ANKMJ
Ankyra Medical Journal

Ankyra Medical Journal (AnkMJ), formerly known as the Journal of Translational and Practical Medicine, regularly publishes international quality issues in the field of Medicine in the light of current information.

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Original Article
A gynecological perspective on incisional hernia in patients after hysterectomy for benign vs. malignant indications
Abstract
Aims: The aim of this study is to compare demographic and perioperative data of patients who developed incisional hernia after hysterectomy at Kocaeli University Medical Faculty and to evaluate potential factors contributing to hernia formation.
Methods: Retrospective data were analyzed for patients who underwent hysterectomy for benign or malignant reasons and later developed incisional hernia at the same hospital. A total of 63 patients, including 27 with malignancy and 36 with benign conditions, were included. Demographic data such as age, body-mass index (BMI), smoking, incision, surgical site infection (SSI), drain, and duration were assessed.
Results: The mean age of the patients was 56.44±9.49 years. No statistically significant differences were found between the two groups regarding age, BMI, comorbidities, smoking, SSI, and drain duration. However, there was a significant difference in the incision, with the Pfannenstiel incision being preferred for benign hysterectomy (p<0.0001). Drain use was significantly more common in malignant cases (p=0.002).
Conclusion: Incisional hernia is one of the most common types of ventral hernia. Incisional hernias are most frequently observed in women, especially following gynecological and obstetric surgeries. In our study, benign cases showed a higher incidence of incisional hernia. Obesity is a significant risk factor for hernia. The average BMI in the study was 31.18±5.22, with no significant difference between the groups. The lower midline incision was identified as the most risky incision for hernia development, though most of our patients had a Pfannenstiel incision. Despite treatment, incisional hernia developed in many patients with SSI. SSI was presence in only 28.6% of those who developed hernia in both groups. Smoking causes tissue hypoxia, and the smoking rate among our patients was 39.7%. Modifiable risk factors can be managed or controlled to prevent hernia development

Keywords : Benign, malignant, hysterectomy, incisional hernia, body mass index, drain

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1. Jadhav GS, Adhikari GR, Purohit RS. A prospective observational study of ventral hernia. Cureus. 2022;14(8):e28240. doi:10.7759/cureus.28240
2. Nachiappan S, Markar S, Karthikesalingam A, Ziprin P, Faiz O. Prophylactic mesh placement in high-risk patients undergoing elective laparotomy: a systematic review. World J Surg. 2013;37(8):1861-1871. doi: 10.1007/s00268-013-2046-1
3. Le Huu Nho R, Mege D, Oua&iuml;ssi M, Sielezneff I, Sastre B. Incidence and prevention of ventral incisional hernia. J Visc Surg. 2012;149(5 Suppl): e3-e14. doi:10.1016/j.jviscsurg.2012.05.004
4. Itatsu K, Yokoyama Y, Sugawara G, et al. Incidence of and risk factors for incisional hernia after abdominal surgery. Br J Surg. 2014;101(11):1439-1447. doi:10.1002/bjs.9600
5. Bosanquet DC, Ansell J, Abdelrahman T, et al. Systematic review and meta-regression of factors affecting midline incisional hernia rates: analysis of 14,618 patients. PLoS One. 2015;10(9):e0138745. doi:10.1371/journal.pone.0138745
6. Holihan JL, Alawadi Z, Martindale RG, et al. Adverse events after ventral hernia repair: the vicious cycle of complications. J Am Coll Surg. 2015;221(2):478-485. doi:10.1016/j.jamcollsurg.2015.04.026
7. Berger RL, Li LT, Hicks SC, Davila JA, Kao LS, Liang MK. Development and validation of a risk-stratification score for surgical site occurrence and surgical site infection after open ventral hernia repair. J Am Coll Surg. 2013;217(6):974-982. doi:10.1016/j.jamcollsurg.2013.08.003
8. Liang MK, Goodenough CJ, Martindale RG, Roth JS, Kao LS. External validation of the ventral hernia risk score for prediction of surgical site infections. Surg Infect (Larchmt). 2015;16(1):36-40. doi:10.1089/sur.2014. 115
9. Erkent M, Şahiner İT, Kendirci M, Top&ccedil;u R. İnsizyonel herni gelişiminde risk fakt&ouml;rlerinin saptanması. Hitit Med J. 2019;1(1):15-17.
10. Jensen JA, Goodson WH, Hopf HW, Hunt TK. Cigarette smoking decreases tissue oxygen. Arch Surg. 1991;126(9):1131-1134. doi:10.1001/archsurg.1991.01410330093013
11. van Ramshorst GH, Nieuwenhuizen J, Hop WC, et al. Abdominal wound dehiscence in adults: development and validation of a risk model. World J Surg. 2010;34(1):20-27. doi:10.1007/s00268-009-0277-y
12. Bickenbach KA, Karanicolas PJ, Ammori JB, et al. Up and down or side to side? A systematic review and meta-analysis examining the impact of incision on outcomes after abdominal surgery. Am J Surg. 2013;206(3): 400-409. doi:10.1016/j.amjsurg.2012.11.008
13. Seiler CM, Deckert A, Diener MK, et al. Midline versus transverse incision in major abdominal surgery: a randomized, double-blind equivalence trial (POVATI: ISRCTN60734227). Ann Surg. 2009;249(6): 913-920. doi:10.1097/SLA.0b013e3181a77c92
Article available in :
Volume 4, Issue 2, 2025
Page : 19-21
https://doi.org/10.51271/ANKMJ-0040
Article Information
Received : 06 Mar 2025
Accepted : 16 Mar 2025
Published : 25 Mar 2025
Corresponding Author :

Hayal Uzelli Şimşek: Department of Obstetrics and Gynecology, Faculty of Medicine, Kocaeli University, Kocaeli, Tukiye

[email protected]
Citation : Uzelli Şimşek H. A gynecological perspective on incisional hernia in patients after hysterectomy for benign vs. malignant indications. Ank Med J. 2025;4(2):19-21.

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