"This is your typical patient who is basically told the minimum, as any more info would become more concerning so the doctor doesn’t want him to be worried. A larger mesh is used to make sure the defect is fully covered, and as he knows the mesh will shrink back a bit anyways. I don’t understand “folded it over." I would need to read his operative report to see if the surgeon explained why he did that.
“The patient shouldn’t be concerned unless he begins to have pain or pressure. Would need to know the name of the device to determine if folding it is appropriate. He states it is in the area of the testicles, so was his hernia so advanced that it had fallen into his scrotum? Is he obese or a smoker? (height and weight?) What type of work does he do?
“If he plans to go back to work, depending on what he does the best advice is that he should not lift anything heavy…for the rest of his life.
“You can have this patient contact me directly. I don’t think he should worry so much and he should follow his surgeon’s advice for now, keeping in mind common sense about heavy lifting. He had a hernia so he has a significantly higher chance of developing another one due to an already weakened abdominal wall.
“The important thing that all hernia patients need to consider is that their abdominal wall CANNOT truly be permanently repaired to heal back to the way it was before they developed the hernia. Hernia is a disease of weakened collagen and tissue allowing structures such as bowel, omentum (fat) or other organs to protrude out of position which can create pain, pressure on nerves and spermatic cord/vas deferens, and even incarcerate/block the bowel. The patient is held together by sutures, the mesh (as a bridge across the defect) they can tear this back apart if they increase intra-abdominal pressure beyond the ability of the repair to hold them from separating again. Tissue does not grow back together.
“The idea was that mesh would decrease the amount of tension across the defect so it wouldn’t be so tight and pull apart, the problem is that it creates excessive foreign body response in many people (too many) with ensuing inflammation and pain. Natural suture repairs (Shouldice, McVay, Bassina, Desarda) are tighter at first, but hopefully the surrounding tissue will stretch over time and become more comfortable (over several months the patient begins to feel more normal) as opposed to mesh which if it does contract and stiffen with excessive scarring will incite pain, could possibly contract into a ball (“Meshoma”) or even split in the middle, adhere to nerves, bowel, bladder, arteries, etc, become infected…an absolute tragedy if any of this happens which is way worse that a pure tissue repair failing."
Mesh News Desk, January 14, 2019, Sen. Rand Paul Chooses Shouldice Clinic for Hernia Repair
MND, Dr. Bendavid tells Parliament adverse events are under-reported, October 2017 (here)
MND, Hernia Mesh: The Debate and the History, October 2014 (here)
MND, Women May Not Always be Candidates for Surgical Mesh, April 2013 (here)