A recurrent hernia is one that has returned, despite being repaired previously. About 2% to 5% of hernias will come back, but this is more likely if patients do too much in the first few weeks after their initial surgery. A hernia recurrence is also a possibility if people strain or become very constipated in the immediate post-operative period. Some hernias may recur years after the earlier operation.
The National Institute of Heath and Clinical Excellence (NICE) recommends that where possible if a previous hernia has recurred, it should be repaired, but using a laparoscopic (keyhole) technique. This is to reduce the risk of chronic pain and damage to tissues when re-operating in existing scar tissue. This method of surgery is also associated with a greater likelihood of a successful outcome.
Patients with a hernia recurrence may notice a painful lump within the scar that may never settle despite rest or lying down. Recurrent hernias are nearly always repaired due to the risk of strangulation.
Your specialist will discuss with you the best method of repair, but it’s almost always performed under general anaesthetic. If a laparoscopic operation is recommended, you will have a small scar near the umbilicus (tummy button) and two scars lower in the abdomen to allow the mesh to be placed under the muscle layer and to cover the defect (hole). Absorbable stitches are used to close the skin.
In some patients, a laparoscopic technique is not possible. The operation is performed through the existing scar. In these groin operations there is a very small risk that the blood supply to the testis on that side may be affected which may mean that it needs to be removed. Although this is a rare situation, your specialist will discuss the risk of this before any decision for surgery is made.