Parastomal Hernia Diagnosis and Repair
A parastomal hernia is a complex type of hernia that forms at the site of a permanent stoma. Although a common occurrence, parastomal hernias can be difficult to treat unless the procedure is performed by a surgeon with substantial interest and experience in hernia repair.
What is a Stoma?
Parastomal hernias occur around a permanent stoma site in patients that have colostomies, ileostomies, or urostomies following intestinal, colon, or urologic surgery. The stoma is the site where the inner intestine connects to the outer colostomy, ileostomy, or urostomy bag.
The Differences Between a Colostomy, Ileostomy, and a Urostomy
Any sort of ostomy surgery is performed to open the abdominal wall and allow the intestine or ureter to reach an outside bag.
The difference between a colostomy and an ileostomy is that the colostomy diverts a part of the large intestine outside of the body whereas an ileostomy diverts a part of the small intestine outside of the body.
A urostomy performs the same basic function, though it redirects urine rather than feces.
How Do Parastomal Hernias Develop?
As previously mentioned, parastomal hernias are incredibly common for those with any type of stoma. This is mostly to do with the fact that the stoma creates a weakness in the abdomen wall, which is very vulnerable to hernia formation during any sort of strenuous activity such as lifting a heavy object or pushing too hard during a bowel movement.
There are of course other factors that have been shown to contribute toward the formation of a parastomal hernia. Those looking to lessen their risk of getting a parastomal hernia should avoid:
- Corticosteroid use
- Becoming obese or malnourished
- Chronic coughing or constipation
Parastomal hernias often occur simultaneously with an incisional hernia (through the original surgery site). Both hernias need to be addressed and repaired for long term satisfactory outcomes.
How Will I Know If I Have a Parastomal Hernia?
There are several unique indications of a parastomal hernia. The primary symptoms include:
- A visible bulge at the stoma site
- Pain around the stoma
- Difficulty keeping your ostomy appliance properly situated
Parastomal hernias are not often dangerous, but can become life threatening if the intestine becomes strangulated. A strangulated intestine will lead to progressive death of the tissue if not treated immediately.
How Do You Treat a Parastomal Hernia?
The treatment for a parastomal hernia will largely vary from one patient to another, as nearly every case is a bit different. The primary objective of parastomal hernia repair surgery is to reinforce the abdominal wall and keep it from allowing the intestine to poke through again.
Most hernias are repaired by covering the weakened area with mesh, but this is not possible for most parastomal hernias since the patient will not have access to their stoma if it is covered by mesh. The hernia may be repaired using mesh if another stoma site is made elsewhere on the abdominal wall.
If stoma relocation is not possible, the hernia surgeon is likely to either repair the hernia or close the stoma entirely. Both of these options depend on the size of the hernia as well as the amount of healthy bowel that the patient has left.
See a Hernia Specialist of Detroit, Michigan
To discuss the ideal treatment option for you and your parastomal hernia, please call Michigan Hernia Surgery today at (248) 551-9090 or fill out our online form to schedule an appointment.