Hernia Mesh

Many patients are suffering from chronic pain as a result of NHS England using mesh to repair hernias, according to surgeons who spoke with the BBC.

NHS England, a part of the Department of Health in the United Kingdom, recommends surgeons in the country use mesh devices to repair hernias. However, more and more patients are coming forward to report complications developed from hernia repairs using mesh.

In one case reported on by BBC’s Victoria Derbyshire, a woman said she suffered pain so severe that it left her screaming on all fours.

Leila Hackett suffered an umbilical hernia after giving birth to her daughter. This occurs when a part of the intestine protrudes through the umbilical opening as a result of a weakened abdominal wall.

She had a repair using a hernia mesh product in 2013 but quickly began experiencing problems.

“Straightaway I could feel the mesh,” Hackett told the BBC. “It was like somebody scratching you from inside your body, it’s so unpleasant and constant.

“It started off like fiery burning agony but it never stopped hurting or itching.”

Despite repeated mentions to her doctor, she was told it was not a problem.

It wasn’t until two years later did she go to a hospital to treat her pain. The mesh stuck to her internal organs, leading to bowel obstruction.

“The pain got so agonizing I was just screaming on all fours,” she said.

It took the surgeon four hours of picking out the pieces of the mesh but once everything was out, she felt better.

“As soon as I came round, I knew the mesh had been removed because I felt normal again,” she said.

Hernia Mesh Often Touted as Safer Alternative

Hernia injuries are very common, with some estimates saying one in 10 people will develop a hernia over their lifetime. Hernias can be repaired in different ways but mesh started to become an option in the 1940s to help prevent a hernia from happening in the same spot.

Hernia mesh products work by strengthening the abdominal wall where the hernia occurred. The mesh can be made of synthetic materials or even animal tissue and sometimes feature coating to minimize complications and help facilitate integration into the surrounding tissue.

Hernia mesh products have become increasingly popular, with only a small percentage of repairs being done without a mesh product, according to the U.S. Food and Drug Administration.

The BBC reported that NHS England said mesh implants have been successfully used to treat hernias for decades and that tens of thousands of patients are treated with mesh every year.

But there may be unexpected complications that people are not aware of, according to a former general surgeon from the UK.

“Severe pain is a common problem and patients aren’t being warned about it,” Peter Jones said. “At least half of patients who have a mesh repair will have a smooth recovery, but in my opinion the risks of a poor outcome are so bad, I wouldn’t want to take that risk.

“I think litigation will come into this. If enough people got together and said, ‘We are suffering and we weren’t warned about it’, that could put a dent into the mesh repair for hernias.”

Study Reveals Mesh May Not Be Better

Mesh is often cited as a better alternative that offers faster recovery time and a smaller incidence of recurrence.

In a comparison between mesh and sutures in hernia repairs published in the Journal of the American Medical Association in May 2014, researchers found using mesh had a small reduction of recurrence but an increased risk of seroma and surgical site infections.

A more recent study published in the journal found that the benefits attributed to mesh like a lower risk of recurrence are offset by other complications associated with mesh.

“In this registry-based nationwide cohort study including 3,242 patients, mesh repair was associated with a lower risk of reoperation for recurrence compared with nonmesh repair over a 5-year follow-up period,” the authors wrote in October 2016. “However, a risk of long-term mesh-related complications for open and laparoscopic mesh repairs partially offset these benefits.”

Techniques that don’t involve hernia mesh are available but not widely used. The Shouldice hernia repair uses a layering method that overlaps muscle layers and keeps tension off the natural tissue. According to the Shouldice Hospital, where the technique was pioneered, there has been a 99.5 percent success rate on primary inguinal hernias for more than 70 years.

NHS England told the BBC that the technique is difficult to replicate in hospitals and mesh remains the recommended method for hernia repairs.