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Archive August 2018 XIX, No. 8

The Queen of Hernia Repairs

I specialize in treating patients with hernia-related complications.

Shirin Towfigh

Shirin Towfigh, MD, FACS


THE FIXER Shirin Towfigh, MD, FACS, doing what she does best: repairing hernia-related complications. Assisting is urologist Paul Turek, MD, FACS, FRSM, an expert in men's reproductive and sexual health.

They call me the Queen of Hernia Repairs. As a surgeon who specializes in complex hernias, I wear my crown with pride. I live, love and breathe hernias, but mostly I treat patients who’ve had hernia repairs and now suffer a complication. These can be complex problems with chronic pain. Examples include:

  • mesh erosion into the bladder or spermatic cord;
  • mesh infection, which almost always requires complete mesh removal — a tricky procedure depending on the type and size of the repair;
  • folded mesh (meshoma) that bunches up into a ball; and
  • nerve entrapment or nerve injury.

The cause of the pain is rarely straightforward, but there’s almost always a solution. But here’s the thing. More and more patients are calling my office in search of non-mesh repairs. Thats’ right. Despite the fact that laparoscopy, in addition to its cosmetic advantages, also tends to result in lower recurrence rates and less chronic pain than open repairs, we’re seeing a resurgence in tissue-based open inguinal hernia repairs.

Why have non-mesh repairs, like vinyl records, suddenly become a thing again? Because laparoscopy necessitates the use of mesh — and the public backlash against mesh has been fervent. Mesh and mesh-related complications are generating a lot of bad publicity, driven mostly by the failure of transvaginally placed mesh for urinary incontinence. Unfortunately, many patients are confusing hernia mesh outcomes with transvaginal mesh outcomes.

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