Measuring symptoms in parastomal hernia: a prospective evaluation using MYMOP2

BACKGROUND: Parastomal hernia (PSH) is a common complication following stoma formation, associated with pain, and impaired quality of life (QoL). Despite this, no validated disease-specific patient-reported outcome measure (PROM) exists for PSH. Non-operative interventions on symptom burden have not been well quantified. The Measure Yourself Medical Outcome Profile (MYMOP2), a patient-generated tool, may capture PSH-specific symptoms and their change over time. OBJECTIVE: To evaluate changes in patient-reported symptom burden, using MYMOP2, following surgical or conservative management in a dedicated specialist PSH clinic. METHODS: A single-centre prospective cohort study included consecutive patients attending a monthly multidisciplinary PSH-only clinic between May 2022 and October 2025. From February 2023, all new patients completed MYMOP2 at baseline and at follow-up (≥ 2 months post-intervention). Demographic and clinical data were obtained from clinical records. The primary outcome was change in MYMOP2 Profile score. Secondary outcomes were changes in domain-specific scores (Symptom 1, Symptom 2, Overall Symptom Score, Activity and Wellbeing) and comparisons between conservative and surgical management. RESULTS: Of 137 patients, 36 completed baseline and follow-up MYMOP2 data (14 conservative, 22 surgical). Baseline MYMOP2 Profile scores were similar (median 16 for both groups). Surgical repair produced significant improvements in MYMOP2 Profile (16 to 5.5, p < 0.0001), Overall Symptom (8.5 to 2, p < 0.0001), Wellbeing (4 to 1.5, p = 0.0015) and Activity scores (4.5 to 2, p < 0.001). Conservative management also resulted in improvements in Profile (16 to 7, p < 0.001), Overall Symptom Score (8 to 3, p = 0.002) and Activity (5 to 1.5, p = 0.005). CONCLUSION: A dedicated multidisciplinary PSH clinic achieves meaningful reductions in patient-reported symptom burden following conservative and surgical management. Although surgery yields greater improvement, non-operative interventions also provide benefit. MYMOP2 is a pragmatic outcome measure for PSH and merits further validation in larger cohorts.