Parastomal Hernia Surgery | PAX Medicus Medical Tourism

Parastomal Hernia

A parastomal hernia is a pathological protrusion of abdominal contents, primarily the small intestine- though other organs may also be involved- through the opening in the abdominal wall where a stoma has been created. This type of postoperative hernia is a complication following stoma formation and affects approximately 50% of patients who have undergone the procedure.

Parastomal hernias typically develop within the first two years after stoma formation but can appear even several years or decades after surgery. There are two types:

  • True parastomal hernia – a stoma opening that is too wide allows the intestines to shift into the stoma channel.
  • Pseudo-parastomal hernia – excessive loosening of the tissues around the stoma causes the intestines to shift into the opening.
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What Is a Parastomal Hernia?

A parastomal hernia occurs when abdominal organs protrude through the abdominal wall opening created for a stoma. It is a common postoperative complication and may affect up to half of all patients with a stoma.

Parastomal hernias most often develop within two years of surgery but may occur many years later. They can be classified as either true or pseudo-parastomal hernias, depending on whether the stoma opening itself widens or whether surrounding tissues loosen.

What Are the Causes of a Parastomal Hernia?

The widening of a stoma opening is primarily influenced by shearing forces that weaken the abdominal wall and increase intra-abdominal pressure- for example, during sneezing, coughing, vomiting, walking, or lifting heavy objects.

Factors that increase the risk include:

  • Advanced age
  • Obesity or excess weight
  • Smoking
  • Steroid therapy
  • Chronic constipation
  • COPD (chronic obstructive pulmonary disease)
  • Diabetes
  • Waist circumference over 100 cm
  • Malnutrition
  • Advanced recurrent disease
  • Postoperative wound complications or infections after stoma formation
  • Incorrect stoma placement
  • Large intestine stoma (higher risk than small intestine stoma)
  • Emergency surgery due to peritonitis or bowel obstruction
  • Presence of other hernias caused by congenital fascial weakness
What Are the Causes of a Parastomal Hernia?
What Are the Causes of a Parastomal Hernia? PAX Medicus Medical Tourism Agency
What Are the Causes of a Parastomal Hernia?

What Are the Symptoms of a Parastomal Hernia?

The most characteristic symptom is a soft bulge around the stoma. This bulge typically:

  • Enlarges over time
  • Reduces when lying down
  • Becomes more visible when standing or during activities that increase abdominal pressure

Other symptoms may include:

  • Difficulties fitting stoma appliances
  • Bowel movement disturbances
  • Adhesions forming inside the hernia sac

Emergency symptoms requiring urgent surgery:

  • Incarceration or bowel obstruction
  • Severe pain around the stoma
  • Fever and vomiting
  • Inability to pass gas or stool

How Is a Parastomal Hernia Treated?

Early preventative measures include wearing a hernia support belt and reinforcing the stoma opening using polypropylene mesh.

Surgical intervention becomes necessary when:

  • The hernia becomes incarcerated or strangulated
  • There is significant hernia growth

Stoma relocation or narrowing the opening with sutures is rarely performed today due to high recurrence rates.

Because parastomal hernia repair is complex, surgery is increasingly performed using minimally invasive methods such as laparoscopy or robotic surgery from within the abdominal cavity.

Advantages of minimally invasive repair include:

  • Ability to detect previously hidden hernias not visible during open surgery
  • Lower recurrence rates compared with traditional techniques
  • Reduced risk of infection and postoperative complications
  • Less postoperative pain
  • Less postoperative pain
    Faster overall recovery

A European multi-centre study involving 61 patients undergoing laparoscopic Sugarbaker repair showed that:

  • 41% had an additional incisional hernia detected during the procedure
  • The recurrence rate after laparoscopic repair was only 6.6% after two years

What Is the Cost of Parastomal Hernia Surgery?

The cost of private parastomal hernia repair depends on factors such as:

  • The chosen surgical method (open, laparoscopic, or robotic)
  • The size and complexity of the hernia
  • The type of mesh used for abdominal wall reinforcement

Details of the procedure, available surgical options, and overall costs are discussed during a preoperative consultation with the lead surgeon.

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Disclaimer
*The Pax Medicus website provides information for guidance only and does not constitute medical advice, diagnosis, or treatment. Pax Medicus does not provide healthcare services and is not a substitute for consultation with a qualified medical professional. Always seek advice from your physician regarding any medical condition. Prices shown are indicative only and subject to confirmation by the healthcare provider. This is the official website of Pax Medicus; we do not operate through agents or third-party sites.

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