Q: I am 60 years male. I underwent Pyelolithotomy twenty two years ago. The right side of my stomach remains slightly swollen. Whenever I get hurt there due to tightening of belt etc, I develop some infection, which in turn causes urinary tract infection (UTI) along with fever. It takes about a week to recover after taking heavy doses of antibiotics. A urologist diagnosed my condition as incisional hernia but did not suggest surgery. The frequency of these attacks have increased due to advancing age as sometimes even bending down also triggers UTI. How can I prevent this from happening?

A:The swelling is typical of a condition called incisional hernia. The abdominal wall is weak at the site of the surgical scar, and the contents within the abdomen push through, causing a bulge. Incisional hernias should be repaired surgically. Why do you get UTI from pressure on the bulge? This is more difficult to answer. You need to be properly evaluated: do you have some other cause of UTI, unrelated to the incisional hernia? I think it is possible (but very unlikely) that your kidney is so close to the skin at the hernia site that injury here results in UTI. My recommendations are:

1. Get fully evaluated by a good urologist for the cause of recurrent UTI
2. Get the incisional hernia repaired