28/01/2018 08:01 GMT | Updated 06/03/2018 16:04 GMT

Hernia Mesh Repair Explained Amid Reports Of Pain And 'Life-Changing' Complications

'It felt like there was barbed wire pressing into me.'

The vaginal mesh scandal continues to dominate headlines after hundreds of thousands of women around the world experienced life-changing complications, but now, campaigners in the UK want to ensure hernia mesh is part of the debate. 

Hernia mesh is used in the treatment of hernias, particularly the most common form, inguinal hernia, where a swelling or lump appears in the groin area. Approximately 70,000 surgical inguinal hernia repairs are performed in England each year and a “growing number” of patients are reporting complications.

Hernia mesh patient Jennifer Coles told HuffPost UK the procedure was debilitating, saying she felt like she had “a piece of glass” caught inside her, leaving her unable to work after surgery.

Now, the All Party Parliamentary Group on Surgical Mesh Implants and campaign group Sling the Mesh have told HuffPost UK they want to see a review of official guidelines around hernia mesh and an audit of past patients’ experiences. 

So, what do you need to know about hernia mesh and if you’ve already had the procedure, should you be worried? 

PhotoGraphyKM via Getty Images

A hernia occurs when an internal part of the body pushes through a weakness in the tissues that hold muscles together. The condition is more common in men, but can affect anyone.

Andrew de Beaux, president of the British Hernia Society, told HuffPost UK: “Think of a hernia in a sense as a tear in your jeans which has happened from wear and tear. You could sew up the tear, but the tear will soon recur. 

“Or you could put a patch of material over the tear - in essence sewing the edge of the patch to less worn fabric - the repair will last longer.”

Hernia mesh is a synthetic material similar to nylon or polyester that’s inserted into the body to “patch” up the weakened area.

Kath Sansom, founder of Sling the Mesh, which was originally set up raise awareness of vaginal mesh complications, said a “growing number of men and women” have been visiting the site looking for advice on hernia mesh.

“It is another case of a quicker, cheaper fix than traditional repairs that take more skill and longer, yet we have men on the page who have lost sex lives, have struggling marriages, lost jobs and are in agonising pain - and none of these risks were explained to them,” she told HuffPost UK.

Jennifer Coles, 33, is just one of the hernia mesh patients now working with Sling the Mesh to raise awareness of complications.

She developed a visible bulge on the left side of her tummy last year and was told a scan revealed a hidden hernia on the right side, too. She was advised to have mesh fitted on both sides of her body.

When she woke up from surgery, Jennifer said it felt as though someone had taken her leg off and “put it back on at a funny angle”.

“I couldn’t seem to straighten it properly. When I got home and I’d healed a little, it felt like I had a tight pair of bikini bottoms under my muscles,” she told HuffPost UK.

The pain didn’t ease over time and in the following months, day-to-day life became a struggle.  

“I’d often take my first few steps of the day with no problems and then I’d catch something inside me like a piece of glass. I really dreaded that happening so I’d walk really carefully,” she said.

“Sitting was also really painful. It would start with a dull ache and over the course of about half an hour, it would gradually start to feel like there was barbed wire pressing into me. I tried so hard, but I couldn’t concentrate in meetings, I was always cancelling on my friends.”

Jennifer Coles

Jennifer claimed she was not warned about complications before receiving surgery and after months of suffering, her family paid for her to see a private consultant and have the mesh on her right side removed. 

“When I woke up I was in more pain, but the deep, vice-like sensation had gone. The surgeon told me there wasn’t even any sign of a hernia,” she said. 

According to Andrew de Beaux, complications directly related to the mesh, such as those reported by Jennifer, “are rare”.

He said the main complication risk after hernia mesh surgery is infection, which has been linked to “less than one in 1,000 mesh implants”.

“Mesh is foreign material, so like any material, be it heart valve, cataract lens or hip replacement, if it gets infected around the time of insertion, treating the infection without removing the material is difficult,” he said.

He added that chronic pain persisting six months after surgery “as a result of involvement of nerves within scar tissue” can happen “after any operation”. 

“In some cases, where mesh is inserted close to where the nerves run, the risk of chronic pain as a result of mesh use is higher, but still low,” he said.

However, Jennifer said since sharing her story online, she’s been contacted by nearly 50 strangers who’ve had similar problems. What’s more, MP Owen Smith, chair of the All Party Parliamentary Group on Surgical Mesh Implants (APPG), said constituents have also reported problems and the group is investigating.

Jennifer Coles
Jennifer found the manufacturer's measurements for the mesh she was given, traced the mesh to scale and taped the paper to herself to better understand the device: "All this plastic for one 2.3cm hernia."

The conflicting messages around the prevalence of complications could be down to the fact there is no official national register of hernia mesh patients. 

According to the Sling the Mesh, NICE (the National Institute for Health and Care Excellence) does not have sufficient guidelines in place around the use of hernia mesh. 

“Hernia mesh in the first instance needs NICE guidelines setting up as it has been used extensively in the UK for around 30 years without anything from NICE,” Kath Sansom said.

“It is a permanent device and virtually impossible to remove, yet just like vaginal mesh, there are no national registries and no audit to track how a patient is doing after a hernia mesh operation.”

MP Owen Smith also called on NICE to “get on with publishing” guidelines on hernia mesh, adding: “I am also calling on the NHS to undertake a full retrospective audit of all patients who have been treated with mesh – for incontinence, prolapse and hernias – and a prospective registry of new patients, so that we may have some clarity on just how many that treatment has caused life-changing complications.” 

As the large scale of the vaginal mesh scandal became clear - with a manufacturer being ordered to pay an American woman $100 million in compensation for complications - NICE updated its guidelines on the procedure in the UK.

It said vaginal mesh repair “should only be used in the context of research” until we know more about complications, adding: “Further research should include details of patient selection, long-term outcomes including complications, type of mesh used and method of fixation, and quality of life.”

But despite reports of complications with hernia mesh, albeit on a smaller scale to date, health bodies do not currently plan to change guidelines. 

The Medicines and Healthcare products Regulatory Agency (MHRA), which is part of the Department of Health and is responsible for the regulation of medical devices, claimed it has not had any evidence which would lead it to alter its current stance on surgical mesh for hernia repairs. 

An MHRA spokesperson told HuffPost UK: “Patient safety is our highest priority and we recognise some patients do develop complications after surgery.

“We encourage anyone who suspects they have had a complication after having a medical device implanted, to discuss this with their clinician and report to us via the Yellow Card scheme regardless of how long ago the implant was inserted.”

A spokesperson from NICE did not want to provide further comment, but said further information on technology appraisal around hernia mesh could be found here.

Andrew de Beaux said people people who’ve already undergone hernia mesh surgery should not panic in light of recent reports on complications, adding: “If they are currently well, it’s highly likely they will remain well.”

But if you are concerned about your recovery or possible complications following hernia mesh surgery, speak to your GP. 

If you’ve experienced complications due to hernia mesh, we want to hear from you. Email rachel.moss@huffpost.com to share your story.