Mesh hernia repair is the most common treatment for hernia injuries today, but hernia mesh has been linked to several painful complications. One reason that a number of surgeons continue to defend the use of hernia mesh is because there is a lower rate of injury recurrence.

While most surgeons acknowledge the risks, they believe that for most patients suffering from a hernia, the benefits outweigh those risks.

That is small comfort to those who have had serious reactions to mesh materials however or have had the device fail altogether.

What is a Hernia?

A hernia can occur when the internal organs push through the muscle or tissue that is typically responsible for holding it in place. Hernias can occur in a variety of areas of the body, but most commonly occur in the abdomen.

People with a hernia may notice a bulge or lump in the herniated area that disappears when laying down. Hernias may be more noticeable when standing up, bending over, or coughing and pain may be present. Special types of hernias may result in other symptoms such as heartburn, chest pain, and trouble swallowing.

In some cases, people with hernias may not notice the issue at all and only discover it during a physical or unrelated medical exam.

Hernias are classified as follows:

• Inguinal hernias: herniation of the lower abdominal wall or groin area, leading to the intestines pushing through
• Hiatal hernia: herniation of the diaphragm muscle, leading to part of the stomach pushing through
• Umbilical hernia: herniation of the abdominal wall near the belly button, leading to the intestines pushing through; more common in children and are capable of resolving without surgery
• Ventral hernia: herniation of the abdominal wall, leading to tissue pushing through; usually acquired through obesity, strenuous activity, and pregnancy; can form at the site of a surgical incision

For the most part, hernias are not life-threatening but they usually will not resolve without surgery. If a doctor determines that the symptoms and complications of a hernia warrant surgery, they may do a hernia mesh repair surgery.

Why Hernia Mesh Repair?

If not treated properly, there is a good chance that a hernia will recur. This is the primary reason that surgeons use surgical mesh when doing hernia repair. Surgical mesh strengthens the repair and makes it less likely that the injury will happen again.

Today, over 90 percent of hernia surgeries are performed with the use of mesh, according to the U.S. Food and Drug Administration.

What is the Failure Rate for Hernia Mesh Repair?

A meta-analysis of nine studies carried out over a 32-year period found that the use of surgical mesh in combination with sutures reduced the rate of hernia recurrence by nearly one-third (2.7 percent vs. 8.2 percent for hernia repairs with sutures only), according to a report by WebMD. However, the authors acknowledge that many factors are involved in the success or failure of a hernia operation, noting that additional research is necessary in order to determine whether or not one is clearly more effective than the other.

Other factors that may increase the risk of hernia recurrence include obesity, use of tobacco, certain medications and how the operation was performed.

What Are Possible Complications of Hernia Mesh Repair?

There are two major types of hernia mesh failure: rejection and erosion, either of which can result in migration of the device (or pieces thereof). Rejection typically occurs shortly after surgery; it is a reaction by the immune system to what it perceives as a foreign pathogen. Erosion/migration, on the other hand, can occur months or even years after the initial surgery.

Consequences of hernia mesh failure include:

• organ perforation
• fistulas (abnormal connections between blood vessels and organs)
• intestinal blockage
• internal hemorrhaging

Any of these can be life-threatening. If you began experiencing abnormal, severe pain, flu-like symptoms (fever), blood in your urine and/or stools or redness and irritation at and around the surgery site, it is important to contact your surgeon immediately.

Why do Hernia Mesh Complications Occur?

Plaintiffs in hernia mesh litigation claim that the devices were poorly designed and/or made from materials that are fundamentally incompatible with human tissues. This is primarily a problem with synthetic mesh; biologic mesh is less likely to cause problems, although infection can be a risk.

Are There Alternatives to Hernia Mesh Repair?

Over the past several decades, medical researchers at the Shouldice Hospital in Toronto have developed techniques of hernia repair that use the patient’s own natural tissues. Your hernia surgeon may be aware of other techniques that do not involve the use of surgical mesh; it is important to be fully informed before making decisions about your hernia treatment.