An inguinal hernia refers to a condition which occurs when contents of the abdomen, such as fat or part of the small intestine, protrudes through a weak spot in the abdominal muscles.
Inguinal hernias include two types:
- Indirect inguinal hernia, which happens due to a defect in the abdominal
wall that is congenital or present at birth.
- Direct inguinal hernia, which usually occurs only in male adults because
of a weakness in the muscles of the abdominal wall.
Although inguinal hernia may be not dangerous, it doesn’t improve on its own and may cause life-threatening complications.
In some cases, inguinal hernia doesn’t have
an apparent cause. But others may result from:
- increased pressure within the abdomen
- a pre-existing weak spot in the abdominal wall
- straining during bowel movements or urination
- strenuous activity
- chronic coughing or sneezing
The following factors may increase your risk
of having inguinal hernia:
- being male
- being older
- being white
- family history
- chronic cough
- chronic constipation
- premature birth and low birth weight
- previous inguinal hernia or hernia repair
The most noticeable sign of inguinal hernias
is a small bulge on one or both sides of the groin. This bulge may increase in
size over time and when you stand up or cough. It can also disappear when lying
down. Besides, people with inguinal hernia may experience:
- pain when coughing, exercising, or bending over
- burning sensations
- sharp pain
- a heavy or full sensation in the groin
- swelling of the scrotum in men
Some people develop inguinal hernias because of the abdominal wall weakness which is present at birth, while others deteriorate their muscles through aging, strenuous physical activities and getting inguinal hernias.
An inguinal hernia may lead to the complications
- pressure on surrounding tissues
- incarcerated hernia
If part of the fat or small intestine from
inside the abdomen becomes stuck in the groin or scrotum and cannot go back
into the abdomen, an incarcerated hernia will form.
If you have an incarcerated hernia, your blood supply to the small intestine may become obstructed, leading to strangulation. This emergency situation may cause the section of the intestine to die.
Possible long-term complications may
- long-lasting pain in the groin
- recurrence of the hernia, requiring a second surgery
- damage to nerves near the hernia
Commonly, a physical exam is all that’s
needed to help make a diagnosis of an inguinal hernia. During the physical exam,
your doctor will check for a bulge in your groin area. In order to complete the
diagnosis more easily, your doctor may ask you to stand and cough or strain so
that a hernia will be more prominent.
Imaging tests may be needed if your doctor:
- is trying to diagnose a strangulation or an incarceration
- is not able to feel the inguinal hernia during a physical exam
- is uncertain whether the hernia or another condition is causing the
swelling in the groin or other symptoms
Imaging tests may be used include:
- abdominal x-ray
- computerized tomography (CT) scan
- abdominal ultrasound
The only treatment for an inguinal hernia is
to repair it through surgery. If your hernia is very small and doesn’t affect
your daily life, you can have watchful waiting. You should visit a doctor
regularly and pay much attention to the symptoms. Once symptoms increase, a
surgery is necessary. Surgery for hernias has two types:
- open hernia repair
This operation usually requires a local anesthesia
in the abdomen with sedation. However, some people may need general anesthesia.
During the surgery, the surgeon will make an incision in your groin and pushes
the protruding tissue back into your abdomen. After that, the weakened area
will be sewed. The surgeon often reinforces it with a synthetic mesh. Finally,
the opening will be closed with stitches, staples or surgical glue.
Laparoscopy is performed on the patient under general anesthesia. The surgeon will have a close-up view of the hernia and surrounding tissue by inserting a laparoscope which is a thin tube with a tiny video camera attached. When watching the monitor, the surgeon uses synthetic mesh or “screen” to repair the hernia.
Despite a shorter recovery time after laparoscopy,
it’s not a proper option for those who have large hernias or have had previous
Surgery for an inguinal hernia is very safe
and almost causes no complications. But you should visit your doctor
immediately if you have symptoms such as:
- redness around or drainage from the incision
- bleeding from the incision
- pain that is not relieved by medication or pain that suddenly
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