What is a hernia?
A hernia is a hole or weakness of the inner lining of the abdominal wall. This layer of the abdomen is lined with a layer called the peritoneum. This makes up what is called the hernia sac.
Are all hernia's the same?
No. There are many types of hernias. Some are more problematic than others.
What causes a hernia?
Some hernias are congenital or “you are born with them”, while others are acquired. The acquired hernias come from a range of activities that increase the pressure in the abdomen such as coughing, sneezing, strenuous bowel movements or heavy lifting.
Why should I fix my hernia?
Hernias can cause symptoms in the form of pain, but the majority of patients have a painless lump or bulge. Intra-abdominal organs (such as fatty tissue, intestines, bladder etc.) can incarcerate within the hernia defect or get stuck which is considered an emergency. Pain and a non-reducible bulge indicate a problem and should prompt an immediate Emergency Room or office visit.
What happens to the hernia if I do not have surgery?
Generally, the hernia gets bigger with time and will not go away without surgery. Sometimes, it may turn into an emergency due to incarceration and if left untreated could lead to serious complications including death.
How is a hernia fixed?
The goal of hernia surgery is to close the hole. This is done either with or without a “Mesh”. A Mesh is stronger, but if it gets infected, it will have to be removed. A hernia can be fixed with either an open or laparoscopic (small incisions and camera) technique.
What is a “Mesh”?
A “Mesh” is a plastic material (usually polypropylene) that looks just like a window screen. It helps reinforce hernia repairs as tissue grows into it and it promotes scar tissue which helps solidifying the repair. It significantly reduces the chance for recurrence or failure.
Do women get hernias?
Yes, women get all the same types of hernias with varying frequencies that men do.
How much pain will I have after surgery?
Pain is different for everyone. Local anesthesia may be used during surgery which mayhave last for several hours. Pain usually peaks within 24 hours after surgery but then gets better with time.
Do I need a dressing or gauze on the wound or incision?
The incision is usually covered with surgical glue. You may cover with clean dry gauze and change daily or as needed if it is draining fluid.
Why do I feel a thick area under the incision?
It is normal to feel a thick ridge of tissue at the incision site. This is healing tissue stimulated by the mesh.
Why is the area swollen?
Tissue trauma from surgery will cause swelling that can take months before it resolves completely. If the swelling continues to persist after several months, please call our office for a follow-up visit.
Why do I have scrotal / penile swelling?
Blood or fluid from surgery can pool down in the scrotum area which, sometimes can produce bruising marks in this area.
Why is fluid draining from the wound?
Occasionally fluid will drain from the surgical wound. If this happens, cover the wound with a clean dry gauze and change daily or as needed. Do not get it wet. If there is significant redness on the wound, pain or fever, call the office to be seen as soon as possible.
What diet should I be on?
Occasionally anesthesia from surgery can cause nausea or vomiting. We recommend starting with a clear liquid diet. This means any food or liquid from which you can see newspaper print through. If this is well tolerated, then advance to your regular diet. Sometimes this nausea and vomiting can last up to 1 or 2 days. If that happens, drink plenty of liquids until you see improvement. If this does not improve in 1 or 2 days, please call our office or go to the Emergency Room.
What activity can I do after surgery?
If your hernia was repaired with an open procedure we recommend no strenuous activity which can put undo tension to the wound and no heavy lifting – do not lift anything weighing more than 10 pounds for 2-4 weeks depending on your tissues. But if you had a laparoscopic (keyhole incision) or robotic assisted hernia repair you may resume your normal activities when the post surgical pain is well tolerated. For all hernia operations, patients can walk the same day. Ask Dr. Klause for details and specifics for your situation.
When should I follow up?
You should have a follow-up visit with Dr. Klause about 7-10 days after your surgery if everything seems normal. If you experience any fevers of over 101, redness, fluid draining, please call immediately or go to the Emergency Room.
What should I do if I have problems urinating?
Some people will develop urinary retention or the inability to urinate after their surgery. If you have not urinated in over 8 hours, and you feel that you need to but can’t, you should contact our office immediately or go to the Emergency Room.
What are the risks of surgery?
Some risks include but are not limited to bleeding, infection, injury to other bodily structures or organs, need for additional surgery, recurrence of the hernia, heart attack, stroke, chronic pain, changing size and location of testicle in the scrotum, anesthesia risks and death. For more information in regards to your case in particular, please contact Dr. Klause.
What are the risks of not having the surgery?
The contents in the hernia could get incarcerated, which could eventually cut off the blood supply to certain bodily structures or organs resulting in severe complications and even death.
How long does the skin glue last?
If the surgical area is kept clean, dry and unscrubbed, it can last for weeks. If it is still on after two weeks, then you can be more aggressive removing it. If it comes off early, it is OK because the surgical sutures are under the skin.
What type of anesthesia will be used during the surgery?
The majority of the time, a general anesthesia is used. Sometimes, though, sedation with local anesthesia is used based on medical circumstances.
Should I take any medications after the surgery?
Yes, a stool softener is recommended and you may use pain medications as necessary.
Should I shave the area before surgery?
No, the team will prep you by shaving the area on the day of surgery. In fact, sometimes shaving at home before the surgery may increase infections risks.
How long is the operation?
Most hernia surgeries take about 30 minutes if everything goes well. Time in the Recovery Room is about 30 minutes and most patients go home the same day of surgery. Complicated abdominal wall hernias or recurrent hernias can take longer - up to several hours in the operating room.
When can I shower?
If Dr. Klause used skin glue, you can shower the same day, but if there are steri-strips or staples, you may shower in about 3 or 4 days. Usually, the glue will fall off in 1-2 weeks. You can remove it in three weeks if it is still there.
When can I work or drive?
Most people can drive and work in about a week. The criteria for driving is that the patient should not be taking any narcotic pain medication and the patient can move around comfortably enough to drive safely.
Is bruising normal?
Yes, some bruising and swelling is expected and is considered normal. If the bruising or swelling is getting larger or expanding, call Dr. Klause’s office or go to the Emergency Room.
Do I need to have my stitches removed?
No, almost all the stitches are under the skin and will absorb in time. They do not need to be removed.
How will I know if I have an infection?
Infections are rare but do happen nonetheless. They generally present with expanding wound redness a few days after surgery and can present even weeks later. Redness following surgery is normal and usually resolves in a few days. A purple pink wound is a normal – healing wound. If it does not clear up or goes away but then comes back again, contact Dr. Klause’s office to get instructions or go to the Emergency Room.
What should I do if I am constipated?
Constipation can happen after surgery and often does to many people. Several options for treatment include milk of magnesia, fleet enemas, Miralax, prune juice, mineral oil. Also, please drink plenty of water and consume a high fiber diet; Metamucil, Citrucel or Benefiber can also be helpful to treat and prevent constipation. If these treatments are not working, please call the office as soon as possible. Dr. Klause commonly will prescribe a stool softener to be started the day of surgery.