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Incisional and parastomal hernias are frequent complications after abdominal surgery. Patients with relevant symptoms should be referred to the local surgical department for diagnosis and indication for surgery. Patients with giant and parastomal hernias are referred to one of the five Danish regional hernia centres. Patients with parastomal hernias often benefit from being referred to a stoma nurse. The most frequent complications after hernia repair are wound complications and recurrence. In case of severe wound infection, incarceration, or strangulation the patient must always be referred acutely, as argued in this review.

Patients with cirrhosis undergoing emergency umbilical hernia repair have increased risk of fatal complications. Of all patients with cirrhosis and umbilical hernia, 43% undergo emergency hernia repair, and thus the feasibility of elective procedures in this patient group was examined. This review found that medical and wound-related complications were the most frequent after umbilical hernia repair in patients with cirrhosis. Accordingly, additional evidence is needed to evaluate methods allowing for elective umbilical hernia repair in patients with cirrhosis.

In male patients with asymptomatic or minimally symptomatic ventral and inguinal hernias, a watchful waiting strategy should be considered. Even though one third to two thirds of these patients will eventually undergo hernia repair, they may still benefit from a watchful waiting strategy, as hernia repair is associated with a range of complications, e.g. wound infection, haematoma, seroma, fistulas and chronic pain. Delay of hernia repair in these patients is not associated with any significant increase in morbidity or mortality, and the risk of incarceration is very low.

It is still unknown whether or not inguinal hernia repair with or without the use of mesh causes infertility in male patients. The objective of this article was to discuss the available literature, to ascertain if the preclinical and clinical findings point towards a causal relationship. The review showed that the question remains difficult to answer due to a limited number of patients included and the discordant conclusions drawn in past studies. The largest recent cohort study came to the conclusion that there was no clinically significant risk of infertility associated with inguinal hernia repair. However, further studies are needed.

Long-term complications after laparoscopic ventral hernia repair with mesh reinforcement are not well documented in the literature. We describe a case of a 63-year-old woman with repeated hernia operations due to a ventral hernia, which ultimately was complicated with mesh migration into the transverse colon.

Persistent pain following groin hernia repair (PPGH) is seen in 2-4% of patients leading to functional and socioeconomic disability. A Danish research unit for PPHG was established in 2010 in collaboration with anaesthetists and surgeons. More than 140 patients have been examined with clinical and electrophysiological methods. Published data on 54 patients, treated with mesh removal and selective neurectomy, demonstrated that 65% patients experienced long-term reduction of pain. The PPHG unit is actively engaged in surgical and pharmacological research in order to improve treatment strategies.