The operative site of the repaired hernia will typically exhibit swelling, hardness and bruising secondary to the tissue fluid and blood under the wound, the wound being pulled together by the stitches and lastly by scar formation. All this will settle within a few weeks as healing progresses. Bruising tends to track downwards as the blood moves under the influence of gravity so at times the genital area can become black and blue in colour, but again will settle.
There can be very extensive bruising in some cases, with a haematoma developing, a collection of blood from persistent bleeding which can cause a bulge near the repair or under the wound itself. This should steadily improve with time but can require surgical intervention and removal of the blood. Testicular swelling may persist for a long period as the bleeding gets down into the scrotum.
During the operation a small nerve which travels across the incision line may be cut through, causing a minor area of numb feeling at the inner end of the incision. To do the operation well this nerve has to be cut but because the numb area gets smaller with time and is hidden under the pubic hair it does not normally cause any problems. A chronic pain problem over the area of the repair can develop in one in twenty patients and can be a significant problem. Nerve stretch as the operation is being done or the nerve becoming tethered as the healing proceeds are possible reasons for this pain. A pain killer can be injected into the painful area to reduce the pain but in some cases the surgeon will need to re-explore the area to find the trapped nerve and release it.
During the operation all the structures close to the hernia, including the tube carrying sperms, the vein and the artery, are all at risk of damage. In recurrent hernia surgery the risk to these structures is greater. Damage to the artery can result in ischaemic damage to the testicle and it may then shrivel and need to be surgically removed. Damage to the tube carrying sperms means that the ability to be fertile will depend on sperm from the remaining testicle which is usually plenty. In older patients the removal of the testicle can be advised before repairing a recurrent hernia to get the best outcome.
An infection in the hernia wound is a risk but not common and antibiotics are prescribed if the wound gets red or inflamed. If an infection worsens and starts producing pus then the surgeon may need to re-open the wound and clean it out to release the infection. The risk of a hernia recurring increases with the presence of infection. Infection of the mesh means it will need to be removed and once the infection has settled the repair will need to be repeated. There is a degree of risk of a deep vein thrombosis (DVT) but this is not common. Getting up and about walking again and keeping the legs and feet moving regularly are helpful to keep the circulation going and prevent DVT.
The chances of a hernia happening again are less than once in twenty cases after the first repair of a hernia. To have a general anaesthetic involves some risk and this is greater if the patient is suffering from a longstanding medical illness or disease. Short term side effects with the frequency of one in ten to a hundred are blurred vision, pain over the site of injection, bruising and sickness. These are easily managed and do not persist for long.
Complications which can occur but less commonly (approximate risk of one to 100 to one to 10,000) are headaches, short term breathing and speaking difficulties, sore throat, lip, tongue and teeth damage and muscle pains. Much more serious complications are extremely rare and occur at less than once in ten thousand times. These include blood vessels and nerve damage, lung injury, eye damage, brain damage, severe allergy reactions and death, liver/kidney failure and injury to the larynx. The likelihood of these complications occurring depends on what other medical conditions the patient is suffering from.
There can be very extensive bruising in some cases, with a haematoma developing, a collection of blood from persistent bleeding which can cause a bulge near the repair or under the wound itself. This should steadily improve with time but can require surgical intervention and removal of the blood. Testicular swelling may persist for a long period as the bleeding gets down into the scrotum.
During the operation a small nerve which travels across the incision line may be cut through, causing a minor area of numb feeling at the inner end of the incision. To do the operation well this nerve has to be cut but because the numb area gets smaller with time and is hidden under the pubic hair it does not normally cause any problems. A chronic pain problem over the area of the repair can develop in one in twenty patients and can be a significant problem. Nerve stretch as the operation is being done or the nerve becoming tethered as the healing proceeds are possible reasons for this pain. A pain killer can be injected into the painful area to reduce the pain but in some cases the surgeon will need to re-explore the area to find the trapped nerve and release it.
During the operation all the structures close to the hernia, including the tube carrying sperms, the vein and the artery, are all at risk of damage. In recurrent hernia surgery the risk to these structures is greater. Damage to the artery can result in ischaemic damage to the testicle and it may then shrivel and need to be surgically removed. Damage to the tube carrying sperms means that the ability to be fertile will depend on sperm from the remaining testicle which is usually plenty. In older patients the removal of the testicle can be advised before repairing a recurrent hernia to get the best outcome.
An infection in the hernia wound is a risk but not common and antibiotics are prescribed if the wound gets red or inflamed. If an infection worsens and starts producing pus then the surgeon may need to re-open the wound and clean it out to release the infection. The risk of a hernia recurring increases with the presence of infection. Infection of the mesh means it will need to be removed and once the infection has settled the repair will need to be repeated. There is a degree of risk of a deep vein thrombosis (DVT) but this is not common. Getting up and about walking again and keeping the legs and feet moving regularly are helpful to keep the circulation going and prevent DVT.
The chances of a hernia happening again are less than once in twenty cases after the first repair of a hernia. To have a general anaesthetic involves some risk and this is greater if the patient is suffering from a longstanding medical illness or disease. Short term side effects with the frequency of one in ten to a hundred are blurred vision, pain over the site of injection, bruising and sickness. These are easily managed and do not persist for long.
Complications which can occur but less commonly (approximate risk of one to 100 to one to 10,000) are headaches, short term breathing and speaking difficulties, sore throat, lip, tongue and teeth damage and muscle pains. Much more serious complications are extremely rare and occur at less than once in ten thousand times. These include blood vessels and nerve damage, lung injury, eye damage, brain damage, severe allergy reactions and death, liver/kidney failure and injury to the larynx. The likelihood of these complications occurring depends on what other medical conditions the patient is suffering from.
About the Author:
Jonathan Blood Smyth is the Superintendent of Physiotherapists at an NHS hospital in the South-West of the UK. He writes articles about back pain, neck pain, and injury management. If you are looking for physiotherapists in Glasgow visit his website.
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