Parastomal hernias develop around stomas created from intestinal loops or urinary outlets after surgery for bladder cancer. Sometimes they are accompanied by additional postoperative hernias in the scars from previous surgeries.

Any created stoma is an unnatural opening in the anterior abdominal wall. Over time, this opening tends to stretch, leading to the formation of a hernia. It is now understood that every permanent (lifetime) stoma should be prophylactically reinforced with an implant, although this is relatively recent knowledge. Advances in medicine and healthcare quality mean that patients with oncological stomas are living longer, providing more time for hernia symptoms to develop at the stoma site. Consequently, the number of surgeries performed due to parastomal hernias is increasing.

These surgeries are as complex as abdominal hernia repairs (see the abdominal hernia section), but also include stoma reconstruction to maintain its function and shape.

Parastomal hernias significantly reduce a patient’s quality of life. Common symptoms include intestinal obstruction, leading to abdominal bloating, cramping pain, nausea, and vomiting. In severe cases, the intestines inside the hernia sac can twist (volvulus), causing tissue death and peritonitis. Such cases require emergency surgery, with a poorer prognosis than elective procedures.

An enlarging hernia also changes the shape of the abdomen, causing difficulties in stoma care. Stoma bags may not adhere properly to the skin and tend to peel off during physical activity. Repairing the hernia greatly improves stoma management comfort and the patient’s confidence in everyday life.

The European Hernia Society classifies parastomal hernias into four categories. In some cases, laparoscopic or hybrid techniques can be used; however, these approaches are not interchangeable with open surgery. The choice of method is always based on the patient’s general condition and the morphology of the defect. This is a highly individualized process dependent on many factors.