The actual mechanism by which these defects produce pain is debatable. Physicians treating chronic pelvic pain patients should be knowledgeable in the diagnosis and surgical treatment of these women.Ī hernia is an abnormal opening or defect through which organs or tissue may protrude. However, women are subject to delayed diagnosis and treatment because they may present to their gynecologists with chronic pelvic pain due to a condition formerly relegated to the discipline of general surgery.
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Pain patterns are very specific to the location and hernia type. The internal images are displayed on a large monitor that the surgeon uses to guide small instruments inserted through the other incisions to repair the hernia.Inguinal, abdominal, and pelvic floor fascial defects cause pain in many patients, male and female. In this minimally invasive surgical procedure, the surgeon makes several small incisions in the lower abdomen and first inserts a tubelike instrument, called a laparoscope, equipped with a camera into one of the incisions. Sometimes, in a procedure known as hernioplasty, the weak area is repaired and reinforced with steel mesh or wire. In this surgical procedure, also known as herniorrhaphy, the surgeon makes an incision in the abdomen above the hernia, pushes any protruding intestine back into the abdomen and repairs the opening in the muscle wall. Treatment will generally consist of one of two types of surgeries: Open hernia repair The treatment will also depend on whether the hernia has negatively affected the results of the original surgery, requiring additional procedures before the hernia can be closed. Specific treatment for an incisional hernia will be determined by your doctor based on multiple factors such as your general health, anatomy, extent and location of the hernia, and desired level of future physical activity. Ultrasound, MRI, CT or other imaging to check for blockage or actual location of the intestinal protrusionĪdditional techniques may also be used if the health care provider believes the rupture has resulted in the movement or protrusion of other organs in addition to intestines. If your provider suspects this is the case, additional diagnostics may include:īlood tests to look for infections caused by intestinal blockage or necrosis If the protruding portion of intestine has become trapped (incarcerated) within the abdominal wall, the blood supply to the intestine can get cut off (strangulation), causing further complications such as necrosis (tissue death). Previous surgeries, locations and outcomes
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Pain in the abdomen, especially around the protrusion Nausea, vomiting, fever or rapid heart rate
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Lump or protrusion in the abdomen at or near the site of a previous incision the patient may be asked to stand and cough, which tends to make the hernia more pronounced The provider will inquire about and/or look for:
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To identify an incisional hernia, a health care provider may use multiple diagnostic techniques but will begin with a medical history and physical examination. Incisional hernias are most likely to occur within three to six months post-surgery but can happen at any time. An incisional hernia can occur for a number of specific reasons individuals who participate in excessive or premature physical activity after surgery, gain considerable weight, become pregnant or increase abdominal pressure in any other way before the incision is fully healed are especially at risk for an incisional hernia. Incisional hernias result from a weakening of the abdominal muscle due to a surgical incision. An incisional hernia occurs at or in close proximity to a surgical incision through which intestine, organ or other tissue protrudes.Ĭlick image to enlarge Incisional Hernia Causes All abdominal surgeries carry a 33 percent risk of a postoperative incisional hernia, and approximately 33 percent of people undergoing abdominal surgery will experience an incisional hernia.