Open Inguinal Hernia Repair

What Is an inguinal hernia?

An inguinal hernia is a protrusion of fatty tissue or sometimes a part of the bowel or intestine which breaks through a weakness in the muscles of the groin in an area known as the inguinal canal. Inguinal hernias are more common in men and become more common with age as muscles become weaker, allowing a hernia to develop.

When is an inguinal hernia repair recommended?

Common causes include a weakness in the abdominal wall which can be present at birth or develop over time. Another common cause is strain or pressure on the abdomen, for example from heavy lifting, chronic coughing, sneezing, constipation causing excessive straining during bowel movements, pregnancy or obesity, all of which increase abdominal pressure and ageing, where muscles weaken naturally over time.

Symptoms of an inguinal hernia are present in about two-thirds of affected people. This may include pain or discomfort, especially with coughing, exercise, or bowel movements. The swelling often appears on standing or exertion, and tends to disappear when lying down. Most people describe symptoms including swelling, which can get worse throughout the day and then go away after a night’s sleep.

What does an inguinal hernia repair involve?

An open inguinal hernia repair involves making a small incision in the groin over the site of the hernia. The hernia is then found between the muscles it is separated from the surrounding tissues and replaced within the abdomen. The muscle layers are then reinforced with a soft, synthetic, non-absorbable mesh which is fixed in place with a few stitches. The individual layers of the incision are then repaired. The skin is closed with an absorbable sub-cuticular or “invisible” stitch so that there is no need for stitch removal afterwards. The operation itself takes around 30 minutes to complete and patients are usually able to go home later the same day.

What are the potential risks and complications of an inguinal hernia repair?

Wound infections are uncommon after this type of surgery. When they do occur patients may need a course of antibiotics. Sometimes bruising may occur around the wound or a swelling develop beneath the wound. This is usually blood and/or tissue fluids which accumulate in the space where the hernia was. The fluid will normally gradually resolve. Very occasionally a collection of fluid may need to be drained.

You should contact your doctor if after the operation you develop any of the following: 

·       Redness around or drainage from the incision

·       Fever

·       Bleeding from the incision

·       Pain that is not relieved by medication or pain that suddenly worsens

Some patients, particularly men, can find it difficult to pass urine after a hernia repair. It is always important to tell your surgeon, before coming into the hospital, if you are experiencing any difficulties passing urine.

Occasionally a catheter may need to be passed if a patient is unable to pass urine and if that is necessary patients usually will have to stay overnight before the catheter can be removed the next day. After an open procedure, some patients might experience some numbness or a slightly odd sensation in the skin below the scar and this can extend to the upper part of the scrotum. This happens when a nerve is bruised or damaged during the procedure. In many cases, the numbness will improve over time. A few patients may continue to experience pain in a hernia wound that does not settle down straight away. We think that this may occur if a nerve is trapped in the mesh material, a suture or the scar. A course of physiotherapy can be helpful initially and sometimes a local anaesthetic and steroid injection will relieve symptoms. It is very rare that a wound needs to be re-explored because of pain. A small number of patients may develop a recurrence of the hernia. Recurrences are far less common these days with the use of mesh but nevertheless can occur occasionally.

Open inguinal hernia recovery time and aftercare

We encourage all patients to stay active following surgery. Walking regularly is the most useful exercise after the operation. Following the operation, patients should avoid heavy lifting for four to six weeks. After about 4 weeks patients should be able to increase their exercise activities, starting with gentle rhythmic exercises such as cycling or cross-training and gradually building up to their normal exercise regimen. Provided there are no wound problems, swimming can also be good at this stage. Patients should be able to return to work within one or two weeks, but if their job involves any strenuous activities then they may need to be off work for longer or carry out only light duties. Patients can usually drive again after one to two weeks, but the surgeon will provide specific instructions regarding this.

Open Inguinal Hernia Repair in Birmingham

Open inguinal hernia repair is a reliable and effective surgical technique that is widely used. While it has a longer recovery time and more post-surgical discomfort compared to laparoscopic options, it remains a popular choice for patients who may not be suitable candidates for minimally invasive surgery. The use of mesh has greatly reduced recurrence rates and the procedure's simplicity ensures that it can be performed in most surgical settings. However, discussing all options with a surgeon is important to choose the best treatment based on individual health conditions.

For more information on finding a surgeon to complete an open inguinal hernia repair in Birmingham, contact Get Well Soon today. Our new website makes it’s easy to compare treatments and prices for a hernia repair and book a consultation online.