Recurrence of a hernia is common - at least 15 per cent of people return for another operation. A few other problems might be confused with a hernia, so do ask your doctor for advice.

Further operations

Unfortunately, each subsequent operation becomes more difficult, and the likelihood of success decreases. This is because the tissues in the area become scarred and it's harder for the surgeon to work out what should be sewn to where. An operation to repair a recurrent hernia has a one in five chance of failing, and by about the third operation there's no more than a 50:50 chance of success.

Risk factors for recurrence

There are several reasons why a hernia may return:

• Wound infection following the original operation - this means the tissues may not heal properly and remain weak.
• Inadequate repair the first time around.
• Post-operative strain on the wound - if you put too much strain on the muscles and other tissues in the area soon after it's been mended, you may undo the surgeon's hard work and cause a weakness to develop in the muscles. Always follow instructions closely after a hernia operation.
• Chronic strain on the abdominal muscles - this could be caused by problems such as putting on a lot of weight.

Surgical techniques

Some surgeons claim the standard way of mending a hernia isn't the best and that a different method produces better results. This may be either keyhole surgery (operating through a tiny hole in the abdominal wall) or making a new incision above the old scar and operating to repair the hernia from inside, behind the weakness in the tissues.

A 'mesh' of artificial fabric is patched over the internal opening of the hernia to block the hole, rather than trying to pull the tissues tighter together. It may be worth asking your surgeon about this technique.

Although many simple hernia operations are performed under local anaesthetic, you'll probably need to be unconscious under general anaesthetic for repair of a recurrent hernia. Exactly how the operation is done will depend on how long you've left the hernia untreated, how many times it has already been repaired, how large it is and so on.

Most people are back at work fairly soon after a hernia repair, but as yours has recurred you may be advised to rest for several weeks.

This article was last medically reviewed by Dr Trisha Macnair in March 2008