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Hernia Mesh Complications

Each year, more than one million people undergo hernia repair procedures. Hernia repair surgery has become fairly routine and common. Even so, hernia repair complications are possible. 1

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Suffering complications after hernia mesh surgery?

According to the U.S. Food and Drug Administration (FDA), following all types of hernia repair procedures the most common complications are: 2

  • Pain.
  • Infection.
  • Hernia recurrence.
  • Bleeding.
  • Perforation — a hole forms in surrounding tissues or organs.
  • Adhesion — scar-like tissue sticks tissues together.
  • Seroma — fluid builds up at the surgical site.
  • Obstruction — the large or small intestine becomes blocked.
  • Fistula — an abnormal connection or tunnel forms between the intestines, organs, or blood vessels.

Hernia Mesh Complications Symptoms

When people undergo hernia repair procedures using hernia mesh, the most common hernia mesh complications symptoms are: 3

  • Pain.
  • Infection.
  • Hernia recurrence.
  • Adhesion.
  • Bowel obstruction.

Other possible hernia mesh complications symptoms include: 4

  • Mesh migration — the mesh moves from where it was originally placed.
  • Mesh shrinkage — the mesh contracts.

Infections

One of the possible hernia mesh side effects is infection.

When you develop what is called a late-onset deep mesh infection, the mesh produces a severe inflammatory reaction in the body. This type of infection can develop months or years after you undergo a hernia repair procedure. 5

Symptoms characteristic of a late-onset deep mesh infection include: 6

  • Chronic pain.
  • Red, swollen, tender skin.
  • Visible pus, at times.
  • Abnormal tunneling or connections between internal organs, intestines, or blood vessels (fistulas), at times.

Doctors may use ultrasound imaging to diagnose a deep mesh infection. The imaging may reveal a mass between muscle layers.

Doctors may also use computed tomography to diagnose a deep mesh infection. This tool may reveal an abnormal density of soft tissue, possibly with the appearance of fuzzy space around the hernia repair site. 7

Bowel Obstruction

Another of the possible hernia mesh side effects is bowel obstruction. Bowel obstruction can be a complication of an initial hernia as well as a hernia that recurs after hernia repair surgery.

In fact, hernias “are the second most common cause of small-bowel obstruction in the United States.” 8

A hernia occurs when the muscles and fibers in the abdominal wall weaken. Part of the intestine, muscle, or fatty tissue may bulge through this weakened area. 9

Hernias can become incarcerated, which means they become trapped in the weak point of the abdominal wall. Incarcerated hernias can obstruct the bowels, leading to severe complications and the necessity to have emergency surgery. Incarcerated hernias also can become strangulated, which means blood flow is cut off from the trapped tissue. Strangulation of a hernia is life-threatening, with the potential for tissue necrosis (death), sepsis, and the need for emergency surgery. 10

Bowel obstruction occurs when a partial or full blockage of some type prevents the contents of the intestines from moving through the digestive track normally. The blockage can occur anywhere in the small (small bowel) or large intestines (large bowel, or colon). 11

Adhesions and Bowel Obstruction

Adhesions can also lead to bowel obstructions. Adhesions are also a possible complication of hernia mesh repair procedures. 12 13

Adhesions are bands of scar-like tissue that have become stuck together. Usually, tissues and organs inside the body have slippery surfaces. This slipperiness allows tissues and organs to move easily against each other. When adhesions form, tissues and organs can stick to each other. 14

Adhesions might make the loops of the intestines stick to surrounding tissues, to each other, or to the abdominal wall. When sections of tissues and intestines are stuck together, they may form a blockage (obstruction) in the intestines or other problems. 15

This blockage can disrupt the digestive tract. Food may not be able to pass through the intestines.

Possible symptoms of bowel obstruction can include: 16

  • Cramping abdominal pain that comes in waves.
  • Vomiting.
  • Loss of appetite.
  • Abdominal swelling.
  • Constipation.
  • Reduction or absence of ability to pass gas or stool.

Minimizing Hernia Mesh Side Effects

In recent decades, hernia repair procedures have become less invasive. Laparoscopic surgical procedures mean that patients may be able to resume some level of normal physical activity more quickly after undergoing surgery. 17

Hernia Mesh Surgery Recovery Time

Doctors typically consider a person’s overall health in making recommendations about postoperative recovery time.

Each patient should be considered individually. Patients who work at home, for example, may be able to return to work shortly after hernia repair surgery, sometimes a week or less. 18

On the other hand, if your job is strenuous, you might need to take more time off of work to recover. For patients engaged in highly physical work or demanding sports, a person might need to wait up to two months to resume full activity level. 19

Gradually becoming more physical over time gives the body time to heal so that the incisions and hernia repair are not stressed. Hernia repair with mesh involves two healing stages: 20

  1. The mesh remains fixed where it is by the strength of sutures or tacks.
  2. Tissue ingrowth is supposed to occur, which is intended to increase the stability of the mesh.

Hernia Repair with Mesh Complications Symptoms

Hernia repair with mesh complications symptoms are possible after undergoing an abdominal operation. In fact, the development of an incisional hernia after an abdominal surgical procedure is a relatively common complication. These hernias develop along the incision. 21

Doctors may use surgical mesh to repair incisional hernias. Possible complications of incisional hernia repair with mesh may include: 22

  • Hematoma, swelling filled with blood near the surgical site.
  • Seroma, a pocket of fluid near the surgical site.
  • Reaction to the surgical mesh.
  • Injury to an internal organ.
  • Infection.
  • Mesh rejection.
  • Fistula, an abnormal tunnel or passage between two areas inside the body.
  • Mesh movement or migration.
  • Mesh erosion.

Possible incisional hernia repair with mesh complications symptoms may include: 23

  • Chronic pain.
  • Nausea.
  • Tenderness in the abdomen.
  • Bleeding.

Other hernia repair with mesh complications symptoms may include infection, among others. 24

Hernia Repair Mesh Complications and Recalls

Hernia repair mesh complications may include pain and infection along with: 25

  • Recurrence of a hernia.
  • Adhesion (when internal tissues become stuck together abnormally).
  • Obstruction.
  • Perforation (a hole or tear in the body’s tissues

These hernia repair mesh complications are the most common problems linked to recalled mesh. 26

Some hernia meshes have been removed from the market by the manufacturer.

If you do not know if the mesh used in your surgery was recalled, withdrawn from the market, or if the FDA has received adverse event reports regarding it, the FDA advises you to contact your doctor for more information. You may also be able to determine the type of mesh implanted by contacting the facility where you had your surgery and obtaining information from your medical file. 27

Inguinal Hernia Complications

An inguinal hernia typically occurs when part of the small intestine or fatty tissue in the abdomen bulges through a weakened area of the lower abdominal wall. That area is also referred to as the inguinal or groin region. 28

Inguinal hernias may be indirect, meaning they were caused by a congenital defect, or they can be direct, which means they are caused by a weakness in the abdominal wall that typically develops over time. Direct inguinal hernias usually happen in men. 29

Inguinal hernias are named for their location. They occur at the inguinal canal, near the groin.

Inguinal hernia complications can include: 30

Incarceration: An incarcerated hernia refers to a bulge of fat or small intestine that has protruded into and lodged itself in the groin or scrotum. It cannot go back. It is stuck there.

Strangulation: An incarcerated hernia can become obstructed. This means the bulge of intestine or fatty tissue can become pinched or squeezed. When this occurs, the blood supply cannot reach the small intestine. This medical condition, known as a strangulated hernia, is an emergency. If a strangulated hernia is not treated, part of the intestines can die.

People should seek medical attention immediately if they experience symptoms of severe inguinal hernia complications, such as a strangulated hernia. These symptoms may include: 31

  • Extreme tenderness at a bulging area in the groin.
  • Painful redness at a bulging area in the groin.
  • Sudden pain that quickly becomes worse and does not go away.
  • Inability to have a bowel movement or pass gas.
  • Nausea and vomiting.
  • Fever.

Umbilical Hernia Repair with Mesh Complications

Umbilical hernias in adults become more common after age 60, when many people’s abdominal muscles start to weaken. Umbilical hernias can be repaired via open or laparoscopic approaches, and either method may use mesh. 32

Umbilical hernia repair with mesh complications may include: 33

  • Large seromas, or pockets of fluid, near the surgical site.
  • Surgical site infections.

Both of these umbilical hernia repair with mesh complications can also result in a recurring hernia. 34

Risk factors for recurrent umbilical hernia with mesh complications may include: 35

  • Obesity.
  • Diabetes.
  • Smoking.

As with inguinal hernias, patients can experience incarceration and strangulation with umbilical hernias. When a portion of intestines or fatty tissue bulges through an organ’s lining, it can become trapped and pinched (incarcerated). 36

When this occurs, the blood supply can be cut off (strangulation). Hernia incarceration and strangulation are medical emergencies that require immediate attention. If not resolved, death is possible. 37

Hernia Surgery Mesh Complications

Severe hernia surgery mesh complications may lead to surgical mesh recalls. In recent years, hernia mesh manufacturers have recalled some hernia mesh models because of significant adverse events. 38

If you want to know whether a specific surgical mesh product has been recalled, you can visit the FDA’s Medical Devices Recalls web page. You can conduct a search and find reports of hernia surgery mesh complications. 39

Hernia Complications, If Not Treated

Hernia complications, if not treated, can be severe. Hernia incarceration and strangulation can cut off the blood supply to various internal organs, depending on where the hernia has developed. 40

Hernia incarceration and strangulation are medical emergencies. These hernia complications, if not treated, can potentially lead to death. 41

  1. U.S. Food & Drug Administration. (2018, February 4). Medical Devices. Hernia Surgical Mesh Implants. Retrieved from https://www.fda.gov/MedicalDevices/ProductsandMedicalProcedures/ImplantsandProsthetics/HerniaSurgicalMesh/default.htm
  2. Ibid.
  3. Ibid.
  4. Ibid.
  5. Chen, T., et al. (2016, August 5). Late-onset Deep Mesh Infection: A Study of Eight Cases Detected from 2666 Consecutive Patients with Abdominal Wall Hernia Repairs. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4976579/
  6. Ibid.
  7. Ibid.
  8. Cleveland Clinic. (2015, March 1). Small Bowel Obstruction Retrieved from https://my.clevelandclinic.org/health/diseases/15850-small-bowel-obstruction
  9. WedMD. (2017, July 22). Understanding Hernia -- the Basics. Retrieved from https://www.webmd.com/digestive-disorders/understanding-hernia-basics
  10. Mayo Clinic. (2018, January 6). Inguinal hernia. Retrieved from https://www.mayoclinic.org/diseases-conditions/inguinal-hernia/symptoms-causes/syc-20351547
  11. Mayo Clinic. (2018, January 5). Intestinal obstruction. Retrieved from https://www.mayoclinic.org/diseases-conditions/intestinal-obstruction/symptoms-causes/syc-20351460
  12. Ibid.
  13. U.S. Food & Drug Administration. (2018, February 4). Medical Devices. Hernia Surgical Mesh Implants. Retrieved from https://www.fda.gov/MedicalDevices/ProductsandMedicalProcedures/ImplantsandProsthetics/HerniaSurgicalMesh/default.htm
  14. U.S. National Library of Medicine. MedlinePlus. (2018, March 1). Adhesions. Retrieved from https://medlineplus.gov/adhesions.html
  15. Ibid.
  16. Mayo Clinic. (2018, January 5). Intestinal obstruction. Retrieved from https://www.mayoclinic.org/diseases-conditions/intestinal-obstruction/symptoms-causes/syc-20351460
  17. Mayo Clinic. (2018, January 6). Inguinal hernia. Diagnosis. Retrieved from https://www.mayoclinic.org/diseases-conditions/inguinal-hernia/diagnosis-treatment/drc-20351553
  18. Forbes, J., et al. (2012, September). Timing of Return to Work After Hernia Repair: Recommendations Based on a Literature Review. Retrieved from https://www.bcmj.org/articles/timing-return-work-after-hernia-repair-recommendations-based-literature-review
  19. Ibid.
  20. Ibid.
  21. Gandhi, D., et al. (2011). Chronic abdominal pain secondary to mesh erosion into cecum following incisional hernia repair: a case report and literature review. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3959323/
  22. Ibid.
  23. Ibid.
  24. Ibid.
  25. U.S. Food & Drug Administration. (2018, February 4). Medical Devices. Hernia Surgical Mesh Implants. Retrieved from https://www.fda.gov/MedicalDevices/ProductsandMedicalProcedures/ImplantsandProsthetics/HerniaSurgicalMesh/default.htm
  26. Ibid.
  27. Ibid.
  28. National Institute of Diabetes and Digestive and Kidney Diseases. (2014, June). Inguinal Hernia. Retrieved from https://www.niddk.nih.gov/health-information/digestive-diseases/inguinal-hernia
  29. Ibid.
  30. Ibid.
  31. Ibid.
  32. American College of Surgeons. (2016, April). Adult Umbilical Hernia Repair. Retrieved from https://www.facs.org/~/media/files/education/patient%20ed/adultumbilical.ashx
  33. Ibid.
  34. Ibid.
  35. Ibid.
  36. Ibid.
  37. Ibid.
  38. U.S. Food & Drug Administration. (2018, February 4). Medical Devices. Hernia Surgical Mesh Implants. Retrieved from https://www.fda.gov/MedicalDevices/ProductsandMedicalProcedures/ImplantsandProsthetics/HerniaSurgicalMesh/default.htm
  39. Ibid.
  40. National Institute of Diabetes and Digestive and Kidney Diseases. (2014, June). Inguinal Hernia. Retrieved from https://www.niddk.nih.gov/health-information/digestive-diseases/inguinal-hernia
  41. American College of Surgeons. (2016, April). Adult Umbilical Hernia Repair. Retrieved from https://www.facs.org/~/media/files/education/patient%20ed/adultumbilical.ashx