Is It the Mesh?

Abstract

It is well known that after inguinal herniorrhaphy, some patients develop inguinodynia. Pain has often been blamed on injury or entrapment of the ilioinguinal nerve. Since the advent of mesh, we have noticed a number of patients with persistent pain even after the ilioinguinal nerve has been transected or blocked. For that reason, a retrospective review was done to analyze whether the mesh could be a culprit for this chronic pain syndrome. A total of 12 cases were reviewed. All patients underwent exploration of the inguinal area, along with removal of the previous mesh and herniorraphy with a McVay technique. After exploration and removal of the mesh, the inguinal pain was greatly improved within 2 months of the time of surgery in all 12 patients. Despite changes in mesh manufacturing and hernia repair technique, we believe that there is a possible correlation between the mesh and inguinodynia in a certain subset of patients that seems to be unrelated to nerve pathology. This correlation may prompt revision in training surgical residents in primary tissue repair and may lead to further investigations regarding patient response to inguinal mesh placement.