Hernia FAQ

Frequently Asked Questions

While the following FAQs may provide additional information, you should always discuss all of your questions in detail with your surgeon.

What is a hernia?

A hernia is a weakness or breakdown of the muscle wall of the abdomen or diaphragm. Abdominal structures such as small intestine can protrude through these areas of weakness or breakdown. This can cause pain and abdominal discomfort, but not always.  Ultimately, the situation can lead to incarceration (tissue being stuck in the hernia) or even strangulation (the cutting off of the blood supply of the tissue protruding through the abdominal wall).  This complication oftentimes can lead to emergent surgery.

What caused my hernia?

All hernias have weakness in the abdominal muscular wall. Most hernias are related to repetitive increased abdominal pressures in addition to the weakness.

Why did I get my hernia?

There may be no single identifiable cause for a hernia. Some things that contribute to the development of a hernia are:

• Older age—muscles become weaker
• Obesity—increased weight places pressure on abdominal muscle
• Sudden twist, pulls, or strains
• Chronic straining
• Family history
• Connective tissue disorders
• Pregnancy— About 1 in 2,000 women develop a hernia during pregnancy
• Previous surgery—the site at which you had an abdominal surgery in the past may create some weakness in the muscle. The chances of the weakness or inadequate healing increase if you are a smoker, have diabetes or developed a surgical wound infection.

Do I need to have my hernia repaired?

Not all hernias require repair. Small hernias may safely be observed in certain situations. All hernias will get bigger over time but the rate at which they enlarge is variable. Which hernias require surgery is an individual decision between the patient and surgeon.

Will I need to have any special diagnostic tests?

The following tests may be used to give your physician a clear understanding of your hernia. (Some blood tests and/or an echocardiogram – or EKG - may be required before you have anesthesia for a surgery.)

• Computerized tomography (CT) scan: This diagnostic X-ray test utilizes computer software to create a detailed,three-dimensional picture of your abdomen. A CT scan is commonly used to detect abnormalities or disease inside the abdomen. It is sometimes used to find a hernia that is not obvious during the physical exam.
• Ultrasound: Sound waves are used to make images of organs and structures inside the body, without the use of X-rays. An ultrasound may be used to find a hernia that is not obvious during the physical exam.

What are the risks of having this surgery?

There are common risks to any type of surgery and the associated use of anesthesia, such as bleeding, wound complications, development of blood clots, breathing difficulties and cardiac complications. The risk of these events is very low for most hernia surgeries. Other risks are more specific to each type of surgery:

• Groin hernias- trouble urinating right after surgery, long-term groin pain, hernia recurrence
• Ventral hernias– risks similar to the groin hernias, including recurrence, but also the risk of injury to the organs located inside your abdomen, fluid collections around the mesh, and other wound complications

Do I need mesh for my hernia repair?

Almost all hernia’s larger than a very small size will benefit from mesh to decrease the recurrence rate. The size of hernia where mesh is a benefit is based on location. Tissues surrounding a hernia are uniformly weaker and will not be as strong as synthetic mesh reinforcement which is typically two to 10 times stronger than healthy body tissue.

Is mesh dangerous?

There are many types of mesh. Hernia meshes typically are made from multiple configurations of polypropylene plastic, polyester plastic, and Gore-Tex. The biggest risk of complication is related to location of mesh and the construction of the material. Mesh is not appropriate for all patients and the risks and benefits will be considered individually. All minimally invasive inguinal hernias require mesh, as do most minimally invasive ventral hernias. Meshes have been shown to decrease pain and shorten recovery time, in addition to decreasing the potential for hernia recurrence.

How much pain will I have after surgery?

The amount of pain is different for each person and everyone reacts to pain in a different way. Some local anesthetic generally is utilized during the surgery, which will help manage pain initially after surgery for a few hours. If you can tolerate it, you will be encouraged to take ibuprofen and acetaminophen in a scheduled way and you also will be given a prescription for medicine to treat any significant pain you may experience.

If you have a laparoscopic procedure, pain sometimes is felt in the shoulders. This is due to the gas (CO2) inserted into your abdomen during the procedure.  Moving and walking helps to decrease the gas and the pain in the shoulders.

Can I exercise before and after a hernia repair?

Yes, but with qualification: Exercise that does not cause pain has not been shown to cause complications prior to surgery. In fact, exercise may be a benefit prior to hernia surgery, according to some current ongoing studies regarding this topic.The decision to exercise prior to hernia surgery should be determined on an individual basis with your surgeon. Exercise after surgery is usually limited to light activity such as walking and lifting nothing heavier than 15 pounds (a gallon of milk weighs roughly 9 pounds) for at least the first two weeks of recovery. Climbing stairs is alright during that time. Generally, driving is restricted for the first week or while narcotic pain pills are being used.