A hernia is a very common problem where part of an integral organ bulges through a weak muscle in the abdomen. There are different types of hernias, one of them is inguinal hernia. An inguinal hernia causes when the intestines from the abdomen protrude through the lower abdominal wall into the groin or inguinal area.
In the case of males, they occur within the inguinal canal and extend into the scrotum. The inguinal canal travels through the abdominal wall and it is a passageway from the abdomen to the genitals. People have two inguinal canals, one on each side of the abdomen.
Types of Inguinal Hernia
There are two types of inguinal hernia:
- Direct inguinal hernia: This type of hernia develops over time due to straining and weakness of the abdominal muscles. It is very common in adult males. Previous surgery may also be one of the causes of direct hernia.
This is not so common in females because the inguinal canal is smaller in females and the round ligament around uterus within the canal acts as the additional barrier alongside the muscle.
- Indirect inguinal hernia: It is caused by a defect in the abdominal wall that will have been present since birth. It is often discovered in the first year of life but remains undetected until adulthood.
While the fetus is still in the womb, there is an internal opening in the inguinal canal. It closes before birth. But if it fails to close completely, a small portion of the intestine slips and causes indirect hernia. This may occur both in males and females but are more common in males.
How do I know I have an inguinal hernia?
The doctor examines you physically, often asking you to cough or strain as hernia comes out in such situations.
The doctor may ask you to get tests like X-rays, ultrasound or CT scan if needed.
- Abdominal X-ray where x-ray machine is placed over the abdominal area and rays are used to take the picture.
- CT scan where the patient drinks a solution or dye is injected in the veins which helps to see the blood flow on the x-ray.
- Ultrasound where painless sound waves are induced to build up an image.
Is surgery important to cure inguinal hernia? What to expect?
If you are diagnosed with inguinal hernia, then hernia surgery does not have to be immediate but it must be monitored closely by the doctor to see if the symptoms get worse. If the hernia tissues get trapped then the surgery will be more urgent. There are two types of surgery:
Open surgery: Under general anesthesia, a cut is made in the groin area and the fat is moved back in the abdomen.
Laparoscopic surgery: Usually done under general anesthesia. Small incisions are made and a laparoscope is used to conduct the surgery. It has a camera on one end which is inserted and using images as a guide, the hernia is repaired.
Why laparoscopic surgery is preferred for inguinal hernia repair?
Laparoscopic surgery is preferred over open surgery as the chances of recurrence are negligible. Following are the advantages of laparoscopic surgery:
- It is less and the patient is able to resume work quickly than in open surgery.
- Because the incisions are very small, laparoscopy seems to be more appealing for cosmetic reasons.
- If the patient needs surgery for both the hernias, laparoscopic surgery allows the surgeon to repair both hernias without making more incisions.
- Repair of recurrent hernia is easier using laparoscope than open surgery.
Remember, only after a thorough examination, your surgeon can determine whether laparoscopic surgery is right for you. The procedure may not be best for those who have problem with general anesthesia, who have had previous abdominal surgery or underlying medical condition.
What is the problem with open inguinal hernia repair?
Adults and children who have a hernia repair through open surgery are at risk for:
- Primary concern is the reaction to anesthesia
- Infection and bleeding at the site because the incision is large.
- Nerve damage, loss of blood supply to the scrotum resulting in testicular atrophy. (rare)
- Damage to the cord that carries sperm from testicles to the penis which results in an inability to father a child.
Can inguinal hernia be life-threatening?
A serious complication can arise if the inguinal hernia is left untreated. It can cause incarceration or strangulation which is serious and rare.
Incarceration occurs when part of the intestine from inside the abdomen gets stuck in the groin area. And cannot go back in the abdomen.
A strangulated hernia occurs when the above situation is not treated. The blood supply to the intestine can be cut causing strangulation of the intestine. This is a very critical situation which needs immediate medical attention.
People are shy and embarrassed to discuss their problem related to hernia, because of the hernia location. But it is important to know that there is only one way to fix it, that is surgery. The sooner you fix it, the sooner you will get relief from the pain and discomfort. Call the doctor in the following cases:
- Bulge of the hernia doesn’t go back inside with the gentle pressure or when you lie down.
- You have continuously increasing pain in the groin area or genital region.
- The bulge changes its color to red or dark
- You know you have a hernia and develop nausea, fever, chills or unable to have a bowel movement.