A bulge beside your stoma — making the bag leak, the skin sore, and clothing awkward. Parastomal hernias are among the most common long-term problems after stoma surgery, and among the most under-treated.
When a stoma (colostomy, ileostomy, or urostomy) is created, the bowel is brought out through a deliberate opening in the abdominal wall. That opening is a permanent point of weakness. Over months and years, abdominal contents can push through alongside the bowel, creating a bulge around the stoma — a parastomal hernia.
Small parastomal hernias may only cause a cosmetic bulge. Larger ones interfere with appliance fitting, cause leakage and skin damage, produce a dragging discomfort, and — less commonly — can obstruct or strangulate bowel, which is an emergency.
Repair is technically demanding because the surgeon must reinforce the wall while preserving a working stoma. This is precisely the kind of surgery that benefits from an abdominal-wall team rather than an occasional operator.
Most parastomal hernias develop slowly. These are the signs that it is time for an assessment.
More prominent on standing, coughing, or straining; often flattening when you lie down. The bulge tends to enlarge gradually over months.
The changing contour makes the flange lift; leakage, skin irritation, and frequent bag changes are the most common reasons patients finally seek help.
An ache around the stoma after prolonged standing, or intermittent cramping — cramping with a swollen, tender bulge needs urgent review.
Not every parastomal hernia needs an operation. Small, comfortable hernias with a well-fitting appliance can be managed with support garments and stoma-care input. Surgery is recommended when the hernia is symptomatic, enlarging, causing appliance failure — or has ever caused obstructive episodes.
The modern operation of choice for suitable patients is the laparoscopic Sugarbaker repair — a keyhole technique in which a composite mesh covers the defect while the bowel is lateralised along the abdominal wall. Open mesh repair and stoma re-siting remain the right choice in specific situations, including infected fields and very large defects.
At THI, every parastomal repair is planned from CT imaging with AI-assisted defect measurement, and discussed with your stoma-care nurse so appliance management is ready from day one after surgery.
Yes — in most cases the stoma is preserved exactly where it is, and the wall around it is reinforced with mesh. Stoma re-siting (moving the stoma to a new location) is reserved for specific situations and is discussed openly if it applies to you.
The meshes used for parastomal repair are composite meshes designed for safe contact with bowel, with a protective anti-adhesion layer. They have a long published track record. Mesh choice and placement plane are tailored to your anatomy and any previous infections.
Parastomal hernias have a higher recurrence risk than routine hernias, which is why technique and experience matter. Mesh-based repairs — particularly the Sugarbaker configuration — have substantially lower recurrence than suture-only repair. Your individual risk is discussed honestly before surgery.
A well-fitted support garment is a reasonable strategy for small, stable, comfortable hernias — and for patients unfit for surgery. It does not stop the hernia enlarging. If the bulge is growing or the appliance is failing, a surgical opinion is worthwhile.
Yes. We routinely repair parastomal hernias for patients whose original surgery was done at other hospitals. Bring your operative notes and any imaging; where helpful, we coordinate with your original team.
Most consultations result in a clear, written plan within 30 minutes. For outstation patients, we offer teleconsultation before any travel is required.