When To Consider Stoma Hernia Repair?

Question

Hi, when does a stoma hernia need repair? My surgeon says he would try to avoid doing it. I have a follow-up visit tomorrow. I recently had a CT scan and an MRI, but there was no mention of the hernia in the reports. Is it better to repair it when it is small or not do anything unless it gets larger and starts to bother me? Any feedback, please?

Ben38 · Accepted Answer

If it's not causing any problems, it's better left alone, as there's a very high risk you will just get another one and end up having one repair after another. Recent research suggests that even with a hernia, core exercises are a must-do, as they may prevent the hernia from getting any bigger or even reduce its size. I've had my hernia for around 10-15 years now.

Philip P · Accepted Answer

Hi. My personal rule is to avoid surgery unless absolutely necessary. I am considering reversal surgery but am not convinced. However, if I do elect to have that, I would get them to attempt to repair my 'medium size' hernia at the same time. If I do not get a reversal, I don't think I would risk surgery just for a hernia, which is inconvenient but not causing me major difficulties. I agree that core strengthening is important. Did you get advice from the hospital on that? Or there will be charities that can advise and even offer online classes in yoga/pilates. Good luck.

w30bob · Accepted Answer

Hi AL,

Docs tend to not want to operate on a hernia because, as an ostomate, you already have a weakened abdominal wall due to the hole for your stoma, so fixing the hernia would probably only be temporary. Think of it like a trampoline with a tear in it (for your stoma) and another tear right next to it. You're just playing with fire, and there's a good chance you can make things worse rather than better. We ostomates tend to think of a hernia the way someone without a hole in their abs (for their stoma) would think... so we figure we can just close up the hernia hole and it will heal solid and new... but the whole abdominal wall in that area is a stressed mess... which is why the hernia appeared in the first place. Fix that hole, and it will reappear at the next weakest part of the wall. Kind of like chasing your tail, if you know what I mean. So docs prefer to leave it alone and see if you can manage it without surgery.

As for exercises... nothing hardcore like sit-ups or anything that will really stress the abdominal muscles. It's like you have a tire with a bulge in the sidewall. If you just go slow and avoid the potholes, you'll be okay for a while. Punch it to 65 and drive like a nut, and that bulge is going to get a lot worse. I know... you're thinking, but a tire sidewall can't get stronger like my abs can. And you're right... but the tear in your abdominal wall isn't going to get any stronger... it's a tear. Low-impact ab exercises are okay, but nothing that's going to make a tear or weak area worse.

;O)

Dido · Accepted Answer

100% agree. I have had a parastomal hernia for 8 years; it has not increased in size, so I wouldn't consider repair unless it increased in size and became unsightly. In general, they do tend to come back after more surgery.

Maried · Accepted Answer

I developed a large hernia (the size of a large grapefruit) after having two children very close together. It became painful, and my bags would not stick well many times. My first repair did not last more than a year; the surgeon had no experience with parastomal repairs.

I found a surgeon with experience—not much, but his skills were good. It has been almost 20 years; no more pain, and my bags stick. I do worry that it may come back, so I do not lift over 25 lbs and exercise, and I am too old for any more children. I am grateful for the repair.

If it is small and there are no other problems, I would not have it repaired until it becomes a problem in your life.

Axl · Accepted Answer

Put abdominal exercises in the search bar here, and you will get many suitable examples. There are those who do sit-ups and crunches, but I won't touch them; too risky. There are many other safe alternatives.

infinitycastle52777 · Answer

I had hernia repair surgery on May 15th of this year. My surgeon told me they typically don't do anything unless it disrupts your pouching. Otherwise, they like to sit on it and just monitor it. Your stoma itself is a man-made hernia. Did you know that? Anyway, I had to have some incisional hernias repaired, and they went ahead and did my parastomal hernia too because it was so close to the incisional hernias that they wouldn't have been able to get the mesh right otherwise. It was robotic surgery, and recovery time was a few months, but I am all better now, thanks to walking and getting the exercise that was recommended. But to answer your question, usually they don't repair a parastomal hernia until it becomes a problem.

w30bob · Answer

Hi AL..........Yes........avoid exercises that are high impact to your abs! Think low impact exercises that work a variety of muscles instead. You want to avoid anything that seriously stresses your abs like sit-ups and crunches. I know........things like walking, swimming, or yoga/Pilates aren't considered serious exercise by many.......but with a tear in your abdominal wall.........they're now your new best friend. It's good to strengthen your core overall, just don't isolate your abs......or you risk your hernia getting bigger. And always wear a hernia support belt when you do any exercising.

;O)

When to Consider Stoma Hernia Repair?

Words of Encouragement from Ostomy Advocates I Hollister