Abdominal hernia is considered to be any opening that is located in the abdominal wall caused by its rupture. It is a very common disease that develops in people, and can occur in the umbilical or inguinal regions – the subject of this article.
Given this, the importance of talking about it is great. Come on.
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What is Inguinal Hernia?
Located in the groin region, the inguinal hernia corresponds to 75% of all existing abdominal hernias and about 3% of the population develops it.
This hernia occurs when there is a rupture in the abdominal muscle and, through it, contents of the cavity, normally part of the intestine, pass through the inguinal canal – passage inside the anterior abdominal wall in which the spermatic cord (men) or the round ligament of the uterus (women).
The disease is much more common in men than in women and can occur on one or both sides of the groin – the so-called bilateral inguinal hernia.
Female inguinal hernia: what is it?
In general, the picture in men and women is quite similar in terms of the mechanism of occurrence. However, the difference consists of anatomy.
While in men it passes the spermatic cord, coming from the testicle, through the inguinal canal, in women it passes the ligament of the uterus. Thus, female inguinal hernia can occur on the axis between the uterus and the pubic bone.
What are the causes of Inguinal Hernia?
Normally, the muscles that make up the abdominal wall are strong enough and prevent a rupture from happening in it. However, this musculature, in some people, is weaker, thus causing the hernia.
Among the causes of this weakness of the abdominal wall are:
- Congenital birth defect, in which there is a weakness in the abdominal region;
- Conditions acquired throughout life, such as increased pressure within the abdomen caused by chronic cough, constipation or prostate disease.
Risk factors
In addition to these causes, some factors also contribute to the appearance of inguinal hernia in an individual, such as:
- Age: as much as the disease may appear at any time in a person’s life, it is more recurrent at the extremes of it, that is, in newborns (due to congenital defects) and in the elderly (due to weakening of the muscle).
- Man: inguinal hernia occurs about 10 times more in men than in women.
- Associated diseases: some diseases generally increase the pressure inside the abdomen and facilitate the occurrence of the hernia, such as intestinal constipation, diseases of the prostate, lung, heart or liver, chronic cough due to smoking, etc.
What are the types of the disease
There are two types of inguinal hernias: direct and indirect.
Direct inguinal hernia
This type of inguinal hernia is more common in adult men. It forms directly – as the name suggests – at a point on the abdominal wall that is broken and allows part of the intestine to penetrate the scrotum. About 2% of men face direct inguinal hernia throughout their lives.
Indirect inguinal hernia
Indirect inguinal hernia occurs because of a problem at the entrance to the inguinal canal that causes it to remain open. This type of disease occurs mainly in children, males, newborns or in early childhood.
The condition is formed by the passage of the bowel loop into the sac that surrounds the testis through a very fragile point in the human body: the hernial ring. About 1 to 2% of newborns are affected by this type of hernia.
Bilateral inguinal hernia
In bilateral inguinal hernia, the patient has a double rupture of the abdominal muscle, that is, on both sides. This causes two hernias to appear.
What are the symptoms of Inguinal Hernia?
The main symptom of inguinal hernia is, in addition to the pain – which can be strong or weak – is its protrusion in the groin area, which becomes more visible when the patient coughs due to force, or weight lifting.
As time goes on, the hernia tends to increase in size, and may even descend into the scrotum.
It is important to remember that many cases can be asymptomatic. But, when there are symptoms, they can also occur:
Groin pain and burning
Pain and burning in the groin area are very common symptoms in patients. Generally, they intensify when there is effort or movement of the body.
Discomfort when coughing or bending
Especially when the patient bends down or coughs, there is a concentrated effort in the groin area. This can make the pain and discomfort more intense.
Pain in the testicles
Pain and swelling in the testicles – Occasionally, when the hernia descends into the scrotum.
General malaise
In some cases, the pain is so intense that it can cause symptoms such as headaches, nausea, vomiting, dizziness and irritation.
Symptoms in children
As some children may already be born with a rupture in the abdominal wall due to a congenital problem, it is necessary to be attentive to the signals that they emit.
To find out if your child has an inguinal hernia, pay attention when he cries, coughs or moves the bowel region, as it is with these movements that the hernia can be visible. Also, check to see if your child is more irritable than usual or has less appetite than before.
How the diagnosis is made
If you are suspicious that you have an inguinal hernia, because you are in pain and / or swelling in the groin area, ideally, you should go to a general surgeon as soon as possible.
This specialist is the best person to give you an exact diagnosis, in addition to referring you to the appropriate treatment – which, in this case, only involves a surgical procedure.
At the doctor’s office, the doctor usually diagnoses the hernia only with clinical analysis, review of symptoms and checking your medical history. About 70% of inguinal hernias can be identified by simple palpation.
The examiner may also ask you, during the exam, for you to cough or blow with your mouth closed, as this makes the injury easier to see and feel.
In a few cases, when the lesion cannot be accurately identified using this method, the doctor may indicate that you do tests such as ultrasound and herniography only for confirmation to be carried out.
Groin hernia treatment
It may not be necessary for the patient to undergo surgery, as many cases of hernia are stabilized.
If there are no symptoms or discomfort, medical observation and monitoring can be maintained, assessing whether the condition remains stabilized. In that case, no other procedure or treatment is needed.
Surgical Treatment for Inguinal Hernia
As mentioned, the best and most viable treatment for inguinal hernia is surgery, as the problem is mechanical and that alone will bring a solution to it. Among the surgical options, there are two: open and laparoscopic.
Open surgery
About 95% of inguinal hernia surgeries are done in an open manner. For this type of surgery, it is necessary that the patient is under the effect of local anesthesia, that is, that blocks the entire spine of the person.
After that, an incision is made in the groin so that the surgeon can push the herniated tissue back to the place of origin and reinforce it with some stitches.
In addition to this procedure, the surgery also relies on the use of a small piece of synthetic mesh, made of plastic material, so that the ruptured abdominal wall is reinforced and prevents the hernia from returning.
If bilateral hernia occurs, it will be necessary to make two incisions, one on each side of the body.
Laparoscopic surgery
As with surgeries performed to treat cholelithiasis and cholecystitis , laparoscopic surgery can also be used to treat inguinal hernia.
This type of surgery consists of applying general anesthesia to the patient and, under the effect of it, three incisions, measuring 0.5 to 1 cm, are made in the abdominal wall.
After that, the abdomen is swollen with carbon dioxide so that the surgeon can do the procedure in the best possible way.
About the procedure, it takes place through the insertion of a laparoscopic (type of tube with a micro video camera) through one of the incisions.
The image that is reproduced there will be transmitted on a monitor, making it possible for the surgeon to see exactly where the lesion is, pull the herniated intestine back into the abdomen and close the hole with surgical clips and a synthetic mesh.
Postoperative guidelines
A patient who needs to undergo an inguinal hernia operation is usually admitted to the hospital between 12 and 24 hours. Recovery from surgery takes place quickly and most daily activities can be returned in a short time.
For this recovery to take place in a healthy way, some guidelines need to be followed:
- There is no special diet for postoperative inguinal hernia. You may experience nausea and vomiting in the two days after the surgery, but this is due to the effect of the medications and anesthetics received at the hospital. If these symptoms occur with you, the ideal is to drink only fluids and in small amounts at a time.
- The surgical cut will be protected with micropore and you must take care of the stitches hygienically, cleaning and replacing it in the correct way.
- Take a deep breath 3 times every hour. This helps to expand the lung better and thus prevent complications from appearing, such as pneumonia.
- Do not lie or sit too much. Ideally, you should walk several times a day.
- In the first postoperative month, you will be able to lift up to 10 kg. Between the second and third, the weight increases to up to 20 kg. After that period, there are no more restrictions.
Postoperative complications
Surgical treatment of inguinal hernia is very efficient and the lesion returns in only 3 to 10% of cases. However, even then, some complications can happen in some patients. Check out which ones are below:
- Infection;
- Hematoma;
- Hernia return;
- Anesthetic risk.
Are there any complications?
When the disease is not properly treated – and the sooner the better – the inguinal hernia can develop some complications.
- Pressure on nearby tissues: most hernias increase in size as time goes by. In men, very large hernias can extend into the scrotum, causing pain and swelling.
- Incarcerated hernia: If the contents of the hernia get stuck right in the weak spot of the abdominal wall, symptoms such as severe pain, nausea, vomiting and an inability to have an optimal bowel movement may occur.
- Strangled hernia: In some cases, incarcerated hernia can cut off the flow of blood from the intestine, thus causing strangulation of the intestine. This fact can lead the patient to the death of the affected intestinal tissue, as well as the patient.
Ways to prevent
Anyone is at risk of developing an inguinal hernia, but some measures can be taken to prevent it:
- Have an ideal body weight for your size;
- Exercise regularly in order to strengthen the abdominal muscles;
- Avoid using too much force when defecating or urinating;
- Avoid lifting very heavy objects;
- Stop smoking if I do;
- Consume fiber-rich foods.
With that in mind and the right information about the disease, it is much easier for you to recognize it and seek the necessary medical help. Share this article with friends and help us spread this information about inguinal hernia to as many people as possible!
