A hernia can return after surgical repair, even though surgery is a common and effective treatment. Understanding the factors that contribute to this recurrence can help individuals take proactive steps.
Why Hernias Can Recur
Hernias can return after surgical repair due to a combination of surgical and patient-related factors. While the majority of hernia surgeries are successful, recurrence rates can vary depending on the type of hernia and repair method used. For instance, some data suggests that about one in six people who undergo hernia surgery might experience a recurrence within 10 years.
The choice of surgical technique plays a significant role in recurrence risk. Tension-free mesh repair, which uses a medical-grade mesh to reinforce the weakened area, generally has lower recurrence rates compared to older tension repair methods where tissues are simply stitched together. Modern minimally invasive approaches, such as laparoscopic surgery, are often associated with lower recurrence rates compared to open surgery, with some studies indicating a recurrence rate of around 1% for laparoscopic repairs versus up to 20% for some open repairs. However, inadequate repair or issues like mesh failure can still contribute to a hernia’s return.
Patient-specific factors also heavily influence the likelihood of recurrence. Conditions that increase pressure within the abdomen, such as chronic coughing, persistent constipation, or heavy lifting, can strain the repaired site before it fully heals or over time. Obesity is another significant risk factor, as excess body weight places increased pressure on the abdominal wall. Other contributing factors include poor nutrition, smoking, which impairs tissue healing, and pre-existing medical conditions like diabetes, which can affect the body’s ability to recover. The original hernia’s characteristics, such as its size or if it was already recurrent, can also impact its return.
Identifying a Recurrent Hernia
Recognizing the signs of a recurrent hernia is important for prompt evaluation and management. The most common indicator is the reappearance of a new bulge or swelling at or near the location of the previous surgical repair. This bulge might become more noticeable when standing, coughing, straining, or lifting.
Individuals may also experience pain or discomfort in the affected area, particularly during activities that increase abdominal pressure. This pain can range from a dull ache to a sharp sensation. A feeling of pressure or heaviness in the region of the old repair site is another common symptom.
In some cases, if the hernia involves the bowel, digestive issues such as nausea, vomiting, or constipation may occur. Redness or tenderness around the site of the previous surgery could also indicate a recurrence. It is advisable to consult a medical professional if any of these symptoms emerge.
Reducing the Risk of Recurrence
Taking proactive steps after hernia repair can significantly reduce the likelihood of recurrence. Following the surgeon’s post-operative instructions is important. This includes adhering to activity restrictions, such as limits on lifting heavy objects, and proper wound care to ensure the incision heals effectively. Engaging in strenuous physical activity too soon after surgery can place undue stress on the repair site before it has had sufficient time to heal and strengthen.
Maintaining a healthy body weight is another important strategy. Excess body weight increases pressure on the abdominal wall. Dietary adjustments can also play a role, particularly consuming a high-fiber diet to prevent constipation.
Quitting smoking is highly beneficial, as tobacco use can impair tissue healing and weaken collagen structure, which is important for a durable repair. Managing chronic conditions that cause increased intra-abdominal pressure, such as chronic cough or conditions leading to urinary straining, can further protect the surgical site. Adopting proper lifting techniques minimizes strain on the abdominal muscles.
Options for Recurrent Hernias
If a hernia is suspected to have returned, the first step involves a comprehensive evaluation by a medical professional. A doctor will perform a physical examination and review the patient’s medical and surgical history. Imaging tests, such as ultrasound, CT scans, or MRI scans, may be ordered to confirm the diagnosis and determine the exact location and size of the recurrent hernia.
Treatment for recurrent hernias almost always involves another surgical procedure. The approach for repairing a recurrent hernia may differ from the initial surgery. Surgeons might consider a different surgical technique, potentially using a larger mesh to provide stronger reinforcement, or switching between an open and laparoscopic approach depending on the specifics of the previous surgery and the nature of the recurrence. Consulting with a specialist, such as a general surgeon or a hernia specialist, is important to discuss the most appropriate course of action tailored to the individual’s specific situation.