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Parastomal Hernia

Welcome to MeetAnOstoMate
17,271 Members
Posted: Sun Aug 17, 2008 2:25 pm
I have a parastomal hernia, Its not actually near the Stoma, but on the Incision scar line from the OP. It doesnt hurt or affect me that much, but its unsightly when I am naked ( not a pretty sight at the best of times) My Doc says it can be repaired with a Mesh patch , but I'm not sure If I want to be cut open again!! What do you think?? Has anyone else had this type of hernia repaired & was it successful.... Many Thanks .... Pete.... Rolling Eyes
  Past Member
Posted: Thu Aug 28, 2008 6:27 pm
I had it repaired and never gave it a thought again,  It wasn't all that bad a procedure.
Posted: Sat Aug 30, 2008 1:25 pm
II too have a peristomal hernia & have discussed it with a surgeon who told me about possible repair methods, mesh patch included. He told me that as long as it doesn't bother me or create problems I could just leave it alone. I dread the thought of being opened up again so, although it is rather unsightly, I will probably put off the repair as long as I can.
Posted: Tue Sep 16, 2008 1:50 pm
I have just found another way to support my hernia, Mine is lower down on the incision scar line.... Cut the legs off Ladies support tights. Worked OK for me & quite cheap.........
Posted: Thu Nov 20, 2008 6:16 pm
I have had a large parastomal hernia now for about 4 years. I have as a result suffered with spinal problems (had to have discectomy and fusion of the cervical spine) and reduced mobility due to the pain in my abdomen, back, legs etc when I walk. I have been advised by my consultant that only 50% of hernias such as these are successfully rectified as whilst there is still a split in the abdomen wall (the stoma) a sneeze, cough etc could very easily result in the same again. I will be waiting to have mine done once (if ever) my ileostomy is reversed.  Confused
Posted: Thu Nov 20, 2008 6:18 pm
                                 
vulcanBMk2 wrote:
I have just found another way to support my hernia, Mine is lower down on the incision scar line.... Cut the legs off Ladies support tights. Worked OK for me & quite cheap.........


You can get supports free from the NHS - not very pretty though, hardly Ann Summers!
Posted: Sun Mar 01, 2009 8:36 pm
Hi folks, i don't know if this is any use to you guys/girls or should be in the innovations section, but it is something to consider when thinking about peristomal repair, i was asked this exact same question not that long ago and i decided to research the subject, so i am going to post this in the exact same way i answered the question origionally, i hope you don't mind as it's easier just to copy and paste it here.

The vast majority of people who develop peristomal hernias learn to live with them, as they cause little or no problem. However, if you are having substantial difficulties with the stoma due to the bulge or have developed pain or episodes of obstruction due to the hernia, an operation to repair the hernia is possible. Unfortunately, this is no small undertaking.

There are a variety of methods and techniques to attempt to repair these hernias. The simplest method is to make an incision in the vicinity of the stoma, push the contents of the hernia sac back into the abdomen and close the muscle layer with some stitches.
Unfortunately, this simple technique has a very high rate of recurrence of the hernia and is rarely used because of the long-term failure rate.

Another "local repair" is to make a similar incision around the stoma and place a piece of synthetic mesh to close the defect.
This technique has a lower recurrence rate but has a greater rate of wound problems. The mesh products that are now available have revolutionized the ability of surgeons to repair many types of hernias. However, placement of this type of "foreign body" always places you at some risk of infection.
Utilizing mesh around a stoma is always somewhat worrisome due to the higher risk of contamination of the mesh with bacteria from the stoma at the time of its insertion.

A further concern is the possibility of placing the mesh too tightly around the bowel as it exits the abdomen. If it is placed too tightly, it may inhibit the emptying of the bowel content through the stoma postoperatively. Also, if it lies up against the mesh it may, with time, slowly erode into the bowel wall, necessitating removal of the mesh.
Alternatively, placing the mesh too loosely may result in not closing the entire hernia defect around the stoma and allow another hernia to occur.

Many peristomal hernia repairs require that the abdomen be reopened, usually through the same incision that was used to create the original stoma. From inside the abdomen, a piece of mesh can be place around the stoma to repair the hernia. This still carries all the possible risks of mesh placement.
However, the risk of contaminating the mesh with bacteria from the stoma is felt to be less and the ability to better judge mesh postion make this a better option than the local repairs.

Lastly, in some cases it is necessary to completely take down the stoma, repair the abdominal wall and create a new stoma in an entirely different location. This is most often the preferred option if there are other problems with the original ostomy, such as a poor location, narrowing of the stoma opening or retraction of the stoma below the skin level.
In these situations, you are far better off with a completely new ostomy than trying to salvage a stoma that was giving you problems even before the development of the hernia.

In summary,
repairing a peristomal hernia is certainly possible, but often requires a major abdominal surgery with all its possible complications.
Therefore, it is not recommend that every perisotmal bulge be repaired. Rather, if adjustments to your stoma appliance can be made such that a reliable seal can be maintained and the hernia remains asymptomatic, there is no need for surgery.

Hope this helps in making the decision as to wether or not you actually need a peristomal repair done.x
Nurse
Posted: Sun Mar 01, 2009 10:23 pm
Swede,
that was a better explanation than I've heard from any physician!

I'd add a couple of things:  it is best to try and prevent them....a hernia support belt for any activity than strains abdominal muscles is advisable; but doesn't completely exclude the possiblity of getting one.

Trying to avoid intra abdominal pressure is thought to help...though hard to live your life that way if going about normal activities of life.



Your general health, prior surgeries and scar tissue, adominal fat present and compliance with activity restriction afterwards are a few things the surgeon looks at for a good repair candidate.

I would suggest consulting a surgeon that specializes in hernia repairs if available.
_________________
* Certified Wound and Ostomy Care Nurse
* Registered Nurse
* Bachelor of Science in Nursing
Posted: Sun Mar 01, 2009 10:39 pm
Cheers whoa.x

P.s. Although i'm sure it will be more suitable posted elsewhere.
Posted: Tue May 19, 2009 11:24 pm
hey swede.........been looking for a good place to enter this forum and you gave it to me. i have a ileo put in last year and have the idea i have a hernia under it. i see the doc next month and thanks to you i have many questions now that i had not thought of. i love these forums as the amount of information and experiences  can not be gotten any where else. again thank you and i hope i can be of assistance to you and others one day.
Posted: Tue Aug 04, 2009 9:04 am
Wow sorry Bearcat, i completely missed your post, glad you found the post useful lol, and once agian sorry for not responding, must have been doing other things at he time.

I hope your hernia repair was/will be a success
Posted: Wed Feb 10, 2010 12:52 pm
I had a mesh patch inserted to repair my hernia - this has partly torn and I have been advised not to proceed with another operation un-necessarily so am steering clear of hospitals!
If you are going to have a mesh inserted, ensure you find a surgeon who is experienced in KEYHOLE surgery, hence avoiding the usually high risk of infection.
Posted: Sat Aug 14, 2010 12:09 pm
just to finish the story. i had the hernia repaired(doc advised at best it was 50-50), but was hard to get the bag to stay on. was done in Mar of this year, just like swede said. he first sewed the muscles together then. a layer of mesh was sewn in. one has to remember that the stoma itself is a man made hernia. it came back about 2 months later and the doc and i are discussing doing it again, but both of us are a  little reluctant go again. it is getting bigger but at present it does not hurt and the bag stays in place, so we're in the "watch every 4 months mode". i do have a hernia belt from Nu-Hope and do recommed them highly, they do help. will up date when info is available
Posted: Tue Oct 04, 2011 11:20 am
Just came across your article which nicely sumarizes the details and risks of hernia surgery. Am considering such for a large parasrtomal hernia under stoma, but your article - and my age - have warranted many second reconsiderations. Nice summary!
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