Pain after umbilical hernia surgery

definition

Umbilical hernia surgery is a very minor procedure. Nevertheless, access to the abdominal cavity must be created, which can lead to pain postoperatively. These occur as soon as the pain medication of the procedure wears off and are also known as wound pain. However, this is completely normal and usually only lasts a few days. Postoperative wound pain usually manifests itself as permanent pressure pain and stabbing pain when moving.
So-called NSAIDs (nonsteroidal anti-inflammatory drugs), such as ibuprofen, can be used for relief.

Causes of the pain

Postoperative pain in the operating area and the sutures is normal and lasts for about 1-5 days, depending on the type of procedure. A manipulation of the surgical area, for example by coughing, laughing, sneezing or lifting heavy loads can lead to pain even for a longer period of time.

Also read our topic: Swelling after an operation- tips for treatment

Depending on the type of anesthesia, postoperative tiredness, nausea and fatigue are also normal. In rare cases, complications can occur, but these can usually be treated very well. Frequent complications are hematomas (bruises) and seromas (accumulation of wound fluid), which are mostly limited to the surgical area and above all to the place where the hernial sac was previously. These either disappear on their own or just have to be punctured (pricked).

Another common complication is skin suture infection. This leads to pain at the injection sites, followed by redness, swelling and pus. It may be necessary to remove the seams with a new fastener.

Rarer complications are deeper-lying inflammations, recurrences (renewed umbilical hernia), adhesions, as well as an intolerance of the suture material or inserted mesh. Adhesions and intolerance may only become noticeable after a long time (months to years) and may make another operation necessary.

diagnosis

In order to be able to make the diagnosis "pain after umbilical hernia surgery" or "postoperative wound pain", it is necessary to rule out other possible causes of the pain:

• If there is an inpatient stay after the procedure, this is guaranteed by regular wound checks.
• In the case of an outpatient operation, during which the person concerned can then go home again, it is advisable to consider the differences between normal postoperative pain and pathological conditions, as described above. If the pain is mild to moderate and lasts only a few days, the course is absolutely normal.
  

Concomitant symptoms

In addition to the pressing and pulling pain that typically occurs at the seam, the pain can also radiate into the groin or the upper abdomen. In addition to pain, postoperative loss of appetite, nausea, vomiting, tiredness, confusion and exhaustion can also occur. This occurs especially if the operation was performed under general anesthesia and should not last longer than a day. Also due to general anesthesia, hoarseness and coughing can occur after the operation. The reason for this is the use of a ventilation hose (tube) during the operation.

When inserting a net for additional stabilization of the fracture site, a foreign body sensation can then occur in the stomach. This usually improves over time, but can also occur permanently. Other accompanying symptoms are hematomas, swellings, leakage of wound secretion from the seam area, redness, small amounts of pus around individual sutures and a feeling of tension around the surgical area.

Treatment / therapy

Postoperative pain typically occurs as soon as the anesthetic pain medication wears off. They intensify within a few hours and reach a maximum, which slowly subsides after about a day. If the pain becomes very severe, it is possible to alleviate it with so-called NSAIDs (non-steroidal anti-inflammatory drugs). These are either automatically prescribed upon discharge or upon request by the attending physician.

Cutting and suturing during an operation cause local inflammation and irritation of smaller nerves. NSAIDs, such as ibuprofen, inhibit inflammation-related pain, making them ideal for relieving wound pain. Other possible drugs are metamizole and paracetamol.

In addition to drug therapy, the most important treatment for postoperative wound pain is physical rest. Lifting heavy loads or doing sport is only recommended after about six weeks. Sufficient rest can significantly reduce the duration and intensity of the pain.

How long have you been in pain?

Surgical pain is usually most severe in the evening or on the day after an operation. They last for about a day and then slowly subside, so that there should be no rest pain by the fifth postoperative day at the latest. Moving or shaking the operating area (coughing, laughing, sneezing, rapid movements, lifting heavy loads, ...) can lead to short-term pain for much longer and should therefore be avoided if possible.If the pain persists or worsens, the wound should be examined by a doctor to rule out or treat inflammation.

Differences in pain: with or without a mesh

Pain after an umbilical hernia operation depends very little on the choice of procedure. With a mesh insert, in contrast to a pure suture technique, additional, slight pain can occur at the fastenings of the mesh.

The main pain, however, arises from the preparation of the surgical area, i.e. the incision, which is present in both techniques.
However, depending on the height at which the net is inserted, a foreign body sensation can occur, which usually disappears after a while. In addition, there is a slightly increased risk of infection caused by foreign bodies with a mesh insert. In rare cases, allergies or intolerance may occur, which may require a new operation with removal of the mesh.

Pain in the upper abdomen

After an umbilical hernia operation, pain mainly occurs around the navel and around the seams. This can cause the pain to radiate into the upper abdomen.

During a laparoscopic (minimally invasive) operation, one of the surgical throcars may be inserted into the upper abdomen, causing pain postoperatively. A mesh insert can also be the cause of pain. Since the mesh is significantly larger than the navel, irritation can occur at one of the attachment points in the upper abdomen.
If therapy with NSAIDs (non-steroidal anti-inflammatory drugs) has taken place, this may also be the reason. NSAIDs increase the production of acid in the stomach, which can lead to upper abdominal pain.

You can also read our topic here: Upper abdominal pain - these are the most common causes