Inguinal Hernia: Post-Surgery Concerns and Diagnosis

Right inguinal hernia

Hello Dr.
Liu, I had surgery for a right inguinal hernia in May last year.
This year, I noticed that the surgical site is sunken, and there is a bulge above the surgical area.
I would like to ask Dr.
Liu if this is abnormal.
Can an ultrasound or X-ray detect any issues inside?

Andy, 40~49 year old female. Ask Date: 2020/05/05

Dr. Liu Mingyue reply Urology

I recommend discussing the above situation further with your attending physician to determine if any additional examinations are necessary.
Thank you, and wishing you good health!

Reply Date: 2020/05/05

More Info

Inguinal hernia surgery is a common procedure, and it is essential to monitor the surgical site for any unusual changes post-operation. Based on your description of the surgical site appearing sunken with a bulge above it, there are several considerations to keep in mind.

Firstly, it is not uncommon for patients to experience some changes in the appearance of the surgical site after an inguinal hernia repair. The sunken area could be a result of the healing process, scar tissue formation, or even the placement of the mesh used during the surgery. However, the bulging above the incision site raises some concerns that should be addressed.

The bulge could indicate a few possibilities:
1. Recurrence of the Hernia: One of the most common complications after hernia surgery is the recurrence of the hernia. This can happen if the mesh does not adhere properly or if there is excessive strain on the surgical site during recovery. A recurrence may present as a new bulge in the area where the hernia was initially repaired.

2. Seroma or Hematoma Formation: After surgery, fluid (seroma) or blood (hematoma) can accumulate in the surgical area, leading to swelling or a bulge. This is usually a benign condition but may require monitoring or, in some cases, drainage.

3. Infection: Although less common, an infection at the surgical site can cause swelling and changes in the appearance of the incision. Signs of infection may include redness, warmth, increased pain, or discharge.

To determine the underlying cause of the changes you are observing, imaging studies such as an ultrasound or X-ray can be very helpful. An ultrasound is particularly useful in evaluating soft tissue structures and can help identify fluid collections, hernia recurrence, or other abnormalities. X-rays may not be as effective for soft tissue evaluation but can be used to rule out other complications.

It is crucial to consult with your surgeon or a healthcare provider who specializes in hernia repairs. They can perform a physical examination and recommend the appropriate imaging studies based on your symptoms and the findings at the surgical site. Early evaluation is essential, especially if you are experiencing pain, discomfort, or any other concerning symptoms.

In terms of post-operative care, it is important to follow your surgeon's recommendations regarding activity levels and follow-up appointments. If you notice any significant changes in the surgical site or experience new symptoms, do not hesitate to reach out to your healthcare provider for further evaluation.

In summary, while some changes in the surgical site can be normal, the bulging you describe warrants further investigation to rule out complications such as hernia recurrence, seroma, or infection. Imaging studies like ultrasound can provide valuable information, and timely consultation with your healthcare provider is essential for proper diagnosis and management.

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