Hernia Mesh

Hernia mesh is a net-like implant — often made from polypropylene plastic — that treats hernias. It prevents the tissue, organs or fat from bulging through muscle walls. Doctors commonly use mesh to treat patients with hernias because of the low hernia recurrence rate.

While typically a safe procedure, there are possible complications, including infection, chronic pain, neuralgia (nerve pain), hernia mesh failure and hernia recurrence. These can lead to additional surgeries. Patients should discuss potential complications and surgery alternatives with their doctors.

Hernia mesh can successfully repair hernias, but complications are possible. Infection, for example, is a risk. One study found that staphylococcus aureus (staph infection) was present in 64% of infected hernia mesh tested.

Sometimes, the risks of hernia mesh outweigh the benefits. The likelihood and severity of complications depend on the surgeon and surgical technique, mesh material and the body’s response.

Research shows that around 16% of patients require revision surgery, with non-mesh or suture-based repairs experiencing higher recurrence rates. The ideal hernia mesh resists infection and an inflammatory response while staying flexible and quickly incorporating into the body’s tissue.

Non-absorbable hernia repair mesh should be a permanent fix, but absorbable mesh typically dissolves in 12–18 months. Hernia recurrence is possible even with non-absorbable mesh.

Research suggests that mesh materials may affect recurrence rates after hernia repair. Polypropylene mesh is highly durable, but it can lead to inflammation in the area. This has a shrinking effect on the mesh, creating higher recurrence rates.

The FDA is aware of complications from recalled meshes and those currently on the market. While many people experience improved quality of life following hernia treatment, others report mild to serious complications.

You may experience fever, flu-like symptoms, nausea, vomiting or constipation. Other signs of hernia mesh failure include chronic pain and severe swelling or tenderness at the surgery site.

A 2024 study published in the journal Current Problems in Surgery found that 12% of patients suffer from chronic pain after having inguinal hernia mesh surgery. In contrast, only 6% of those who had the surgery without mesh experienced similar long-term pain.

A 2024 retrospective study published in Cureus found that 17.2% of hernia repair patients reported complications.

Experts also recognize obesity and diabetes as important risk factors for postoperative complications.

Hernia mesh failure can occur a few weeks to a few years after your surgery. Talk to your doctor if you notice anything wrong or unusual after your hernia surgery.

Hernia mesh materials fall into different categories: synthetic, biological, coated, composite and hybrid meshes. Mesh is available in different weaves, sizes and strengths as patches and plugs.

Different mesh materials lead to varying rates of complications. In an April 2023 meta-analysis in Surgery, researchers concluded that biologic meshes increase the rate of complications on surgery site infections and hernia recurrences. As an alternative, uncoated synthetic mesh with large pores may be suitable for open ventral (abdominal) hernia repair.

Biologic hernia mesh uses animal or human donor tissue — often intestines or skin of cows and pigs — with the cells removed to create a collagen net. The material breaks down over time and absorbs into the body.

A surgeon may choose this mesh for a strangulated hernia or if there is an infection in the location. Recurrence is a potential complication.

A surgeon could use a woven or knitted sheet of synthetic mesh. These materials remain in the body indefinitely and include polyester, polypropylene or expanded polytetrafluoroethylene (a material made from thin, porous sheets of minerals). These types of mesh are chemically inactive and should minimize reaction complications.

While polypropylene is one of the more common mesh materials, it can wear away or break down over time. If this occurs, the mesh could protrude or cause injury to surrounding tissue.

These materials have non-absorbable or absorbable coatings, such as cellulose, beta-glucan, omega-3 fatty acids or collagen. The coatings minimize the body’s inflammatory response.

A leading benefit of choosing a coated or composite mesh is that surgeons can use it in the abdomen’s peritoneal cavity with little risk of adhesion (scar tissue) formation. Studies show varying degrees of inflammation risk from composite mesh, depending on the materials used.

Glue fixation has several advantages over the use of sutures in hernia repair. Glue reduces the occurrence of several significant side effects, including chronic pain, acute post-surgery pain and hematomas (bleeding outside of the blood vessels). In addition, patients who receive hernia surgeries with glue fixation typically return to normal activities faster than those with sutures.

Several manufacturers voluntarily withdrew or recalled their hernia mesh from the market. Some recalls resulted from packaging errors, higher-than-expected failure rates or the risk of serious complications such as adhesions, pain and hernia recurrence.

Manufacturers should (and usually do) voluntarily withdraw products if they violate laws administered by the FDA. A drug or device recall occurs when there is evidence that the product is harmful or defective. In some cases, if a manufacturer fails to recall a faulty product voluntarily, the FDA may issue a mandatory recall.

A dozen major hernia mesh manufacturers dominate the U.S. market. Product options come in various sizes across brands.

Manufacturers that issued a recall for one or more of their hernia mesh products include Atrium Medical, Bard Davol, Ethicon/Johnson & Johnson and Covidien/Medtronic. If you have questions about which hernia mesh was used in your surgery, contact your surgeon’s office.

Thousands of hernia mesh lawsuits accuse manufacturers of producing devices that cause serious complications.

Four major mesh makers are central to separate multidistrict litigations, significant court actions that combine similar lawsuits in a single federal court. In MDLs, plaintiffs receive a portion of the settlement award, often based on the severity of their case.

Hernia mesh manufacturers often settle out of court with plaintiffs to avoid going to trial. For instance, in February 2023, the Attorney General for the state of Kentucky announced that Ethicon settled litigation for close to $10 million.