The region of the hernia repair is commonly affected by hardness, swelling and bruising which are related to the clotted blood and fluid under the wound, the stitches pulling the wound together and finally by scar tissue formation. These difficulties all settle over time as the area heals. The genitals can be affected by bruising and then they can become black and blue. This is because downwards is the obvious direction for any bleeding to track after the hernia repair.
There can be very extensive bruising in some cases, with a haematoma developing, a collection of blood from persistent bleeding which can cause a bulge near the repair or under the wound itself. This should steadily improve with time but can require surgical intervention and removal of the blood. Testicular swelling may persist for a long period as the bleeding gets down into the scrotum.
A small area of numbness of the skin is common just below the inner end of the wound. This is caused by division of a nerve which crosses the area of the hernia. The nerve may be divided in order to do a good repair and the area of numbness will get smaller. Since it is small and lies under the pubic hair it is not usually noticeable. About one patient in 20 may develop persistent pain in the area of the hernia operation and this can be very troublesome. It is probably due to stretching of a nerve during the operation or tethering of a nerve as part of the healing process. It often responds to a special pain killing injection, but very occasionally it may be necessary to operate on the area again to look for the trapped nerve and to try and release it.
Because a hernia lies next to the artery and vein to the testicle and the tube which carries sperms, all these are at risk during the operation. They are in greater danger during surgery for a recurrent hernia which has been repaired before. If the artery is damaged then the testicle may shrivel up or may need to be removed. If the tube carrying sperms is damaged then fertility will depend on sperms from the other testicle, which are usually quite sufficient. Before operation for recurrent hernia the surgeon will sometimes advise removal of the testicle in older patients in order to do the best possible repair.
Wound infection is uncommon but is a risk and if the wound reddens then a prescription for antibiotics will be necessary. The wound may need to be surgically explored to release infection if pus develops and starts oozing from the wound. The hernia is more likely to return with an infection present. A further operation may be needed to remove infected mesh and then the hernia will be repaired once more at a later time. After hernia repair deep vein thrombosis (DVT) is rare but important, with doctors taking special precautions should the patient have a raised risk of clotting. To reduce the risk of thrombosis it is useful to start moving the legs and feet and getting walking about again.
The chances of a hernia happening again are less than once in twenty cases after the first repair of a hernia. To have a general anaesthetic involves some risk and this is greater if the patient is suffering from a longstanding medical illness or disease. Short term side effects with the frequency of one in ten to a hundred are blurred vision, pain over the site of injection, bruising and sickness. These are easily managed and do not persist for long.
Less common complications with a frequency 1 in 100 to 10,000 cover pains in the muscles, damage to the lips, teeth or tongue, headaches, temporary problems with speaking, sore throat and short term breathing difficulties. Serious and very rare complications with a frequency of less than 1 in 10,000 cover kidney and liver failure, long term nerve or blood vessel damage, damage to the lungs, eye injury, voice box damage, brain damage, severe allergy reactions and death. The rarity of these complications means that the frequency depends on co-existing medical problems. - 14130
There can be very extensive bruising in some cases, with a haematoma developing, a collection of blood from persistent bleeding which can cause a bulge near the repair or under the wound itself. This should steadily improve with time but can require surgical intervention and removal of the blood. Testicular swelling may persist for a long period as the bleeding gets down into the scrotum.
A small area of numbness of the skin is common just below the inner end of the wound. This is caused by division of a nerve which crosses the area of the hernia. The nerve may be divided in order to do a good repair and the area of numbness will get smaller. Since it is small and lies under the pubic hair it is not usually noticeable. About one patient in 20 may develop persistent pain in the area of the hernia operation and this can be very troublesome. It is probably due to stretching of a nerve during the operation or tethering of a nerve as part of the healing process. It often responds to a special pain killing injection, but very occasionally it may be necessary to operate on the area again to look for the trapped nerve and to try and release it.
Because a hernia lies next to the artery and vein to the testicle and the tube which carries sperms, all these are at risk during the operation. They are in greater danger during surgery for a recurrent hernia which has been repaired before. If the artery is damaged then the testicle may shrivel up or may need to be removed. If the tube carrying sperms is damaged then fertility will depend on sperms from the other testicle, which are usually quite sufficient. Before operation for recurrent hernia the surgeon will sometimes advise removal of the testicle in older patients in order to do the best possible repair.
Wound infection is uncommon but is a risk and if the wound reddens then a prescription for antibiotics will be necessary. The wound may need to be surgically explored to release infection if pus develops and starts oozing from the wound. The hernia is more likely to return with an infection present. A further operation may be needed to remove infected mesh and then the hernia will be repaired once more at a later time. After hernia repair deep vein thrombosis (DVT) is rare but important, with doctors taking special precautions should the patient have a raised risk of clotting. To reduce the risk of thrombosis it is useful to start moving the legs and feet and getting walking about again.
The chances of a hernia happening again are less than once in twenty cases after the first repair of a hernia. To have a general anaesthetic involves some risk and this is greater if the patient is suffering from a longstanding medical illness or disease. Short term side effects with the frequency of one in ten to a hundred are blurred vision, pain over the site of injection, bruising and sickness. These are easily managed and do not persist for long.
Less common complications with a frequency 1 in 100 to 10,000 cover pains in the muscles, damage to the lips, teeth or tongue, headaches, temporary problems with speaking, sore throat and short term breathing difficulties. Serious and very rare complications with a frequency of less than 1 in 10,000 cover kidney and liver failure, long term nerve or blood vessel damage, damage to the lungs, eye injury, voice box damage, brain damage, severe allergy reactions and death. The rarity of these complications means that the frequency depends on co-existing medical problems. - 14130
About the Author:
Jonathan Blood Smyth, editor of the Physiotherapy Site, writes articles about Physiotherapists, physiotherapy, physiotherapists in Manchester, back pain, orthopaedic conditions, neck pain and injury management. Jonathan is a superintendant physiotherapist at an NHS hospital in the South-West of the UK.
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