Pain after hernia surgery

After undergoing inguinal hernia or sports hernia surgery, approximately 2-4% of patients may experience chronic pain. Patients are classified as having chronic pain if postoperative pain lasts for more than 3 months, with it impacting on daily leisure activities.

The most common reason for this pain is an injury, kinking, or scarring to the sensory nerves located in the inguinal canal. This is more likely to occur with open repairs as opposed to keyhole operations. Some argue it is the mesh that causes the pain but most recent studies show that the risk of chronic pain is only reduced slightly during open repairs when mesh is not used. The best way to avoid chronic pain by far is to have a keyhole procedure particularly if under the age of 55.

In this blog post, you’ll discover how you can manage chronic post-operative pain after hernia surgery.

What does chronic post-operative pain feel like after hernia surgery?

Like any surgery, you are likely to feel some amount of pain after undergoing a hernia repair. So, how can you tell if you are suffering with normal or chronic pain?

The pain you experience often changes when there is a nerve problem after hernia surgery. Patients often describe it as severe and sharp. It may also feel more like a stabbing pain and is usually localised to a specific area on the inguinal area. You’ll find certain motions can also make the pain much worse. In men, it may even radiate to the testicle in some cases.

What causes chronic pain after mesh-based hernia repair?

Sometimes, chronic post-operative pain develops when the nerve becomes entangled with the mesh or the non-mesh repair used in the initial open surgery. The purpose of the mesh is to act as a support structure to bridge the weakened inguinal floor or plug the internal ring. It typically takes several weeks to become effective, as it becomes incorporated into the tissues of the inguinal floor, with scar tissue acting as a natural adhesive.

The mesh is designed to come into contact with muscles, the conjoint tendon, or the inguinal ligament. But it can also adhere to other structures in the area. These include nerves, blood vessels. When the nerves are affected, it can cause moderate to severe pain. Unfortunately ,even not using mesh in open operations (sutured or stitch repairs) can still damage nerves and lead to chronic pain.

Normally, the nerves are able to move freely in the inguinal canal, but when they become entangled with the mesh or stitches, any movement in a certain direction can trigger pain signals to the brain. These symptoms may not appear until several weeks after surgery, as the scar tissue takes time to form.

If you do develop chronic post-operative pain, you can undergo mesh and or suture removal surgery.

Understanding mesh removal surgery

Mesh removal surgery is a similar procedure to the initial hernia repair surgery, though it can be more complex. In some instances, it may require a rebuild of the abdominal wall. Depending on the type of mesh used, all or just a portion of the mesh may need removing.

The mesh removal surgery typically lasts up to two hours. It is usually carried out under general anaesthesia, and in some cases, you may need to stay in the hospital for at least a day. The recovery process may take several weeks or even months, depending on the complexity of the surgery.

Mr Stellakis can perform mesh removal surgery both open and laparoscopic for patients who are experiencing chronic post-operative pain. Book an appointment today to talk through the procedure and whether it would help eliminate the pain you are experiencing.