Parastomal hernia

What is it?

A parastomal hernia is an abdominal hernia adjacent to an artificial stoma. A permanent artificial stoma sometimes needs to be placed in patients undergoing intestinal surgery. If a rectum tumour is close to the sphincter, sometimes the anus has to be removed and a colon stoma (colostomy) is placed.

In case of malignant tumors of the bladder, sometimes an artificial urine outlet has to be created with a stoma made with the small intestine (ileostomy). This requires an opening in the abdominal wall, and a hernia often forms next to the ostomy through which the intestines can protrude.

Does every parastomal hernia require surgery?

A parastomal hernia is very common in patients who have a permanent stoma. According to some surgeons, almost all ostomy patients have a parastomal hernia to a greater or lesser degree. Research has shown that a parastomal hernia can be prevented in most patients by applying a prosthesis or a mesh around the stoma. However, colon surgery is considered a surgery where infection occurs very easily; therefore, most surgeons are afraid of placing a mesh out of fear of infection. Because a parastomal hernia often does not cause much discomfort, surgery is usually not performed and a watchful waiting approach is chosen.

The main reasons for a recovery operation of a parastomal hernia are:

• ostomy pain and parastomal hernia
• obstruction of the intestines protruding into the parastomal hernia
• difficulty applying the stomas and making them adhere properly
• difficulty rinsing the stoma
• aesthetic nuisance because the parastomal hernia can become very large

Because discomfort of a parastomal hernia often occurs at a later stage, patients with parastomal herniae who are undergoing surgery often have a large hernia/volume.

Treatment

Read more about the different treatments: parastomal hernia repair.

Interesting link:

• Ostomy Ilco non-profit

Latest publication date: 15/12/2023