The low transverse Pfannenstiel incision and the prevalence of incisional hernia and nerve entrapment.
OBJECTIVE
The authors determined the prevalence of incisional hernia and nerve entrapment in patients with a low transverse Pfannenstiel incision.


BACKGROUND
The literature on the Pfannenstiel incision suggests an incisional hernia rate of 0.0% to 0.5%. However, in these series, physical examination, which is essential in the authors' view, was not performed. To the authors' knowledge, the prevalence of nerve entrapment after the Pfannenstiel incision is not known or has never been published.


METHODS
All adult women, operated on between 1986 and 1992 using a Pfannenstiel incision and not having had another lower abdominal incision other than for laparoscopy, were invited for follow-up at the outpatient department. All patients were interviewed and subjected to a physical examination, with special interest to the presence of incisional hernia or nerve entrapment.


RESULTS
In patients having had a Pfannenstiel incision, no incisional hernias were found. In patients also having had a laparoscopy, the incisional hernia rate was 3.5%. Nerve entrapment was found in 3.7%. The length of the incision was identified as a risk factor (p = 0.02).


CONCLUSIONS
Incisional hernia is a rare complication of the Pfannenstiel incision. Complications of nerve damage, however, are not uncommon and should be recognized. When possible, nerves should be identified and preserved, especially when extending the incision more laterally.
Luijendijk
R W
RW
Department of General Surgery, Leyenburg Hospital, The Hague, The Netherlands.
Jeekel
J
J
Storm
R K
RK
Schutte
P J
PJ
Hop
W C
WC
Drogendijk
A C
AC
Huikeshoven
F J
FJ
D000005:Abdomen / Q000294:innervation / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006555:Hernia, Ventral / Q000453:epidemiology* / Q000209:etiology; D006801:Humans; D008875:Middle Aged; D009408:Nerve Compression Syndromes / Q000453:epidemiology* / Q000209:etiology; D011183:Postoperative Complications / Q000453:epidemiology* / Q000209:etiology; D015995:Prevalence; D013514:Surgical Procedures, Operative / Q000009:adverse effects