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.