The lowest purported risk of hernia recurrence is associated with the use of synthetic mesh and stitches, although hernia mesh fails from time-to-time despite the best efforts of experienced surgeons. Biologically-sourced hernia mesh fails at a slightly higher rate, leading to a medium risk of recurrence if it is applied with stitches in the original repair.

According to the Cleveland Clinic, man-made mesh is constructed from non-absorbable and absorbable synthetic polymers—polypropylene and polyglycolic acid or polycaprolactone. Biologic mesh is made from collagen-based sterilized materials sourced from pigs or cows.

Although hernia mesh fails to keep some hernias from coming back, the highest risk of recurrence is assigned to a surgical repair in which just stitches and no mesh is used. This is because the mesh is used to widen the surface area, which is strengthened in the procedure, according to the University of California, Irvine Medical Center.

Without this widening, the anatomical pressure on the herniated area can be significant. This alleged high-risk level of recurrence without mesh underscores the notion that it does have its place, despite the risks. As with any invasive medical procedure, however, a risk-benefit analysis should be undertaken with your physician before repair.

What are other risks of hernia mesh failure besides hernia recurrence?

While they can occur with or without the use of mesh, reported problems with mesh and hernia repair include infection, adhesions, bowel obstruction, fistulas, seromas, pain, bleeding, and perforation of nearby organs due to migration. Mesh has also been noted to abnormally contract over time as well.

What are adhesions and how do they contribute to bowel obstruction?

Adhesions are basically internal scar tissue which the body creates in response to surgical interventions. They are made up of fibrous bands that form in between and around two injured surfaces adjacent to one another. Some adhesions are relatively benign, but some can cause problems with organ function by twisting and pulling at them.

The biggest danger is bowel obstruction, a potentially fatal condition. In bowel obstruction, the adhesion can cause the small intestine to kink up and prevent the free movement of its contents through the gastrointestinal tract.

What are symptoms of bowel obstruction?

The first symptom of bowel obstruction is typically pain in the abdominal region. While a person might feel the urge to defecate, they cannot pass gas or stool. Sometimes, according to Medical News Today, even passing gas is difficult to impossible. If the bowel is partially obstructed, the person may develop diarrhea, but pressure continues to build in the intestines.

If the blockage remains untreated, the intestines can split and allow for bacteria spillage throughout the abdominal cavity. This quickly becomes a very critical, life-threatening situation.

What is a fistula?

A fistula is an abnormal connection, tunnel, or hole between two organs not typically connected. A fistula is typically formed when an area of tissue begins to die off due to prolonged lack of blood supply. The area starts to disintegrate, allowing for the tunneling to occur.