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Hernia returned 3 months after surgery

I am a 39 year old woman and had open inguinal hernia surgery on the left side w mesh on Jun 8, 2009. I had a golf ball size bulge, which was painless initially but had started bothering me with a burning pain - 3/10. I have had 2 c-sections in 2005 and 2007. I followed all precautions post hernia surgery and did not lift anything heavy / exercise for 4 weeks post surgery.

Now 3 months later, I am noticing the same reducible bulge in my left groin area after straining/heavy lifting/exercising. I do moderate cardio and Yoga, also I have two toddlers and am bending and active all day. If I press on the bulge it goes back in. It is almost the same size as pre surgery. There is some discomfort in the area, and pain when I bend over several times during the day. The groin area below my incision is numb. The surgeon got in through my c-section incision - about 3 inches on the left side.

I met my surgeon today and he did a physical exam and gave me the news that my hernia had come back. He thinks it is a new hernia stemming from the c-section incision. I will try and explain what I understood. He said that the incision he made (last 2.5 inches of my c-section scar on the left side) was a small distance away from the vertical c-section incision; and the tissue in this "inbetween spot" had low blood supply and a lot of abdominal pressure, so the c-section incision has split open and the hernia has come through again. He does not think any sutures have come loose, but the tissue he attached the sutures to, has "torn".

He says the best way to find out for sure is to do a laparoscopy and once he sees the exact situation, he will put another piece of overlapping mesh, this time from inside the abdomen (so when pressure is exerted on the abdominal wall the mesh will tighten up further).

I am not sure what I should do at this stage and have the following questions:

1. In the first place, could he / should he have attached the mesh in a manner that puts less pressure on my c-section incision? Did he mess up in any way, or am I among the very very few people this has happened to, he told me that this is very rare for the hernia to come back in three months.

2. Does what he is saying sound right? I do not want to go under the knife again so soon - have 2 toddlers dependent on me. He said there will be the usual 4 week restrictions on activity this time too. Should I consider switching surgeons?

3. Can I have another surgery (lap this time) so soon after the earlier open hernia procedure?
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replied September 13th, 2009
I cannot comment on the technical aspects of your prior hernia repair, as I was (obviously) not there. However, all hernias repairs are associated with a known risk of recurrent hernias.

Based upon the information that you have provided, a diagnostic laparoscopy and laparoscopic mesh repair of your recurrent hernia would, indeed, be the appropriate next step. If you are otherwise in good health at this time, I see no clinical reason why you cannot undergo a laparoscopic hernia repair at the present time.

Sincerely/ Robert A. Wascher, MD, FACS

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