Risk Factors for Pfannenstiel Incisional Hernia Following Cesarean Delivery and Outcomes after Laparoscopic and Open Surgical Repair

Background: To analyse risk factors for cesarean section (CS)-induced incisional hernia in reproductive-aged women. Outcomes of minimal invasive herniorrhaphy and open technique were presented. Methods: Records of patients with Pfannenstiel hernia between 2010 and 2022 were reviewed. Risk factors fo...

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Main Authors: Nevin Sakoglu, Aysun Firat
Format: Article
Language:English
Published: IMR Press 2024-03-01
Series:Clinical and Experimental Obstetrics & Gynecology
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Online Access:https://www.imrpress.com/journal/CEOG/51/3/10.31083/j.ceog5103062
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author Nevin Sakoglu
Aysun Firat
author_facet Nevin Sakoglu
Aysun Firat
author_sort Nevin Sakoglu
collection DOAJ
description Background: To analyse risk factors for cesarean section (CS)-induced incisional hernia in reproductive-aged women. Outcomes of minimal invasive herniorrhaphy and open technique were presented. Methods: Records of patients with Pfannenstiel hernia between 2010 and 2022 were reviewed. Risk factors for incisional hernia were evaluated with surgical outcomes. Results: 76 patients were included. Mean age was 46 ± 8.1 years. Bulging (81.5%), pain or discomfort (57.8%) and distention (31.5%) were the most common symptoms. We combined ultrasonography (90.7%) with contrasted tomography (71%) or magnetic resonance imaging (30%) for surgical planning. Risk factors were found as multiple previous CSs, local wound complications such as seroma, hematoma or abscess, body mass index >25, smoking, pregnancy-induced diabetes mellitus, emergency CS, and inadequate surgical technique (each, p < 0.05). In open technique (51.3%), fascia was closed by polydioxanone suture, with onlay mesh fixation. In laparoscopic hernioplasty (48.6%), tacker was used for mesh reinforcement. There was no bowel injury. Early complications were seroma and infection (p < 0.01 and p < 0.05, respectively). Most significant late complication was recurrence (7.8%). Conclusions: Clinicians should be ready to encounter more reproductive aged women with incisional hernia, since worldwide CS rate continues to rise. Awareness of risk factors, imaging methods, surgical options and outcomes are of great importance.
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spelling doaj-art-071db29f8ecb46a791a36cd8c15ce67a2025-08-20T03:55:24ZengIMR PressClinical and Experimental Obstetrics & Gynecology0390-66632024-03-015136210.31083/j.ceog5103062S0390-6663(24)02315-7Risk Factors for Pfannenstiel Incisional Hernia Following Cesarean Delivery and Outcomes after Laparoscopic and Open Surgical RepairNevin Sakoglu0Aysun Firat1Department of General Surgery, University of Medipol, Medical Faculty, 34718 İstanbul, TurkeyDepartment of Obstetrics and Gynecology, University of Health Sciences, Istanbul Education and Research Hospital, 34098 İstanbul, TurkeyBackground: To analyse risk factors for cesarean section (CS)-induced incisional hernia in reproductive-aged women. Outcomes of minimal invasive herniorrhaphy and open technique were presented. Methods: Records of patients with Pfannenstiel hernia between 2010 and 2022 were reviewed. Risk factors for incisional hernia were evaluated with surgical outcomes. Results: 76 patients were included. Mean age was 46 ± 8.1 years. Bulging (81.5%), pain or discomfort (57.8%) and distention (31.5%) were the most common symptoms. We combined ultrasonography (90.7%) with contrasted tomography (71%) or magnetic resonance imaging (30%) for surgical planning. Risk factors were found as multiple previous CSs, local wound complications such as seroma, hematoma or abscess, body mass index >25, smoking, pregnancy-induced diabetes mellitus, emergency CS, and inadequate surgical technique (each, p < 0.05). In open technique (51.3%), fascia was closed by polydioxanone suture, with onlay mesh fixation. In laparoscopic hernioplasty (48.6%), tacker was used for mesh reinforcement. There was no bowel injury. Early complications were seroma and infection (p < 0.01 and p < 0.05, respectively). Most significant late complication was recurrence (7.8%). Conclusions: Clinicians should be ready to encounter more reproductive aged women with incisional hernia, since worldwide CS rate continues to rise. Awareness of risk factors, imaging methods, surgical options and outcomes are of great importance.https://www.imrpress.com/journal/CEOG/51/3/10.31083/j.ceog5103062cesarean sectionpfannenstiel incisionincisional herniarisk factorslaparoscopyherniorrhaphysurgical outcomes
spellingShingle Nevin Sakoglu
Aysun Firat
Risk Factors for Pfannenstiel Incisional Hernia Following Cesarean Delivery and Outcomes after Laparoscopic and Open Surgical Repair
Clinical and Experimental Obstetrics & Gynecology
cesarean section
pfannenstiel incision
incisional hernia
risk factors
laparoscopy
herniorrhaphy
surgical outcomes
title Risk Factors for Pfannenstiel Incisional Hernia Following Cesarean Delivery and Outcomes after Laparoscopic and Open Surgical Repair
title_full Risk Factors for Pfannenstiel Incisional Hernia Following Cesarean Delivery and Outcomes after Laparoscopic and Open Surgical Repair
title_fullStr Risk Factors for Pfannenstiel Incisional Hernia Following Cesarean Delivery and Outcomes after Laparoscopic and Open Surgical Repair
title_full_unstemmed Risk Factors for Pfannenstiel Incisional Hernia Following Cesarean Delivery and Outcomes after Laparoscopic and Open Surgical Repair
title_short Risk Factors for Pfannenstiel Incisional Hernia Following Cesarean Delivery and Outcomes after Laparoscopic and Open Surgical Repair
title_sort risk factors for pfannenstiel incisional hernia following cesarean delivery and outcomes after laparoscopic and open surgical repair
topic cesarean section
pfannenstiel incision
incisional hernia
risk factors
laparoscopy
herniorrhaphy
surgical outcomes
url https://www.imrpress.com/journal/CEOG/51/3/10.31083/j.ceog5103062
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