Necessary duration of follow-up to assess complications of mesh in hernia surgery: a time-lapse study based on 460 explants.

Purpose: Risk of complications following hernia repair is the key parameter to assess risk/benefit ratio of a technique. As mesh devices are permanent, their risks are life-long. Too many reports in the past assessed mesh safety prematurely after short follow-ups.

A Pathology of Mesh and Time: Dysejaculation, Sexual Pain, and Orchialgia Resulting From Polypropylene Mesh Erosion Into the Spermatic Cord.

Objective: The ubiquitous use of polypropylene mesh in hernia surgery has spawned a new clinical syndrome: chronic post-herniorrhaphy neuralgia. A subset of that clinical picture is dysejaculation, sexual pain, and orchialgia. We propose to identify the processes that lead to that pain.

A mechanism of mesh-related post-herniorrhaphy neuralgia.

Purpose: The objective is to compare nerve densities in explanted polypropylene meshes in patients with or without chronic pain. Pain has supplanted recurrences as a complication of hernia surgery. The increased incidence of pain mirrors a parallel increase in the use of polypropylene meshes.

Localized duodenal lymphoma masquerading as a duodenal ulcer.

A 64-year-old woman presented with atypical abdominal pain, weight loss, melena and hematemesis. Reactivation of a peptic ulcer was diagnosed and she was treated with antacids and cimetidine. When her symptoms recurred 4 months later, a perforated duodenal ulcer was noted on roentgenograms.

Failure of LeVeen shunting in refractory ascites--a view from the other side.

We have reviewed our experience with 11 patients treated with LeVeen peritoneovenous shunts during a 22-month period from March, 1976, through December, 1977, to assess long-term results and shunt patency. Nine patients had follow-up studies to assess shunt patency at a mean of 26 months. After insertion of the shunt, the mean weight loss was 7.

Maintenance of home hyperalimentation in patients with high-output jejunostomies.

We studied four patients with high-output end jejunostomies (greater than 3,000 mL/day) who were receiving home hyperalimentation. With knowledge of urine and stoma output, standard total parenteral nutrition fluid was infused and titrated according to individual needs, first during the hospital stay and then on follow-up office visits. Mean daily stoma output for the group was 3,556 mL/day.