Inguinal Hernias

Inguinal hernias (IH) seldom make the headlines. Yet they're one of the most common types of hernia, affecting millions of people around the world.
They occur when soft tissue, usually part of the intestine, protrudes through a weak point in the groin, where the abdomen meets the thigh. The resulting bulge can be painful, sometimes excruciatingly so, especially when you cough or lift a heavy object.
Some people develop or acquire the abdominal weakness that leads to a hernia in adulthood. But more often the weakness occurs at birth, when the abdominal lining (peritoneum) doesn't close properly. And although far more men than women have inguinal hernias, no one is immune, including infants, pregnant women and older adults.
Photo credit: Google
The two types of inguinal hernia have different causes.
Indirect inguinal hernia. Indirect inguinal hernias are congenital hernias and are much more common in males than females because of the way males develop in the womb. In a male fetus, the spermatic cord and both testicles starting from an intra-abdominal location descend through the inguinal canal into the scrotum, the sac that holds the testicles. Sometimes the entrance of the inguinal canal at the inguinal ring does not close as it should just after birth, leaving a weakness in the abdominal wall. Fat or part of the small intestine slides through the weakness into the inguinal canal, causing a hernia. In females, an indirect inguinal hernia is caused by the female organs or the small intestine sliding into the groin through a weakness in the abdominal wall.
Photo credit: Google
Direct inguinal hernia. Direct inguinal hernias are caused by connective tissue degeneration of the abdominal muscles, which causes weakening of the muscles during the adult years. Direct inguinal hernias occur only in males. The hernia involves fat or the small intestine sliding through the weak muscles into the groin. A direct hernia develops gradually because of continuous stress on the muscles.
The two main types of surgery for hernias are as follows:
  • “Open” hernia repair. In open hernia repair, also called herniorrhaphy, a person is given local anesthesia in the abdomen or spine to numb the area, general anesthesia to sedate or help the person sleep, or a combination of the two. Then the surgeon makes an incision in the groin, moves the hernia back into the abdomen, and reinforces the muscle wall with stitches. Usually the area of muscle weakness is reinforced with a synthetic mesh or screen to provide additional support an operation called hernioplasty.
  • Laparoscopy. Laparoscopic surgery is performed using general anesthesia. The surgeon makes several small incisions in the lower abdomen and inserts a laparoscope a thin tube with a tiny video camera attached to one end. The camera sends a magnified image from inside the body to a monitor, giving the surgeon a close-up view of the hernia and surrounding tissue. While viewing the monitor, the surgeon uses instruments to carefully repair the hernia using synthetic mesh.
People with inguinal hernia need to consult a physician in order to know what type of surgery is needed to treat such disease.


digestive.niddk.nih.gov

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