We call inguinal hernia to the exit of some content of the abdominal cavity, through an orifice in the inguinal area. The content that comes out can be simply fat or intestinal loops.
This type of hernia is more common in men than in women.
Causes of inguinal hernia
There are two types of causes for these hernias:
- Congenital hernias: they are produced by a lack of closure in the inguinal duct that comes out of the abdominal cavity to the scrotum, a duct where the veins and arteries that go to the testicle are located. When there is no closure in this duct, the intestinal loops can also come out. This type may be evident at birth, but may also show symptoms at older ages.
- Acquired hernias: exertion, such as straining during bowel movements, persistent coughing, lifting heavy objects, etc … together with a deterioration of the fibroconnective tissues of the groin, cause the appearance of an inguinal hernia. In short, any activity that raises intra-abdominal pressure, in addition to the above examples are also: overweight or increased prostate size that conditions an effort for urination.
Symptoms of inguinal hernia
The most common symptom is the appearance of a bulge in the groin, which often does not cause pain, although sometimes there is discomfort or mild pain that increases with walking or performing some effort. Normally when the person is lying down this protuberance is not appreciated.
The complication of inguinal hernia is its strangulation, this occurs when, for various reasons, there is an outflow of more abdominal contents into the hernia and it can no longer return to its place. Then there is pain in the area, inflammatory signs in the inguinal bulge (red, hot, harder) and it is also accompanied by nausea, vomiting and abdominal discomfort. If this happens, urgent surgery is required.
How to detect an inguinal hernia
Diagnosis of the hernia is made by physical examination by the specialist, as well as in situations of doubt an ultrasound scan can be performed.
Surgery, definitive treatment for inguinal hernia
Surgery is the only definitive solution for inguinal hernia.
Currently, the surgeon specialist performs inguinal hernia repair by placing mesh or prosthesis, for two main reasons:
- On the one hand, if the deteriorated tissue is sutured, the likelihood of recurrence is much higher.
- On the other hand, mesh repair allows less tension of the suture lines and this leads to less postoperative pain, less recovery time and minimal recurrence rates.
There are different surgical techniques, both laparoscopic and open surgery. Of the latter, the most commonly used at present are the Lichtenstein technique (tension-free technique based on the placement of a mesh to repair the hernial orifice) and the Rutkow-Robbins technique, in which, in addition to the mesh, a cone or plug is introduced into the hernial orifice. Using these techniques, recurrence rates of less than 1% are obtained.