An incisional hernia develops through the deeper layers of a previous surgical wound. A recurrent hernia is one that returns after an earlier hernia repair. These conditions often involve scar tissue, altered anatomy or previously placed mesh and can range from a small localised defect to a complex abdominal wall problem. Specialist assessment helps define what has happened and whether another operation is appropriate.
Why do incisional hernias develop?
Healing may be weakened by wound infection, a blood or fluid collection, smoking, diabetes, obesity, poor nutrition or long-term steroid use. Repeated pressure from coughing, constipation or heavy strain may also contribute. However, an incisional hernia can occur even when the original recovery appeared straightforward.
Why can a hernia recur?
Recurrence may reflect the size and biology of the original defect, tissue quality, infection, ongoing abdominal pressure or factors related to the first repair. It does not automatically mean that the earlier surgery was performed incorrectly. Understanding the original technique and mesh position is important when planning further treatment.
Symptoms and diagnosis
Symptoms include a bulge through a scar, aching, pulling, pressure or reduced core confidence. The lump may increase when standing or coughing. Your surgeon will review previous operation notes where available and examine the abdominal wall. CT imaging is frequently helpful because it shows defect size, muscle position, scar tissue and previous mesh. Ultrasound may suit selected smaller defects.
Treatment and abdominal wall reconstruction
A minimally symptomatic hernia may sometimes be monitored. Surgery can involve closing the defect, reconstructing the abdominal muscles and reinforcing the repair with mesh. The operation may be open, keyhole or robotic where appropriate. Previous mesh is not automatically removed; revision or removal is considered only when required for the new repair or a specific mesh-related problem.
Risks and urgent symptoms
Complex or repeat surgery can carry increased risks of bleeding, infection, seroma, delayed wound healing, bowel injury, chronic pain, mesh complications and another recurrence. Seek emergency care for severe pain, vomiting, increasing abdominal swelling or a firm irreducible lump.
Frequently asked questions
Can an incisional hernia appear years after surgery? Yes. The weakness may become noticeable long after the original incision has healed.
Does a recurrent hernia always need another operation? No. Treatment depends on symptoms, progression and the balance of risks and benefits.
Will previous mesh need to be removed? Not usually. Removal is considered only when clinically necessary.