Archive October 2018 XIX, No. 10

How to Answer Patients' Hernia Mesh Questions

Amongst fear and fabrication, be the voice of reason.

Shirin Towfigh

Shirin Towfigh, MD, FACS

BIO

FAKE NEWS
Shirin Towfigh, MD, FACS
FAKE NEWS Help your patients decipher negative reports about hernia repairs and revisions.

Patients are much more informed about hernia mesh than they used to be, but you know the old saying: A little knowledge is a dangerous thing. Much of what they’re consuming can do more to confuse than to clarify. There’s a lot of stories out there, from botched operations and painful post-surgery complications, to defective designs and product recalls, to lawsuits and verdicts with lots of commas and zeros. That’s where we come in. When patients reach out to us with their questions, comments and concerns, we can allay their fears and set them straight.

1. I saw a report on mesh — now I’ll never get a hernia mesh repair!

Patients usually overreact after reading unbalanced reports about hernia repairs and complications attributed to mesh. Case in point: ‘Hernia mesh complications affect more than 100,000.’ Last month’s BBC report (osmag.net/eZ9EeF) pointed to a 12% to 30% complication rate. That is much higher than high-level data support. The report lumped all hernias together, but we know that the risks associated with the repair of abdominal wall hernias differ from the risks of pelvic and inguinal hernias. The report’s discussion of complications and chronic pain is incorrect or, at best, misleading. This causes anxiety for patients.

In the same report, a well-known and highly respected specialist, reported performing “3,000 mesh removals because of chronic pain — after which only 2 of the patients had not gone on to become ‘pain-free.’” That’s quite an amazing outcome, but it hasn’t been substantiated.

Buried under the mistakes and misleading discussion, the report made a valid point: Hernia surgery, as with any surgery, has risks and complications; the use of mesh adds to the risk of mesh-related complications.

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