Non Mesh Inguinal Hernia Post-op Instructions

Surgery

You have just undergone non mesh inguinal hernia repair, otherwise known as Shouldice repair. This involves making an incision in your lower abdomen in order to gain access to your hernia or hernias. The hernia is repaired by suturing the abdominal muscles together in four separate layers in order to close the defect causing the hernia. This is a non mesh inguinal hernia repair, typically done under local anesthesia with sedation.

Pain

Soreness, pain in the lower abdomen and groin after surgery is normal. Pain will be worse with movement, changing positions from laying to seated to standing. Male patients may notice new pain in the testicle after surgery. This is normal and will go away over time.

Most of our patients take only Tylenol and ibuprofen for pain management after surgery. If you have been advised in the past not to take one of these medications, please follow those instructions. Applying ice to the surgery site for 20 minutes at a time can also be helpful. You may be given a prescription for a muscle relaxant (Robaxin) to help with your postoperative pain.

We recommend taking the following (if allowed) every 6 hours for the first few days after surgery as needed:

  • 650mg to 1g of acetaminophen (Tylenol)
  • 400mg to 600mg of ibuprofen (Advil or Motrin)

    If you are experiencing significant pain that is preventing you from going on a walk or falling asleep, please call the office to discuss prescription pain medications. Opioid pain medications like oxycodone, will cause constipation, so we recommend following the instructions below for constipation.

  • Constipation

    Constipation is a common side effect of anesthesia and surgery, and even more common if you are also using opioid pain medication.

    If you have a history of constipation or require opioid pain medications:

  • Start your usual regimen: Begin taking your usual remedy (e.g., prune juice) immediately after surgery, if you haven’t already
  • Add Colace (aka stool softener)

    If you don’t have a usual regimen or develop constipation:

  • Start with Colace and Sennakot: Follow the dosage instructions on the bottle. This combination can take a couple days to work.

    If no improvement after 3 days:

  • Stop Colace and Sennakot.
  • Start taking Milk of Magnesia. Follow the dosage instructions on the bottle.

    If no improvement after 2 days:

  • Stop Milk of Magnesia.
  • Start taking Magnesium Citrate. Follow the dosage instructions on the bottle.

    Important:
    It’s safe to strain with bowel movements: Don’t worry about straining during bowel movements after surgery.

    You’re not alone: Many people experience constipation after hernia surgery – it may take time, but this too shall pass!

  • Incision

    The incision is closed with dissolvable sutures – these do not need to be removed.

    You will either have surgical glue or a plastic bandage over your wound.

  • If you have glue over the incision, this will fall off on its own 2-3 weeks after surgery. No dressing needs to be applied to this area.
  • If you have a clear plastic bandage over your wound, this should be removed in 48 hours. You do not need to replace this bandage. The steri-strips (tape bandage) underneath should be left on. These will fall off on their own in about 2 weeks or will be removed at your post-op appointment.

    Your incision will turn hard about 7-10 days after surgery. This is due to scar tissue, and is a normal part of healing. This hardness will eventually soften and smooth out.

    Bruising in the groin and genitals is normal after surgery. MALE patients may find that your scrotum or penis will become discolored, and you will have swelling in the region of your hernia and incision. FEMALE patients may find that your labia will become swollen and discolored. This discoloration and swelling will resolve with time.

    Many patients have used Arnica Montana, either as a gel or orally, to reduce swelling and bruising after surgery. Arnica is a safe, homeopathic medicine that works well in many patients. Most natural food stores will carry it.

  • Bathing

    You may shower at any time after surgery. There is either waterproof glue or a waterproof bandage over your incision. Once this bandage is removed (48 hours after surgery), you can continue to shower with the steri-strips over the incision. You do not need to put a new dressing over the top.

    Please avoid baths, hot tubs, pools, or soaking in water for 2 weeks after surgery, as this can increase your risk of an infection.

    Activity

    Following surgery, you are encouraged to do as much walking as is comfortable. You may climb stairs, taking them one at a time and slowly. We recommend walking at a leisurely pace for the first 3-4 weeks.

    Avoid exercise, strenuous activity, lifting over 25lbs, and repetitive actions for 3-4 weeks after surgery. After 3-4 weeks, you may slowly resume these activities, but do so slowly and progressively, and listen to your body if it is telling you to stop or slow down.

    You may drive 24 hours after surgery if you feel up to it, as long as you are not taking any prescription pain medications. We typically recommend you avoid driving for 48-72 hours unless necessary.

    Precautions

    Although not commonly seen, any incision is susceptible to infection. If you develop a fever of 101 degrees or above, have unexpected pain, redness or drainage from the incision, please contact our office.

    Your pain and swelling should gradually improve after the second or third postoperative day. If you have new, constant pain after feeling good for a couple of days, please contact our office. 

     

    Call the office if you have questions or concerns about your recovery:
    (617) 466-3373