Erectile dysfunction after your hernia surgery

So you’re going in for a hernia operation, and you’re afraid it’ll ruin your performance in bed.  

We can’t promise you that nothing will go wrong, but we can tell you it’s not likely. Hernia repairs aren’t supposed to involve any of your sexual equipment and the possible complications that could indirectly affect your lovemaking tend not to last. Hernias and hernia repairs vary a lot, and so do the guys who have them, so actual data is hard to crunch about this. However, a very thorough study in Europe broke down the risk for common hernia repair recently, and you’ll be glad to know it’s pretty good news: overall, there’s only about a 5% chance of anything going wrong in your surgery, and ‘going wrong’ doesn’t usually mean anything very lasting. The truth is, hernias are not considered extremely serious these days, and there’s no real reason you shouldn’t recover after your repair and be the same guy you always were. In fact you might even perform better than you’re doing now in the bedroom, if your hernia’s been bad enough to get in the way.

To explain more, let’s talk through what a hernia is (there’s more than one kind), what the options are for fixing them (these get better all the time), and where trouble brews, if it brews (and what happens next).

Here’s what a hernia is...

The word refers to any kind of rupture, where something pushes through something else, perhaps through a tear or a weak spot. Herniation, wherever it is, typically looks like a bulge that shouldn’t be there. It’s a kind of injury, sometimes a complication of an earlier injury. There are lots of places where this can happen. One’s along your upper stomach and diaphragm. That’s called a hiatal hernia. You can get an umbilical one at your belly button. Incisional ones push through old scars. General abdominal ones are the ventral kind. Femoral hernias are in your outer groin, and inguinal ones are in your inner groin.

The inguinal kind is probably the one you’re worried about if you’re reading this article. It’s the one that makes a lump in your groin or enlarges your scrotum, so it’s the one that seems dangerously close to your sexual equipment. It’s also the kind of groin hernia that men usually get - about 97% of the time. They’re really common. Worldwide, there are about 20 million inguinal hernia repairs done every year.

Here’s how repair works...

Not everybody gets these fixed, sometimes hernias don’t cause any problems and not every surgeon bothers with them.  

To fix them, it used to be that surgeons would open a flap and suture up the torn tissue, like any other injury. They still do it this way for babies, smaller hernias, hernias that are complicated, or if there’s infection. Your author had this done once, and it was no big deal.

These days, however, most hernias are repaired with a surgical mesh, because that kind of repair is less likely to fail. It can be a permanent synthetic mesh, designed to stay forever, or, more usually, an animal-derived mesh, that absorbs and disappears by the time your body’s healed up and strong enough to hold together by itself.

They don’t have to open a flap to do this nowadays, either. Some surgeons prefer laparoscopic ‘keyhole’ surgery instead. You can talk to your surgeon about which is better for you. Suture and mesh are both possible with flap or keyhole.  

Inguinal repair is actually so slick and so routine now, that it’s often done under local anesthesia, in an outpatient setting. You’re home watching football the same day.

If there’s any trouble...

When complications happen (and remember, some hernias are more complex than others), they’re usually lingering pain, infection, repair failure, tissue that sticks together, intestinal blockage, bleeding, fluid build-up, or accidental perforations in surrounding structures. But these things are not common. Only a few percent of people ever need to go back to their doctor, and their numbers are dwindling, mostly because better meshes are on the market now. The problem used to be that meshes shrank, or patients’ bodies rejected them as foreign matter.

But notice what’s not on the list of complications. Normal inguinal surgery has nothing to do with the parts of your anatomy that you use in sex.

There can be outright accidents, where there’s injury of the spermatic cord or its components, or very occasionally nerve damage, that can reduce genital sensitivity, and that doesn’t typically reverse itself. So it’s not absolutely impossible that you’d have trouble getting and sustaining erections after an inguinal hernia repair. But you’d have to be really unlucky for that to happen.  

The happy ending...  

In other words, complications that affect your love life are not what you should associate with routine inguinal hernia surgery. Normally there won’t be any complications, and, if there are, they’re probably reversible. Here’s the way one important study on the subject summarises your risk:

Guys do better in bed after their surgery than they were doing before, because the hernia itself had been causing problems. If they didn’t feel like sex right after, it’s because (reasonably enough) they were sore. Mesh repair itself had no effect at all on sexual performance, and in this study there were no complications. This study, the authors point out, is exactly in line with other studies. Even in men who have had repeat operations, and who have been examined for possible effects on serious things, like testicular arterial flow, it’s all been good.

The numan take

It’s not absolutely impossible that something can go wrong and interfere with your love life. But it isn’t likely. Hernia repair, by its nature, just isn’t supposed to have any negative effects on your sexual activity. Rest up, like you would after any surgery, or any injury for that matter, and you should be up and about again pretty soon.