Inguinal Hernia
Also known as: Groin Hernia
What is it?
A hernia is the protrusion of an organ through the
wall that normally contains it. An inguinal hernia
occurs in the groin area, when an organ, usually a part
of the intestine, protrudes through the abdominal wall
into the inguinal canal. The inguinal canal carries the
spermatic cord in men and a round ligament that is
attached to the uterus in women.
Who gets it?
Inguinal hernias are more likely to occur in males
than females. People who are obese, have lost a great
deal of weight, or have had abdominal surgery are at
higher risk for hernias. The risk also increases with
age. People with a family history of inguinal hernias
are more likely to also have them. Inguinal hernias can
occur in children and adults.
What causes it?
Inguinal hernias are caused by a weakness in the
abdominal wall. In some people, this weakness is
congenital, which means it is present at birth. In
others, it develops over time, as a result of excessive
weight gain or loss, physical activity that places
pressure on the abdomen, pregnancy, straining during
bowel movements because of constipation, straining
during urination because of an enlarged prostate, or
chronic and intense coughing. Because the abdominal
wall is weak, the hernia occurs during abdominal
strain.
What are the symptoms?
An inguinal hernia causes a bulge in the groin area,
which can extend to the scrotum in men. This type of
hernia is often painless, but may be tender and can
cause discomfort during any type of physical strain,
such as lifting or coughing. Men may feel a heaviness
around the scrotum. The bulge may disappear when the
patient is lying down, and be more visible when
standing up. A hernia can often be pushed gently back
into place. This is called a reducible hernia. When a
hernia cannot be pushed back into place, it means a
piece of the intestine has become trapped, or
incarcerated, in the inguinal canal. Symptoms include
pain, nausea, vomiting, inability to have a bowel
movement, and a bulge that remains even when lying
down. When a portion of the intestine is incarcerated,
its blood supply can be cut off, which means the
intestinal tissue will die. This condition is called a
strangulated hernia. Inguinal hernias usually increase
in size with time and can occur on both sides of the
body (bilateral inguinal hernia).
How is it diagnosed?
To diagnose an inguinal hernia, a doctor must
perform a physical examination. Your doctor will look
for a bulge in the groin area and may ask you to cough
as he puts light pressure on the area. Coughing causes
the hernia to bulge out further.
What is the treatment?
Patients with inguinal hernias can wear a special
type of belt, called a truss, to support the hernia and
keep it from bulging out. They should also avoid any
activities that cause abdominal strain. However, most
patients elect surgery to repair inguinal hernias and
avoid the possibility of a strangulated hernia. The
procedure to repair a hernia involves pushing the piece
of intestine back into place and repairing the
abdominal wall so the intestine cannot push through
again. Hernia surgery, called herniorrhaphy, used to
involve a large incision and a long recovery period.
However, many hernia repairs can now be performed
through laparoscopic surgery. The surgeon uses a
special viewing instrument called a laparoscope,
inserted through a small incision in the abdomen. The
laparoscope is like a tiny video camera that gives the
surgeon a clear view of the abdominal area. Other small
incisions are made to insert the surgical instruments
used to push the intestine into place and repair the
abdominal wall. The surgeon may use a procedure called
hernioplasty to reinforce the entire inguinal area with
synthetic material, like a tire patch. Laparoscopic
hernia surgery can be performed on an outpatient basis.
Incarcerated and strangulated hernias require emergency
surgery and hospitalization. Laparoscopic surgery may
not be recommended for very large hernias.
Self-care tips
Although there is no way to prevent hernias due to a
congenital weakness or family history, you can help
reduce your risk for an inguinal hernia. Follow a
healthy diet that is high in fiber and drink plenty of
fluids to prevent constipation, maintain a healthy
weight through diet and exercise, and avoid cigarette
smoking, which can cause chronic coughs. If your job
requires heavy lifting, learn the proper way to lift
and wear a support garment.
This information has been designed as a comprehensive and quick reference
guide written by our health care reviewers. The health information written
by our authors is intended to be a supplement to the care provided by your
physician. It is not intended nor implied to be a substitute for
professional medical advice.
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