Hernia mesh
Research
Chronic postoperative pain, current controversy on inguinal hernia, expert patient perspective, bioethics, and global health Authors draw attention to a meaningful public health concern regarding chronic pain after inguinal hernia repair, emphasizing the need for thoughtful, evidence‑based, and patient‑focused management. Despite its frequency (27% of men), this procedure, often perceived as benign, can lead to disabling pain (0.5–6% of cases) and daily handicap, which is underestimated by official registries. The article highlights the discrepancy between clinical data, registry data, and the reality experienced by patients with chronic postoperative pain that is often undertreated, overlooked, or misunderstood – and who still tend to be attributed to psychological causes such as anxiety or depression.
Science Direct 34: September 2026
Mesh shrinkage after transabdominal preperitoneal inguinal hernia repair
Synthetic mesh is now used for inguinal hernia repair in most cases. It is well known that the indwelling mesh contracts after placement in the body, regardless of the material. The aim of this study was to develop a method for indirect measurement of the mesh area postoperatively that allows for easy comparison with the condition of the mesh immediately after surgery. The results of the present study showed that “mesh surely shrinked over time and there was no adverse effect of mesh shrinkage on the patients outcomes in this population. Mesh would shrink over time regardless of the sort of mesh but it did not affect the patients outcomes”.
Scientific Reports 13: 3894. March 2023.
Patients with systemic reaction to their hernia mesh: an introduction to mesh implant illness
In the authors’ practice, an increasing number of patients have required mesh removal due to a systemic reaction to their implant. This study presents the authors’ experience in diagnosing and treating a subpopulation of patients who required mesh removal due to a possible mesh implant illness. Authors see a rising incidence of patients who suffer from systemic reaction following mesh implantation.
Journal of Abdominal Wall Surgery, January 2023. DOI: 10.3389/jaws.2023.10983.
Are late hernia mesh complications linked to Staphylococci biofilms? The purpose of this study was to investigate the link between bacterial biofilms and negative outcomes of hernia repair surgery. As biofilms are known to play a role in mesh-related infections, we investigated the presence of biofilms on hernia meshes, which had to be explanted due to mesh failure without showing signs of bacterial infection. Springer, March 2022. DOI: 10.1007/s10029-022-02583-0
The Surgical Disaster of the Mesh Infection
Necessary duration of follow‑up to assess complications of mesh in hernia surgery: a time‑lapse study based on 460 explants
As mesh devices are permanent, their risks are lifelong. Too many reports in the past assessed mesh safety prematurely after short follow-ups. This study aimed to explore what length of follow-up would reveal the full extent of complications – and concluded: “Follow-up of more than 15 years is needed to fully assess complications after mesh hernia repair.”
Hernia 25: 1,239-1,251. September 2020.
Pure tissue repairs: a timely and critical revival
Latest paper suggests 37% of patients with hernia mesh suffer complications including pain and loss of sex life.
Hernia 23: 493-502. May 2019
Unreported clinical trial of the week: prospective outcomes study of wall hernia repair with composite mesh (NCT02341430)
Each week The BMJ writes about one unreported clinical trial – and November 2018, it looked “A Longitudinal Prospective Outcomes Study of Laparoscopic Abdominal Wall Hernia Repair Using Symbotex™ Composite Mesh”. This phase four trial had an estimated enrollment of 50 adult participants with a Grade I or II ventral hernia. The trial was not randomised with single group assignment for treatment with the Symbotex Composite Mesh. The primary outcomes were hernia recurrence, quality of life, hernia associated pain and movement limitations, reoperation rate, percutaneous intervention rate, and adverse events. As of 31 October 2018, this trial was 50 days overdue to report…
Why we remove mesh
Study of 105 patients over four and a half years shows the number of people having mesh removed is 22% – that is a super high rate of 1 in 4.5 people and a wholly unnaceptable risk.
Hernia 22: 953-959. October 2018.
A pathology of mesh and time: dysejaculation, sexual pain, and orchialgia resulting from polypropylene mesh erosion into the spermatic cord
The ubiquitous use of polypropylene mesh in hernia surgery has spawned a new clinical syndrome: chronic post-herniorrhaphy neuralgia. A subset of that clinical picture is dysejaculation, sexual pain, and orchialgia. This study identified the processes that lead to that pain.
Annals of Surgery 267(3): 569-575. March 2018.
Factors influencing the reporting of adverse medical device events: qualitative interviews with physicians about higher risk implantable devices
Postmarket surveillance of medical devices is reliant on physician reporting of adverse medical device events (AMDEs). Little is known about factors that influence whether and how physicians report AMDEs, an essential step in developing behaviour change interventions. This study explored factors that influence AMDE reporting.
It concluded: “There may be little point in solely educating or incentivising individual physicians to report AMDEs unless environmental conditions are conducive to doing so. Future research should explore policies that govern AMDEs and investigate how to design and implement postmarket surveillance systems.”
BMJ Quality & Safety 27(3): 190-198. February 2018
Bilateral endoscopic totally extraperitoneal (TEP) inguinal hernia repair does not impair male fertility
This study claims hernia mesh does not cause infertility in males. However, it only follows-up patients for 6 months – and the average time for problems to present is 7 to 10 years later…
Hernia 21: 887-894. August 2017.
Recurrence of inguinal hernias repaired in a large hernia surgical specialty hospital and general hospitals in Ontario, Canada
The risk of recurrence following an inguinal mesh hernia repair is five times higher than the Shouldice non-mesh repair. Independent research by the University of Toronto studied more than 235,000 patients from 1993-2007.
Canadian Journal of Surgery 59(1): 19-25. February 2016.
Mesh-related SIN syndrome. A surreptitious irreversible neuralgia and its morphologic background in the etiology of post-herniorrhaphy pain
The ubiquitous use of synthetic materials in hernia surgery has brought about a new clinical syndrome: surreptitious irreversible neuralgia (SIN). It is surreptitious because it is of slow onset, unsuspected and enigmatic to clinicians; irreversible because the pain is progressive, unrelenting and unresponsive to treatment. Removal of the mesh does not guarantee pain relief. Neuralgia following mesh insertion, when it occurs, remains a poorly understood phenomenon.
This study concluded: “The presence of mesh does not significantly affect nerve density, while the nerves and their terminal ends are in a vulnerable position about the mesh and within its pores. These pores need to be viewed as ‘mini-compartments‘ of biological tissue where the vasculature, nerves and their receptors are exposed to potential mechanical and chemical factors: scarring, entrapment, compression, tugging, deformation, contraction, hypoxia/acidosis, inflammation and edema.”
International Journal of Clinical Medicine 5(13): 799-810. July 2014.
Litigation following groin hernia repair in England
Between 1995-2009, litigation following surgical procedures has cost the NHS more than £1.3 billion. In total, 398 claims were made. Of these, 209 cases had been settled, of which 144 were in favour of the claimant at a cost of £7.35 million. Testicular injury and chronic pain featured in 40% of all claims. The study concluded: “Patients should be fully informed of the incidence of testicular injury and chronic pain during the consent process.”
Hernia 14: 181-186. December 2009.
Researchers
Robert Bendavid – the most published and respected researcher who extensively studied hernia mesh complications.
Vladimir Iakovlev – has published extensively on hernia and surgical mesh, including several papers with Robert Bendavid.
News and discussion
Hernia mesh used ‘with no clinical evidence’ – January 2020
The BBC Victoria Derbyshire show reports on how hernia mesh has little or no clinical evidence. In response, the Royal College of Surgeons says 1 in 10 people suffer complications following an inguinal hernia mesh repair. Watch the full BBC Victoria Derbyshire show clip:
Hernia mesh parliamentary debate – September 2019
Jim Shannon pleads that patients must be warned of mesh risks. Hansard
Is hernia mesh really that unsafe? – March 2019
British Hernia Centre view point by Andrew de Beaux. Read his viewpoint – sadly, it blames media hype. That old favourite. It doesn’t tally with our experience.
Surgeons offer advice on how to communicate with concerned patients – January 2019
Surgeons need to take time to listen to patient concerns and talk to them about the state of the evidence for hernia mesh, said B. Todd Heniford – the chief of gastrointestinal and minimally invasive surgery at Carolinas Medical Center in Charlotte, North Carolina – at the American College of Surgeons 2018 Clinical Congress. General Surgery News
‘I have tried to end my life’: hernia mesh patients overwhelmed by pain – July 2018
Several women who have had hernias repaired with plastic surgical mesh say the subsequent pain they have endured has driven them to contemplate – and sometimes even attempt – suicide. Doctors, they add, have offered little in terms of solutions. CTV News
Hernia mesh – a story of deception, tragedy and hope – May 2018
Nutritionist, health educator and wellness consultant Luke Yamaguchi shares how having “36 square inches of polypropylene mesh in my body, my health would turn into a veritable train wreck”. Read his blog
97,000 people have this operation each year – here’s what happens when it goes wrong – April 2018
Huffington Post reports on how hernia mesh complications are leaving people in intensive care.
New hernia surgery standards paid for with industry money – March 2018
Drug Watch reports that hernia mesh guidelines are funded by industry – the two main sponsors are Bard and Johnson & Johnson.
Risks from surgical mesh in hernia repair too high, Canadian surgeon says – January 2018
Robert Bendavid, a past-president and a founding father of the American Hernia Society, tells Stuff the incidence of chronic pain following all types of hernia repairs had increased substantially since the use of surgical mesh from the mid-1990s.
Hernia mesh disaster – October 2017
A hernia patient talks about how no tests show anything is wrong, yet the pain gets worse and painkillers get stronger. He didn’t even know mesh had been inserted. His life, his enjoyment, his hobbies – all gone.
Canada has a ‘big blind spot’ on medical device safety: study – September 2017
A study found more than 7,200 medical devices were recalled in Canada between 2005-14 – and ranged from hospital beds to major joint implants to hernia mesh. CTV News
J&J’s Ethicon recalls Physiomesh flexible composite hernia mesh – June 2016
Johnson & Johnson subsidiary Ethicon recalled one of its surgical mesh products after studies showed higher revision rates after a type of minimally invasive hernia repair using its Physiomesh flexible composite mesh. Mass Device
The Medical and Healthcare products Regulatory Agency (MHRA) knew of concerns in 2011 and did nothing to protect patients
A meeting of the MHRA Committee on the Safety of Devices – held on July 7, 2011 – heard about a workshop in March 2011 that discussed vaginal tapes and the complications associated with the devices. It considered:
- The increased number of women reporting mesh complications.
- Concerns mesh was approved without enough clinical data.
- Surgeons implanting without adequate training.
…but the MHRA did nothing. Read the minutes (page 14)
Lawsuits
Bard hernia mesh lawsuit alleges failure to warn about risks from recalled patch – May 2017
A lawsuit indicates that problems with the design of Bard Monofilament Soft mesh caused severe damage following a hernia repair. AboutLawsuits.com
Canadian patients join class-action suit over recalled hernia mesh – March 2017
Canadian hernia surgery patients launched a class-action lawsuit against the maker of a now-recalled surgical mesh, claiming they weren’t warned of its dangers. CTV News
Hollis Law provides a good one-stop shop for information about hernia mesh complications.
Mesh types
Bard Monofilament soft mesh caused severe damage following a hernia repair. AboutLawsuits.com
Double trouble: Coviden Symbotex Composite mesh is made of both porcine biomesh and polypropylene. Warnings of infections, allergic reactions and not to cut the mesh. Also warns of product placement.
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