Page 123 - International guidelines for groin hernia management

Hernia

Groin hernia repair can be done with or without mesh. Pain
Mesh, if it is used, serves to reinforce and strengthen the Pain—of some type—occurs after nearly all surgeries.
area of the hernia. Your surgeon will advise the proper treatment so that you
Also, either an ‘‘open’’ or a ‘‘laparo-endoscopic’’ or so- are comfortable as you recover. The pain following groin
called ‘‘key hole’’ approach can be used to repair a groin hernia repair is usually mild and is commonly well treated
hernia. An ‘‘open’’ approach (which may also involve with paracetamol and other non-narcotic pain relievers.
mesh) means that a surgical incision is made in the groin Some patients suffer from longer lasting or more mod-
and the repair is done through this one incision. In a ‘‘la- erate pain. Pain not controlled with recommended medi-
paro-endoscopic’’ approach, one or more small incisions cations, or moderate, severe or long-lasting pain should
are made and repair is done with the aid of tiny cameras prompt a visit to your surgeon. Severe chronic pain
and other small specialized surgical equipment. Many (thankfully very rare) can be debilitating and should
variations on these general themes are routinely used today. prompt a visit to your surgeon who will advise other
Mesh is proven to be safe and is well tolerated by the treatment options.
human body. Recurrence
Repair of your groin hernia may well be done in a day Groin hernias can recur in a small number of patients. See
surgery (or ‘‘same day’’) surgery center. This means that your surgeon if you start having the groin symptoms again
you’ll get to go home the day of your surgery once you’re that caused you to see a doctor originally. Treatments are
fully awake, recovered and ready. available.
Depending on your particular circumstances, groin
hernia surgery can be done painlessly with local (area of Groin hernia operation: recovery
the hernia only), regional (in a larger region of the body) or
general (whole body) anesthesia. Again, your surgeon and Expect some pain or groin discomfort after surgical repair
the anesthesiologist will discuss these options with you. of your hernia. Depending on the surgical technique used
and other factors (like the complications described above)
Complications almost all patients should be completely comfort-
No operation is risk free. Immediately after operation it able within 1–2 weeks. Use your pain relievers as recom-
could be difficult to urinate due to some pain in the oper- mended as you recover. Support the surgical area during
ated region. Sometimes a catheter in the urinary bladder is coughing, sneezing or straining in the first few days after
needed to empty the bladder. In male patients it is not too your operation. Do routine activities that you feel capable
uncommon that the catheter needs to be removed first after of doing. A period of rest or a lifting restriction is not
some days. Like every other operations, groin hernia sur- necessary after a groin hernia operation.
gery complications include: bleeding, infections, blood clot Most surgeons will use dissolvable stitches, which do
formation, pneumonia and others. Thankfully, these are all not need to be removed. If non-dissolvable stitches were
rare. used, they will be removed after a week.
Specific groin hernia complications are described below. If you have urgent questions or problems please consult
Hematoma your general practitioner, your surgeon or a hospital.
A hematoma is a collection of blood in the body’s tissues
and can be recognized by a bluish discoloration and Further reading
swelling in the area of the surgery, usually several days The following website is endorsed by the HerniaSurge
after surgery. The hematoma (blood) can spread to the base Guidelines Group: http://www.herniasurge.com
of the penis and scrotum in men, or into the labia majora If information in this leaflet is missing or unclear, please
(vaginal lips) in women. It usually goes away on its own inform the HerniaSurge Group via their website.
after several days and should not concern you. A hematoma
causing severe pain, marked swelling or black discol- Acknowledgements The HerniaSurge Group gratefully acknowl-
edges the able editing assistance of M.D. Burg, MD in the preparation
oration of the skin should prompt an urgent doctor visit.
of these chapters. Dr. Burg works as an Assistant Clinical Professor
Seroma and Attending Physician in the UCSF/Fresno Emergency Medicine
A seroma is a collection of blood plasma (not blood Residency Program.
cells but the clear liquid in blood) that commonly collects The HerniaSurge Group gratefully acknowledges N.E. Simons
(Medical Student) for managing the Mendeley reference manager.
after groin hernia surgery. Most go away without treatment
The Guidelines development was sponsored by an educational and
in 6–8 weeks. Very large or infected seromas (both very research grant from Johnson & Johnson and Bard companies.
uncommon) may require drainage. See your surgeon if you The HerniaSurge Group is very grateful for the financial support
are concerned and he/she will advise you. provided by The European Hernia Society.

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