Questions About Small Incisional Hernia After Surgery

Hi all,

I had surgery in April to remove my large bowel. The surgery was carried out laparoscopically.

About 2 weeks ago, I noticed a slight bulge at the top of my stoma and another bulge of about 5 cm (without any pain) above an incision that was made under my belly button and just above my groin.

I was worried I had a parastomal hernia and an incisional hernia and had an appointment with the surgeon who did my bowel surgery on Monday. He examined me and said I didn't have a parastomal hernia. He also wasn't convinced I had an incisional hernia either and referred me for an ultrasound. He did say that steroid use is a risk factor with hernias, and I've been on steroids for ulcerative colitis and proctitis for over a year.

I had the ultrasound yesterday, and the doctor who did it confirmed I have a small 0.5 cm hernia which is causing the visible bulge. I had a few questions for any of you who have had/have a small incisional hernia:

How would a small incisional hernia be treated? From what I've read, it seems surgery is the only way to repair a hernia.

Does such a small hernia even have to be treated?

Is it inevitable for an incisional hernia to get bigger?

Do any of you have an incisional hernia that has stayed asymptomatic and remained the same size for a number of years?

Thank you.

Qualifier: I can't address the question of years; I had my stoma reversal and hernia repair all during this year... But I can share what I've been through.

After the surgery that resulted in my colostomy, I developed two hernias... a parastomal and an incisional hernia.

I immediately started wearing a support belt that had a hole that would fit tightly around my stoma. They never did get very big, and with my recent stoma reversal, they were both repaired. My surgeon said he had to do "a lot of tissue manipulation," and they are gone for now.

I often feel a bit of pain at my old stoma site when I sneeze, cough, laugh, or push when on the toilet, and I'm around two months post-surgery. I've learned to hand splint, which is easy for most occasions, but not when I sneeze or cough because of the reflex to cover my mouth.

My surgeon said hernia recurrence is common, but that he's confident I won't go down that path. I'm hoping he's right.

What I can share that may be of value is that a belt may help keep them from growing. It kept mine from growing. I wore mine everywhere but the shower, even when sleeping.

And of course, you should always check with your surgeon before making any changes.

0.5 cm is very tiny, and no, asymptomatic hernias do not need to be surgically repaired. For us, the risk of hernia is greater because we have that opening in our abdominal wall, and I've also been told that if it's not a problem, it shouldn't be fixed because there can be complications. You may want to look into ostomy support belts to help prevent a larger hernia from developing.

Hi Rodr24,

Many thanks for sharing your experiences. It was really useful.

Yes, I do wear a support belt around my waist to help prevent a parastomal hernia. However, I'm not sure if this belt would support the incisional hernia that I don't have, as this particular hernia is lower down below my belly button. The belt I have doesn't go down that far. I'm wondering if I need another support garment for the incisional hernia.

Hi Kas,

Thanks for your reply.

Yes, I do already wear an ostomy support belt. However, it doesn't go as far down to the incisional hernia that I've developed. I'm wondering if I need another belt that goes further down. I'll look into it.

I'm glad to hear that such a smaller hernia doesn't need surgery!

My Ostomy Journey: Kimberly | Hollister

Hello, what did the doctor who did the ultrasound and confirmed the hernia advise?

I had a parastomal hernia that was fixed during my colostomy takedown, but then right afterward, I developed an incisional hernia next to my belly button along the scar line where I had my original ostomy surgery. I had a bad cough directly after takedown surgery, and holding the incision with my hand or pillow when I coughed and sneezed did not help. Coughing caused the hernia.

The hernia has grown some despite wearing a support belt every day (I wear a Brava belt because that is most comfortable for me) - but I think this is more due to me gaining a little weight back, which I now need to lose. The hernia isn't painful, but sometimes there is pressure, and of course, I feel it limits me because I can't do much - seems like everything I try to do affects my core. When I am lying down or reclined, it fully retracts - so I put my belt on in the reclined position and I wear it all day. It helps to keep the hernia "in" and gives support.

The only fix is surgery... I will need an abdominal wall reconstruction due to the size of mine (not the largest they've seen but fairly sizable) - you would probably just need the standard repair if surgery is even advised at this point. I've been putting off the surgery due to lots of various reasons, but I will need to have it eventually. Meanwhile, I am careful not to lift anything too heavy and just monitoring it.

Please watch for any pain, throwing up, hernia changing color, etc. - they told me the smaller ones have the potential to get incarcerated and that piece of bowel could strangle off. I was told mine was so large that there is little worry of that because the large ones basically just go freely in and out due to the large opening in the abdominal wall - but it could still happen, and I need to go in right away if I experience any symptoms.

You could see a few different doctors... some would probably say that you should get it repaired before it has a chance to get larger; some may tell you to just be careful and monitor the situation.

This is not medical advice from me, just my experience with hernias. Best of luck, friend! :)

Hi DexieB,

I'm sorry to hear about your incisional hernia. To be honest, until I saw the swelling above the incision, I didn't even know an incisional hernia was a thing. I was only given minimal information about a parastomal hernia. No doctor or nurse mentioned incisional hernias being a risk post-surgery.

In answer to your question, the consultant radiologist didn't advise what to do next. He just said he would speak to my surgeon. I'll then have to make an appointment with my surgeon, who will talk me through the results.

I can't be sure, but the way my surgeon is, he may advise getting it surgically removed. I'm definitely going to get other opinions.

I'm still coming to terms with my ileostomy and quite frustrated at such complications. I was even reflecting on hernia repairs. It's like abdominal surgeries make our cores weaker, which increases the likelihood of hernias. And then further surgeries are needed to repair the hernias, and it seems to me this would make our cores even weaker!

Thanks. Yes, it's very frustrating to have this complication after all we have been through! And like you said, not enough information is given about this being a possibility after surgery.

I met with two surgeons who both told me the same thing... surgical fix. They are opposed to me 'just living with it' - they believe the abdominal wall should be completely functional. That's what they do for a living; they fix problems - so I'm not surprised. But at this point in time, I'm all 'surgeried out'! I am not mentally or physically prepared, as I have already had three abdominal surgeries, so I'm not thrilled about #4.

My bowel is functioning perfectly, so I am afraid to tempt fate. I am also terrified of having a whole sheet of mesh in my abdomen (I doubt you would need this, but that's what I would need). So - although I know I will eventually need surgery, I'm trying to reason with my hernia as long as possible!

You're totally right about the attitude surgeons can take, and as you say, it's their job. The ones you met sound like mine! Mine thinks everything can be surgically fixed with little consideration of the complications faced by patients after surgery.

"That's what they do for a living," ain't that the truth!

Six weeks out of surgery, struggling with infections and a fistula, fresh from a readmission for sepsis, still unable to walk properly, and one of my surgeons notices my urostomy is recessed and immediately starts discussing revision surgery.

Are you f***ing kidding me? This was my third abdominal surgery; I may yet need a fourth to repair the fistula. No way I am discussing revision surgery right now! Duh.

Yeah, isn't it amazing how fast they are to rush a person back into surgery!? I am glad you're taking time to heal 😊

I'm having my incisional hernia repaired in May. I have a loop of intestine sticking out through the hole in my abdominal wall and have no choice but to have it fixed. Otherwise, I could get a strangulated intestine. That would require emergency surgery. While I am getting my incisional hernia repaired, the surgeon is going to try to repair my parastomal hernia. The way they do both is with mesh. It can usually be done laparoscopically, according to my surgeon, as long as it's small enough. But it does involve pain because they have to go in and sew up the part of your abdominal wall that has the hole in it and then put in the mesh. I am told it will feel like doing 1,000 sit-ups when you haven't done 1 in a really long time. I am not big on pain, so I am not looking forward to that part, but it won't hurt forever. And I will get over it. Hopefully, this will be the last of my hernias, but there is no promise of that, as more hernias can always come. But my surgeon said I should be able to go back to weight training after the 4-week recovery period. So I am excited about that.

Keep us posted, Infinity! I am scheduled for the end of April, but will probably be pushing it off longer, LOL!