How to treat hernias?
Hernia belts or truss
hernia truss
A hernia doesn't always require surgery. Recent studies showed that asymptomatic men with groin hernias can safely be managed without surgery because the risk of complications is very small.
Hernia belts are usually elastic, applied around the abdomen to keep the hernia from bulging out of the belly. A truss is a special kind of hernia belt which prevents bulging of a groin hernia and is used as a support garment.
These are recommended for patients who have no symptoms or patients who cannot tolerate surgery or undergo general anaesthesia. Nevertheless, surgery is the best choice of treatment. There are no medical or surgical alternatives to a femoral hernia repair. The operation is necessary as a femoral hernia is a potentially dangerous condition.
Do I need an operation?
If you have a hernia, whether or not you will need surgery will depend on:
An operation is the treatment of choice for both inguinal and femoral hernias.
How is the surgery performed?
Traditionally hernia repair was done by pulling together the muscle and tissue. This generates tension, causing pain and a longer recovery period. New methods of repair involve the use of a synthetic mesh to "patch" the hernia in a tension free manner. These types of repair give very low recurrence rates.
There are two methods:
Open surgery: A cut is made usually around 1-2 cm above the hernia. The surgeon will push the lump back into the abdomen. The opening is then reinforced with a mesh patch.
Keyhole surgery: Less invasive and involves several smaller, usually three, tiny cuts, allowing the surgeon to use various instruments to push the hernia inside. Then the opening is repaired by inserting a mesh to prevent the hernia from coming back again.
Hernia surgery can be accomplished as day case surgery, and under local anaesthetic in many cases, depending on your general health.
- The location of the hernia: femoral hernias and hernias in the groin are more likely to require surgery; abdominal hernias are less likely.
- Types of symptoms you have: some hernias may not cause symptoms, others may be painful. If you have a strangulated hernia you may have other symptoms such as fever and pain or may vomit bile or blood.
An operation is the treatment of choice for both inguinal and femoral hernias.
How is the surgery performed?
Traditionally hernia repair was done by pulling together the muscle and tissue. This generates tension, causing pain and a longer recovery period. New methods of repair involve the use of a synthetic mesh to "patch" the hernia in a tension free manner. These types of repair give very low recurrence rates.
There are two methods:
Open surgery: A cut is made usually around 1-2 cm above the hernia. The surgeon will push the lump back into the abdomen. The opening is then reinforced with a mesh patch.
Keyhole surgery: Less invasive and involves several smaller, usually three, tiny cuts, allowing the surgeon to use various instruments to push the hernia inside. Then the opening is repaired by inserting a mesh to prevent the hernia from coming back again.
Hernia surgery can be accomplished as day case surgery, and under local anaesthetic in many cases, depending on your general health.
Are there any complications from the operation?
Hernia surgery is very safe. Infrequently, patients might have:
- Excessive bruising or swelling.
- A reaction to the mesh by producing fluid around it.
- Infection of the wound or in rare cases the mesh. However, this is virtually abolished by antibiotics given during surgery.
- Pain and numbness in the groin area caused by damage to a nerve during surgery. The pain usually resolves with time and medicine may be injected in the area if the pain continues.
- There is always a risk of general anaesthesia, the anaesthesiologist (a doctor who administers anaesthesia) reviews the risks of anaesthesia with the patient and asks about medical history and allergies to medications.
- Hernia recurrence.
Recovering form surgery
Patients should be able to go home the same day or the day after the surgery. It is important for patients to eat a good diet to avoid constipation, care for the wound and not strain themselves too soon after surgery.
It is advisable not to drive for one week after surgery. Returning to work will depend on the type of work you do: two weeks away from office duties and four-six weeks away from heavy manual work. Similarly, heavy gardening, lifting suitcases or vigorous gym exercise should be avoided for four weeks.
You may find sex painful or uncomfortable at first, but it is fine to have sex when you feel like it.
It is advisable not to drive for one week after surgery. Returning to work will depend on the type of work you do: two weeks away from office duties and four-six weeks away from heavy manual work. Similarly, heavy gardening, lifting suitcases or vigorous gym exercise should be avoided for four weeks.
You may find sex painful or uncomfortable at first, but it is fine to have sex when you feel like it.