Abdominal Wall Hernia Recurrence: Why It Happens and How to Prevent It

Abdominal wall hernias can occur at the umbilicus, groin, epigastrium, incision lines and rarer sites. Even after a good period following surgery a hernia may develop in or near the same area. This is called recurrence.

Why does recurrence occur?

• An unsuitable technique or mesh was chosen
• Undersized mesh — insufficient coverage
• Wound infection or haematoma
• Conditions that impair healing: diabetes, smoking, advanced age, malnutrition
• Factors that raise intra-abdominal pressure: obesity, chronic cough, heavy lifting, constipation
• Individual differences in collagen tissue

Who is at higher risk?

• Patients with a high body mass index
• Smokers
• Patients with poorly controlled diabetes
• Patients previously operated on for a hernia in the same area
• Patients with chronic cough or constipation

How to reduce recurrence?

• Appropriate mesh size and material
• Surgical technique matched to hernia type (laparoscopic/open, onlay/sublay)
• Pre-operative weight loss and glycaemic control
• Stopping smoking at least 4 weeks in advance
• Avoiding heavy lifting for an appropriate period after surgery
• Treatment of constipation and chronic cough

What happens if it recurs?

For a recurrent hernia the previous technique, mesh type and reason for recurrence are re-evaluated. Repair may require a different approach or plane. Such operations are best planned in experienced centres. The decision is individualised based on imaging, examination and the patient's overall condition.

This content is for general information only. For personal diagnosis and treatment decisions please consult your doctor. For emergencies, contact the nearest medical facility.