Severe complaints after umbilical hernia and hernia surgery. Is the surgery reversible?
July 13, 2011 | 15,00 EUR | answered by Dr. med. Ralf Berg
Hello dear medical team,
I underwent a surgery 7 weeks ago, during which a cut was made above my belly button, approximately 5cm long. A very minimal umbilical hernia was directly repaired above the belly button and a hernia a few centimeters above that. The hernia was the only critical issue diagnosed and would have been sufficient as the focus of the surgery! Personally, I thought it would be more beneficial to address both issues at once to improve the appearance of my abdomen. This was a big mistake!
Immediately after the surgery, I had no noticeable discomfort. However, after a few weeks, since the stitches inside have begun to heal, I suddenly feel as if I have a button at the belly button that won't open where the umbilical hernia was repaired - there is now a relatively hard lump there. I have a constant pressure sensation towards the upper abdomen, my skin is tight, my breathing has become shallower (I can no longer breathe properly into the abdomen, as if something is pressing on the air from the belly button), the wrinkling (I have had 2 pregnancies and some excess skin tissue) is different and less favorable than before, as the wrinkles seem unable to spread across the entire abdomen. The abdomen now appears to be divided into 4 parts, with 4 skin pouches, whereas before it was just one.
The most bothersome aspect is that I can no longer breathe properly and relax my abdomen. It is constantly under pressure and tension. Even when lying down, so I have trouble sleeping. Urination is also difficult.
Overall, I feel constrained like in a corset. Sitting has suddenly become more strenuous. Not to mention the clearly visible scar, which causes the skin to contract.
Furthermore, where the hernia was operated on, there was a small hardening before the surgery. It never bothered me much, just could be felt. The hardening is still there, but now not in the same place, but next to the scar! And at that spot it hurts and has even become inflamed.
I have since found out that the surgeon who treated me has received poor reviews, as he has suggested unnecessary surgeries for other patients and some have gone wrong.
I deeply regret agreeing to this surgery and would like to reverse it if possible.
Now my questions:
a) What could this hardening be and what can be done about it?
b) Can the minimal umbilical hernia repair be undone so that the abdomen can finally feel like it did before the surgery and the tensions disappear? Or do I have to live with this forever?
c) What else could be done in this case to regain comfort?
Thank you for your response. This situation is also causing me a lot of psychological distress.
Dear patient,
It is evident from your descriptions that this issue is not only affecting you physically but also psychologically.
The necessity for correcting abdominal wall hernias is a tricky one. (The terms hernia = Latin and Bruch = German refer to the same thing = a more or less large gap in the abdominal walls, into which, depending on the size of the gap, intestines (small intestine, abdominal mesh) can get trapped). If you have no complaints, there is only the risk of intestines becoming trapped, potentially leading to a bowel obstruction, which generally does not require surgery. However, if there are existing symptoms or a high risk of complications, surgery is advisable.
It seems that you did not have significant complaints, but rather decided to undergo surgery with the idea of improving the appearance of your abdominal wall. This has not only not been confirmed but has now worsened. It is clear that this is very distressing. However, for improving and tightening the abdominal walls, a hernia operation was not necessary, but rather a cosmetic surgery (abdominoplasty), which is not covered by insurance.
Whether the hernia above the navel justified surgery, I cannot determine here on the internet, nor can it be determined retrospectively. Now, good advice is indeed expensive.
1. First of all, I would like to give you a fundamental piece of advice, even if it is uncomfortable: Do not rush into a re-operation! Every operation results in new scars, and how they contract after a few months is unpredictable, as you have now experienced.
2. More important than surgery (which can always be done later) is to achieve freedom from complaints. Stretching and conservative measures (e.g. physiotherapy, injections of painful scar tissue components) are necessary and should be used for a sufficient amount of time.
3. I recommend that you seek independent advice from a surgical center that was not involved in your previous treatment, as you have reported complaints from urination to breathing. The inflammation in the area of the ongoing hardening that you described must also be monitored. After these fundamental discussions, I will now address your
4. initial question about the existing hardening. Due to the inflammation alone, an examination (in addition to physical examination, also with ultrasound) should clarify whether a re-operation is necessary or if one should wait.
5. Dealing with the umbilical hernia is more difficult. Simply reopening it will likely result in the formation of a larger umbilical hernia, which may cause you even greater problems. Here too, you should be examined and advised by an experienced surgeon.
6. I have already answered question c: Treatment of connective tissue, muscle plates, and abdominal walls with physiotherapy and physical methods. If possible, give the tissue time to heal under therapy before considering any further intervention. (3-6 months) Possible surgical corrections should only be made once the tissue trauma and the tightened abdominal walls have calmed down and been stretched again.
Please remember: surgery cannot simply undo everything as you would like. Therefore, I urgently advise you to seek good advice before considering another surgery and to be aware of the consequences. (It should have been clear that a new scar would be in the middle of your abdomen after the surgery. The fact that it bothers you now suggests that you were expecting a significant improvement in your abdominal wall from the hernia surgery and may have agreed to the surgery too quickly. If you cannot cope with the altered skin folds, consider cosmetic surgery as a last resort, but only from a doctor specialized in this area. Do not rush into anything again.
I hope this can guide you on a path and wish you success in implementing it. Make an appointment with your primary care physician and discuss the suggested post-treatments with them. Also, ask which surgical colleague he would most likely refer you to for your hardening problem.
Best regards, Dr. R. Berg
