BACKGROUND: Inguinal hernia repair has evolved from open suture methods to mesh repair which is preformed either open or laparoscopically. Mesh hernia repair has improved the outcome in regards to patient care and recurrence rate but it is also associated with a number of complications. The complications of mesh hernia repair such as deep seated infections, mesh erosion and mesh perforation into nearby viscera has been scarcely reported in literature.
METHODS: We report a 43 years old male case of diverticulosis adherent to a migrated mesh plug from previous laparoscopic inguinal hernia repair procedure.
CONCLUSIONS: The choice of mesh material, appropriate suture placement and closure of the peritoneum after mesh repair is very crucial to avoid long term mesh complications.
CONCLUSIONS: The aim of this case report is to present a rare complication of mesh erosion with colovesical fistula and abscess formation.

Chronic groin pain (Inguinodynia) following inguinal hernia repair is a significant, though under-reported problem. Mild pain lasting for a few days is common following mesh inguinal hernia repair. However, moderate to severe pain persisting more than 3 mo after inguinal herniorrhaphy should be considered as pathological. The major reasons for chronic groin pain have been identified as neuropathic cause due to inguinal nerve(s) damage or non-neuropathic cause due to mesh or other related factors. The symptom complex of chronic groin pain varies from a dull ache to sharp shooting pain along the distribution of inguinal nerves. Thorough history and meticulous clinical examination should be performed to identify the exact cause of chronic groin pain, as there is no single test to confirm the aetiology behind the pain or to point out the exact nerve involved. Various studies have been performed to look at the difference in chronic groin pain rates with the use of mesh vs non-mesh repair, use of heavyweight vs lightweight mesh and mesh fixation with sutures vs. glue. Though there is no convincing evidence favouring one over the other, lightweight meshes are generally preferred because of their lesser foreign body reaction and better tolerance by the patients. Identification of all three nerves has been shown to be an important factor in reducing chronic groin pain, though there are no well conducted randomised studies to recommend the benefits of nerve excision vs preservation. Both non-surgical and surgical options have been tried for chronic groin pain, with their consequent risks of analgesic side-effects, recurrent pain, recurrent hernia and significant sensory loss. By far the best treatment for chronic groin pain is to avoid bestowing this on the patient by careful intra-operative handling of inguinal structures and better patient counselling pre- and post-herniorraphy.