The president of the Canadian Hernia Society, Dr. John Morrison, has been spreading word of an "epidemic" of mesh-related complications he has been witnessing for the past few years. "...And unfortunately, there's no end in sight," he says. "It's going to get worse because almost all hernias are now repaired with mesh."
But just how bad is this epidemic, and how much worse will it get? There is a significant debate within the medical community about how to measure the relative success or failures of surgical mesh.
In this blog post I examine some ways medical practitioners calculate the failure rates of hernia mesh, explain how some of these rates tend to worsen over time, and offer some information about what people experiencing painful complications can do.
The Gold Standard
How do you measure success when it comes to the 100,000 hernia surgeries performed in Canada every year? Prior to the introduction of modern suturing techniques and surgical mesh, a staggering number of hernias (10-30%) would return following an operation. Subsequent operations generally had much less chance of success.
The introduction of tension-free surgical mesh dramatically reduced the rate of recurrence and greatly increased the popularity of mesh among physicians and surgeons. According to Dr. Morrison, "The gold standard of hernia repair is the recurrence rate. People measure the success of hernia surgeries by how many came back afterwards."
Understandably, no one wants a hernia to return following an operation; by this measure – recurrence rates for laparoscopic mesh surgeries range from about 0.5% to 4% – the trend towards using surgical mesh was a resounding success.
However, those numbers don't tell the full story. And it's a story mainstream news media, including the renowned investigative journalists at CTV's W5, are beginning to tell.
By The Numbers: Hernia Recurrence
Although recurrence is one of the possible complications from surgery, it is certainly not the only one. Other reported complications from defective hernia mesh include bowel obstruction, fistulas, adhesions, and most commonly infections and chronic pain (pain lasting longer than three months).
Medical practitioners disagree about the true rate of all complications, including recurrence, following hernia mesh surgery. Some doctors, such as Dr. David Urbach, surgeon‐in‐chief at Toronto's Women's College Hospital, have said they believe complications are exceedingly rare; only up to 2% of patients will experience them. Others, such as Dr. Morrison, suggest the generally accepted rate of complications, including chronic pain, ranges between 10-15%. Still other American studies have pegged the rate as high as 43%, and suggest a rate of about 20% is most accurate.
Why the difference in numbers? In some cases, the studies or individual reporting by doctors use different definitions of pain. In other cases, the studies have not tracked the long-term consequences of defective mesh.
Dr. Vladimir Iakovlev, Director of Cytopathology at Toronto's St. Michael's Hospital, states that Canadian doctors "probably don't know exact rates of complications at this stage. Some complications occur [after] four or five years and sometimes [he gets] a mesh explant 10 years after implantation. So a study needs to follow patients for at least 10 years or so to actually catch that true complication rate."
Dr. Morrison explains that hernia complications involving mesh can happen at any time. Infection, one of the most common complications, "can happen on Day 1 or Day 1,001," due to foreign body reactions.
Defective Hernia Mesh Removal: Gone But Not Forgotten
While any surgery comes with the risk of complications, the medical literature is increasingly suggesting hernia repairs using defective mesh products are causing many problems over the long-term.
Declining recurrence rates might mean more hernias are gone for good, but the patients who experience complications weeks, months, or years later will not soon forget the operation that implanted the defective mesh in their bodies.
In fact, as W5 reports, a growing number of mesh patients are desperately searching for surgeons, such as Dr. Morrison, who will perform surgery to remove, not just repair, the defective mesh in hopes it will fix the problems they are experiencing.
"They feel that nobody will listen to them.," Dr. Morrison says of patients experiencing life-altering pain. "And that is the most striking feature of all, that they are getting passed from one professional to another to another," he said.
We Will Listen To You
There may be disagreements about hernia mesh failure rates and conflicting numbers. But, ultimately, victims of defective hernia mesh who are suffering serious complications are not just a number or a statistic; they are human beings whose lives have been severely impacted by a defective medical product.
If you or a loved one has required revision surgery or your physician has recommended this option, you may meet the threshold to be eligible for legal action against the manufacturers of the defective product. An experienced hernia mesh lawyer can listen to your story and inform you about your ability to seek damages for the pain and suffering this defective product has caused.
The content of this article is intended to provide a general guide to the subject matter. Specialist advice should be sought about your specific circumstances.