Inguinal Hernia

Description

An inguinal hernia occurs when tissue, such as part of the intestine protrudes through a weak spot in the abdominal muscles. The resulting bulge can be painful, especially when you cough, bend over or lift a heavy object. However, many of the hernias do not cause pain.

An inguinal hernia isn't necessarily dangerous. Does not improve on its own, however, and can lead to life-threatening complications. Your doctor may recommend surgery to fix an inguinal hernia that's painful or enlarging. Inguinal hernia repair is a common surgical procedure.

Symptoms

Inguinal Hernia signs and symptoms include:

  • A bulge in the area on either side of your pubic bone, which becomes more apparent when it is in vertical position, especially if you cough or strain
  • A burning sensation or a sensation of pain in the bump
  • Pain or discomfort in your groin, especially when bending over, coughing or lifting
  • A heavy or dragging sensation in the groin
  • Weakness or pressure in the groin
  • Occasionally, the pain and swelling around the testicles when the protruding intestine descends into the scrotum

Signs and symptoms in children

Inguinal hernias in infants and children as a result of a weakness in the abdominal wall that is present at birth. Sometimes the hernia will be visible only when a baby is crying, coughing or straining during bowel movements. He or she may be irritable and have less appetite than usual.

In an older child, a hernia is likely to be more evident when the child coughs, strains during a bowel movement or standing for a long period.

Signs of problems

If you are not able to push the hernia, the contents of the hernia can be trapped (incarcerated) in the abdominal wall. Strangulated Hernia can become strangulated, which cuts off the blood flow to the tissue that is trapped. A strangulated hernia can be life-threatening if not treated.

The signs and symptoms of a strangulated hernia include:

  • Nausea, vomiting, or both
  • Fever
  • Sudden pain that quickly intensifies
  • A hernia bulge that turns red, purple or black
  • Inability to move the bowels or pass gas

When to see a doctor

Seek immediate medical attention if a hernia bulge turns red, purple or black, or if you experience other signs or symptoms of a strangulated hernia.

Consult your doctor if you have pain or noticeable bulge in the groin on either side of your pubic bone. The lump is likely to be more noticeable when you're standing, and usually can be felt if you place your hand directly on the affected area.

Causes

Some of inguinal hernias do not have an apparent cause. Others might occur as a result of:

  • The increased pressure within the abdomen
  • A pre-existing weak spot in the abdominal wall
  • Straining during defecation or urination
  • The vigorous activity
  • Pregnancy
  • Chronic coughing or sneezing

In many people, the weakness of the abdominal wall that leads to an inguinal hernia occurs before birth, when a weakness in the muscle of the abdominal wall does not close correctly. Other inguinal hernias develop later in life when muscles weaken or deteriorate due to age, strenuous physical activity or the cough that accompanies smoking.

Weaknesses can also occur in the abdominal wall later in life, especially after an injury, or abdominal surgery.

In men, the weak point usually occurs in the inguinal canal, where the spermatic cord enters the scrotum. In women, the inguinal canal takes a ligament that helps hold the uterus in its place, and sometimes hernias occur when the connective tissue of the uterus and adheres to the tissues surrounding the pubic bone.

Risk factors

The factors that contribute to the development of an inguinal hernia include:

  • The fact of being a man. Men are eight times more likely to develop an inguinal hernia than women.
  • Be greater. The muscles weaken with age.
  • Be white.
  • The history of the family. You have a close relative, like a father or a brother, that has the condition.
  • Chronic cough, such as smoking.
  • Chronic constipation. The causes of constipation, straining during bowel movements.
  • Pregnancy. Being pregnant can weaken the abdominal muscles and cause increased pressure on the inside of your abdomen.
  • Premature birth and low birth weight. Inguinal hernias are more common in babies who are born prematurely or with low birth weight.
  • Inguinal hernia or hernia repair. Even if your previous hernia occurred in childhood, you are at greater risk of developing another type of inguinal hernia.

Complications

The complications of an inguinal hernia include:

  • The pressure on the surrounding tissues. The majority of inguinal hernias enlarge over time if not repaired surgically. In men, large hernias can extend into the scrotum, causing pain and swelling.
  • Incarcerated hernia. If the contents of the hernia become trapped in the weak point in the abdominal wall, the content can obstruct the bowel, leading to severe pain, nausea, vomiting, and the inability to have a bowel movement or pass gas.
  • The strangulation. Strangulated Hernia can cut off the flow of blood to a part of your bowel. Strangulation can lead to the death of affected bowel tissue. A strangulated hernia is life-threatening and requires immediate surgery.

Prevention

You can't prevent the birth defect that makes them susceptible to an inguinal hernia. However, you can reduce the stress on the abdominal muscles and the tissues. For example:

  • Maintain a healthy weight. Talk with your doctor about the best exercise and diet plan for you.
  • Emphasize foods rich in fiber. Fruits, vegetables, and whole grains contain fiber, which can help prevent constipation and straining.
  • Lifting heavy objects with care or avoid lifting heavy objects. If you have to lift something heavy, always bend from your knees and not the waist.
  • Stop smoking. In addition to its role in many serious diseases, smoking often causes a chronic cough, which can cause or aggravate a groin hernia.

Inguinal Hernia

Diagnosis

A physical exam is usually all that is needed to diagnose an inguinal hernia. Your doctor will check for a bulge in the groin area. Because standing and coughing can make a hernia more prominent, it is likely to be asked to stand and cough or strain.

If the diagnosis is not clear, your doctor may order an imaging test, such as an abdominal ultrasound, computed tomography or magnetic resonance imaging.

Treatment

If the hernia is small and isn't bothering you, your doctor might recommend watchful waiting. Sometimes, using the support of a truss may help alleviate the symptoms, but check with your doctor first, because it is important, what the soul feels good, and it is being used appropriately. In children, the doctor may test the application of manual pressure to reduce the package before you consider surgery.

Enlarging or painful hernias usually require surgery to relieve discomfort and prevent serious complications.

There are two general types of hernia operations — open hernia repair and minimally-invasive hernia repair.

Open hernia repair

In this procedure, which can be performed with local anesthesia and sedation or general anesthesia, the surgeon makes an incision in the groin and pushes the protruding tissue back into the abdomen. The surgeon then sews the weakened area, often reinforced with a synthetic mesh (hernioplasty). The opening is then closed with stitches, staples, or surgical glue.

After the surgery, you'll be encouraged to move as soon as possible, but it can be several weeks before you are able to resume their normal activities.

Surgery minimally invasive hernia repair

In this procedure that requires general anesthesia, the surgeon operates through several small incisions in the abdomen. The surgeon may use either laparoscopic or robotic instruments to repair the hernia. The Gas is used to inflate the abdomen to perform the internal organs easier to see.

A small tube equipped with a small camera (laparoscope) is inserted into one incision. Guided by the camera, the surgeon inserts small instruments through other small incisions to repair the hernia with synthetic mesh.

People who have a minimally invasive procedure, the repair may have less discomfort and scarring after surgery and a faster return to normal activities. The long-term results of laparoscopic surgery and open surgery of hernia are comparable.

Minimally invasive surgery, hernia surgery that allows the surgeon to prevent scar tissue from a previous hernia repair, so it may be a good option for people whose hernias recur after the opening of the hernia surgery. It could also be a good option for people with hernias on both sides of the body (bilateral).

As with open surgery, it may be a couple of weeks before you can return to your usual level of activity.

Preparing for your appointment

It is likely to start by seeing your primary care provider. Here's some information to help you prepare for your appointment.

What you can do

Make a list of:

  • Your symptoms, including when they started and how they may have changed or worsened with time
  • Key personal information, including recent changes in the life and medical history of the family
  • All medications, vitamins or supplements that you are taking, including dose
  • Questions to ask your doctor

Have a friend or family member, if possible, to help you remember the information that is obtained.

For an inguinal hernia, some basic questions to ask your doctor include:

  • What is the most likely cause of my symptoms?
  • What tests do I need?
  • What treatments are available and what you recommend for me?
  • If I need surgery, what will my recovery be like?
  • I have other health conditions. How can I best manage these conditions?
  • What can I do to prevent another hernia?

Do not hesitate to ask other questions that you may have.

What to expect from your doctor

Your doctor may ask you several questions, such as:

  • When did your symptoms begin?
  • The symptoms stayed the same or worsened?
  • Do you have pain in the abdomen or in the groin? Is there anything that the pain that you feel worse or better?
  • What physical activity you must perform in your job? What other physical activities, generally, to participate?
  • Do you have a history of constipation?
  • You've had a history of inguinal hernia?
  • Do you or do you smoke? If so, how much?

What you can do in the meantime

Get emergency medical help if you have nausea, vomiting or fever, or if the hernia bulge turns red, purple or black.

Symptoms and treatment of Inguinal hernia