Hernias develop when an organ protrudes through a weakness in the muscle that should keep it in place. Inguinal hernias are the most common type of hernia. So, what do you need to know about inguinal hernias?
The inguinal canal is an area at the lower, anterior abdominal wall that contains the round ligament of the womb in women and the spermatic cord in men. We each have two, one on either side in the groin area. An inguinal hernia is usually a protrusion of intestine or fat from the abdominal cavity into the inguinal canal. If you have an inguinal hernia, you will generally notice a lump in your groin area which gets more visible when you cough. When you lie down, it tends to slide back into its rightful place, so the lump will go away. An inguinal hernia may cause no problems or there may be pain, especially on lifting heavy objects or coughing.
A direct inguinal hernia occurs more frequently in men than woman and is due to a weakness in the tissue of the abdominal wall. An indirect inguinal hernia is the most common cause of groin hernia and is due to a defect during development in the womb: it is the most common type of groin hernia in women but is still more common in men. Men are less likely to suffer complications from it, than women.
If you think you may have an inguinal hernia, a visit to your doctor is recommended. It is diagnosed simply and without any special medical test. He or she will examine you standing and lying down. A swelling which increases on coughing and decreases on lying down is sufficient for the diagnosis of a straight-forward inguinal hernia.
An inguinal hernia can get bigger over time. The intestine together with its contents may protrude more frequently into the inguinal canal and this runs the risk of the intestine obstructing. There is also risk of the blood supply to that area of intestine being cut off, which can cause damage to the tissue, in a process known as strangulation.
For men in particular, if a hernia is not symptomatic it is possible to take a ‘watchful wait’ approach. However, for all types of hernia, the only effective treatment is a hernia repair. Hernia cannot improve on their own. Surgery may be performed as a day case and involves relocating the herniated organ back to the abdominal cavity and then closing the weakened abdominal wall with sutures. The area may be strengthened with mesh. This type of surgery is very common and has few risks, on which your doctor will advise you.
Emergency surgery for strangulation or obstruction of an inguinal hernia carries a higher risk of complications than a planned surgery which happens before serious side-effects occur.
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