What is an Inguinal Hernia?
An inguinal hernia happens when tissue that is soft – most of the time part of the intestines – bulges thru a tear or a place that is weak in the lower wall of abdomen. The bulge that results may be painful – particularly when the individual coughs, lifts an object that is heavy or when bending over.
Although this is not essentially dangerous alone, this type of hernia does not get better or go away by itself. An inguinal hernia may cause complications that can be life-threatening. It is because of this, that the individual’s primary care physician is probably going to advise repair of the hernia surgically, especially if painful or becomes too large. Inguinal hernia repair is a fairly common procedure surgically.
Inguinal Hernia Symptoms
Some of these types of hernias do not create any symptoms and an individual might not know they have one until the physician catches it during a routine exam. But more than likely, the individual is able to see and feel the bulge that is created by the intestine protruding. This bulge is normally more noticeable when the individual stands upright, particularly if they strain or cough.
Symptoms and signs of an inguinal hernia include:
- Budge in the area on either side of the pubic bone
- Burning, aching or gurgling sensation at the bulge
- Discomfort of pain in the groin, particularly when coughing, lifting or bending over
- Dragging or heavy sensation in the groin
- Pressure or weakness in the groin
Inguinal hernias in children or newborns are caused from a fault in the wall of the abdomen that is present at birth. At times this hernia may be seen only when the infant is coughing, crying or straining during a bowel movement. In a child who is older, a hernia is most likely to be apparent when the child strains during a bowel movement, coughs or stands for any lengthy time period.
Your primary care physician needs to be seen if there is a noticeable or painful bulge in the area on either side of the pubic bone. This bulge is most likely to be more noticeable when standing upright and can normally be felt when a hand is put directly over the area affected.
The hernia should be able to be gently and easily pushed back into the abdomen when the individual is lying down. If not, the swelling can be reduced enough by applying an ice pack to the area so that the hernia can slide in easily. Lying with the pelvis higher than the head can also help.
If it is still not possible to push the hernia in, this herniated intestine may have become confined in the wall of the abdomen – a condition that is serious and that might require immediate medical attention. This condition can also be accompanied by vomiting, nausea, rapid heart rate, fever, sudden pain which intensifies quickly, and a hernia bulge that turns dark, red or purple. If any of these symptoms or signs occurs call the family physician right away.
Inguinal Hernia Causes
Often these hernias have no cause that is apparent. But many happen as a result of:
- Extra pressure within the abdomen
- Pre-existing weaknesses in the abdominal wall
- Combination of pressure increase in the abdomen and a pre-existent weakness in the abdominal wall
- Heavy lifting
- Straining with bowel movements or urination
- Pregnancy
- Fluid in abdomen
- Chronic sneezing or coughing
- Excessive weight
In many individuals, the wall of the abdomen weakness that causes these hernias happens at birth when the peritoneum or abdominal lining does not close correctly. Other hernias developed late in life when deterioration or weakened muscles due to aging, strenuous physical action or coughing that usually come with smoking puts the last bit of pressure on the abdomen causing the hernia.
With males, the spot that is weak normally happens along the inguinal canal. In this area the spermatic cord that encloses the vas deferens – tube carrying sperm – goes in the scrotum.
With women, the inguinal canal has a ligament that keeps in place the uterus and hernias often occur where the connective tissue from the uterus fastens to tissue which surrounds the pubic bone.
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Men are most probable to have along the inguinal canal a weakness due to the way males grow in the womb. With males, testicles develop in the abdominal region and move thru the inguinal canal in the scrotum. Usually quickly after birth, this canal closes virtually completely, leaving only room enough for spermatic cord to go through, but it is not big enough to permit the testicles to transport back in the abdomen.
But, often the canal does not properly close, leaving an area of weakness. There is little chance that this inguinal canal will not close after delivery in baby girls. But females are more apt to have hernias develop in the femoral canal which is a hole near the inguinal canal that allows the femoral vein, artery and nerve to go thru.
Weaknesses may also develop in the wall of the abdomen late in life, particularly after any injury or some surgeries in the cavity of the abdomen.
But whether or not an individual has a weakness that is pre-existing, extreme pressure in the abdomen from heavy lifting, straining, excess weight or pregnancy can cause a hernia.
Inguinal Hernia Treatment
When hernias are small and not bothering the individual physicians usually take a “watch and wait” approach. But hernias that are painful or enlarging will normally need surgical repair to relieve discomfort as well as to prevent any serious complications.
Inguinal Hernia Surgery
There are generally two (2) types of operations for hernias:
Herniorrhaphy
This is a procedure that is also referred to as “open” repair, and the surgeon makes one incision in the groin and then pushes the intestine that is protruding back into the abdomen. Then the surgeon will repair the torn or weak muscle by suturing this area together. Often the area that is weak is also strengthened as well as reinforced with a synthetic mesh which is a procedure known as hernioplasty.
Laparoscopy
With laparoscopic surgery, the surgeon uses many very small incisions instead of only one. Then a fiber-optic tube containing a miniature camera is introduced into the abdomen thru one incision and surgical instruments that are also small are inserted thru the remaining incisions. The surgeon then does the surgery using the camera as the guide by following on a monitor. With surgery that is laparoscopic, synthetic mesh is always the technique used to patch-up the hernia – hernioplasty.
The pros of laparoscopic surgery include:
- Less discomfort
- Fast return to normal activities
- Less scarring
This technique is a great choice for individuals whose hernias recur following the traditional surgery for hernias due to the fact that laparoscopic approach allows the surgeon to work around any scar tissues from earlier surgery. It is also recommended for individuals who have a hernia on each side of the body – “bilateral inguinal hernias”.
But laparoscopic repair does have disadvantages such as:
- Increased risk of complications
- Increased recurrence following surgery
Inguinal Hernia Pictures
