Suprapubic incisional hernia. Our experience of seven years

Abstract

Introduction: The repair of suprapubic incisional hernias represents a complexity due to its proximity to the bony flange of the pelvis and neurovascular structures such as epigastric arteries and iliac package, the difficulty of adequate adaptation and a good margin of prosthesis protection. Material and methods: Retrospective observational analysis of the HIS repaired in our hospital between January 1, 2012 to January 1, 2019. Abdominal CT was performed preoperatively in Valsalva to all patients. The variables related to the applied surgical treatment, postoperative complications and the overall recurrence rate were studied. Results: 25 patients with HIS were operated. Only 20 % of the incisional hernias were pure suprapubic (M5), the mean hernia transverse diameter being 7.7 cm. In 4 cases, preoperative administration of botulinum toxin and progressive pneumoperitoneum was necessary. All patients underwent a Stoppa repair. Postoperative morbidity was 28 %, mostly related to the surgical wound, although a patient died due to an intestinal fistula. The mean postoperative follow-up was 29 months, not finding hernia recurrence. Conclusions: In our experience, the repair of suprapubic incisional hernias is complex, with no negligible morbidity, but acceptable rates of hernia recurrence. Palabras clave: Hernia incisional, eventración, prótesis, hernioplastia, hernia suprapúbica.