Overview of complications of inguinal and femoral hernia repair
- David C Brooks, MD
David C Brooks, MD
- Associate Professor of Surgery
- Harvard Medical School
- Section Editors
- Michael Rosen, MD
Michael Rosen, MD
- Section Editor — Hernia Surgery
- Professor of Surgery
- Cleveland Clinic Foundation
- Jerome P Richie, MD, FACS
Jerome P Richie, MD, FACS
- Section Editor — Cancer of the Urethra, Penis, and Ureter; Urologic Surgery; Prostate Cancer
- Elliott Carr Cutler Professor of Surgery
- Harvard Medical School
Complications after inguinal or femoral hernia repair are relatively common. The incidence is higher after emergent repairs and recurrent hernia repairs compared with elective repair. With the transition to tension-free repair, hernia recurrence is less frequent while other complications, such as post-herniorrhaphy neuralgia, have become more prominent.
Complications that occur in the perioperative period include wound seroma/hematoma, urinary retention, bladder injury, and superficial wound infection, while complications that occur later following hernia repair include persistent groin pain and post-herniorrhaphy neuralgia, testicular complications, deep wound/mesh infection, recurrent hernia, and mesh migration and erosion.
Complications associated with inguinal and femoral hernia repair will be reviewed here. The operative techniques for inguinal and femoral hernia repair, including methods to prevent complications related to repair, are reviewed elsewhere. (See "Open surgical repair of inguinal and femoral hernia in adults" and "Laparoscopic inguinal and femoral hernia repair in adults".)
Complications after inguinal or femoral hernia repair are relatively common, with the incidence depending upon the clinical circumstance under which the repair was performed as well as the site and type of the hernia .
Urgent and emergent procedures are associated with higher complication rates compared with elective repair [2,3]. In one review of 1034 groin hernia repairs, overall complication rates were 27 percent for acute hernia repairs and 15.1 percent for elective repairs . Higher complication rates are also seen with repair of recurrent hernia compared with primary hernia repair. In studies comparing open and laparoscopic repair, the overall incidence of complications is similar; however, the nature of the complications differs. Identifiable differences are discussed below. (See "Overview of treatment for inguinal and femoral hernia in adults", section on 'Primary hernia'.)
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- PERIOPERATIVE COMPLICATIONS
- Urinary retention
- Bladder injury
- Superficial wound infection
- LATER COMPLICATIONS
- Persistent groin pain and post-herniorraphy neuralgia
- Testicular complications
- Deep wound/mesh infection
- Recurrent hernia
- Mesh migration and erosion
- SUMMARY AND RECOMMENDATIONS