Treatment of a patient with bilateral inguinal and pubic hernias following pelvic trauma (case report)

The inguinal and pubic regions represent complex anatomical areas where the close proximity of abdominal organs predisposes to the development of surgical, urological, gynecological, and oncological diseases. Repeated interventions in these zones are technically demanding and carry a high risk of complications. Additional challenges arise in patients who have sustained pelvic trauma with subsequent fixation of pelvic bones using metallic implants, which alters anatomical landmarks and increases the likelihood of hernia formation. Objective. To present a long-term clinical observation of a patient with multiple recurrent inguinal hernias and the subsequent development of an irreducible pubic hernia following pelvic trauma and multiple surgical interventions. Case report. We describe a 15-year follow-up of a 56-year-old patient who sustained a pelvic injury requiring fixation of the pubic bone with a metallic plate. Over time, the patient developed bilateral inguinal hernias with multiple recurrences, infection of synthetic meshes, chronic fistulous tracts, and testicular atrophy. Repeated reconstructive operations included removal of infected mesh implants, bilateral orchiectomy, and complex reconstruction of the inguinal canals using autologous tissues. In 2020, the patient developed an irreducible pubic hernia containing small bowel and sigmoid colon. Reconstruction of the anterior abdominal wall was performed using a polypropylene mesh placed in a sublay position. The postoperative period was uneventful, and during 10 months of follow-up the patient had no recurrence or pain, with complete recovery of functional capacity. Conclusion. This clinical case illustrates the significant role of post-traumatic pelvic changes, mesh infection, and altered anatomical relationships in the development of recurrent inguinal and pubic hernias. Combining autologous tissue reconstruction with synthetic prostheses enables favorable functional outcomes even in complex recurrent cases.