernia repairs is the best method, with a reduced risk of recurrence and improved outcomes when compared with inguinal hernia operations using only sutures. In a recent 2018 report comparing mesh with non-mesh hernia operations, there was no difference in the frequency of chronic post-operative pain.

What if I have more questions?

Some patients find that a face-to-face consultation to discuss techniques of hernia repair and the material used, can be beneficial. A consultation with Mr Coombs at The Hernia Clinic can allow patients time to understand which method of repair might be best for their personal circumstance.