Mesh shrinkage is the potential pathogenesis of chronic somatic pain following transabdominal preperitoneal repair: Report of two cases

Abstract

Although mesh‐related pain, termed “somatic pain,” is a well‐known pain syndrome following Lichtenstein repair, few reports are available on somatic pain following transabdominal preperitoneal repair (TAPP) and its pathogenesis remains unclear. We report on two patients with refractory somatic chronic pain following TAPP. In the present two cases, both mesh fixation with rigid permanent metal tackers and mesh shrinkage resulting in contractile forces on the groin musculature could be considered as potential mechanisms in the etiology of chronic somatic pain following TAPP. The lessons learned from these two cases are: (a) mesh shrinkage resulting in contractile forces on the groin musculature could be considered as potential mechanisms in the etiology of chronic somatic pain following TAPP; (b) partial mesh removal would be an effective alternative to total mesh removal in those patients for remedial surgery.

Inguinodynia after inguinal hernioplasty - clinical and surgical management: a literature review

“…Chronic postoperative pain is frequently reported after inguinal hernia repair with mesh, from 11.0% to 40.5%, and has a significant impact on quality of life [20]. Men repaired with mesh for an inguinal hernia do not have impaired fertility compared to unrepaired men.…”

“…There are cases in which the removal of the mesh is enough to stop the chronic pain, although, the removal itself may cause nerve damage when firmly adhered to the structures, resulting in pain persistence. In this scenario, partial removal of the mesh or its removal followed by neurectomy is recommended [1,4,20].…”