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What is inguinal hernia?
An inguinal hernia occurs when tissue, such as part of the intestine, protrudes through a weak spot in the abdominal muscles. The resulting bulge can be painful, especially when you cough, bend over or lift a heavy object. An inguinal hernia isn't necessarily dangerous. It doesn't improve on its own, however, and can lead to life-threatening complications. Your doctor is likely to recommend surgery to fix an inguinal hernia that's painful or enlarging. Inguinal hernia repair is a common surgical procedure.
Some inguinal hernias have no apparent cause. Others might occur as a result of:
Increased pressure within the abdomen
A pre-existing weak spot in the abdominal wall
Straining during bowel movements or urination
Chronic coughing or sneezing
Factors that contribute to developing an inguinal hernia include:
Being male. Men are eight times more likely to develop an inguinal hernia than are women.
Being older. Muscles weaken as you age.
Family history. You have a close relative, such as a parent or sibling, who has the condition.
Chronic cough, such as from smoking.
Chronic constipation. Constipation causes straining during bowel movements.
Pregnancy. Being pregnant can weaken the abdominal muscles and cause increased pressure inside your abdomen.
Premature birth and low birth weight.
Previous inguinal hernia or hernia repair. Even if your previous hernia occurred in childhood, you're at higher risk of developing another inguinal hernia.
Inguinal hernia signs and symptoms include:
A bulge in the area on either side of your pubic bone, which becomes more obvious when you're upright, especially if you cough or strain
A burning or aching sensation at the bulge
Pain or discomfort in your groin, especially when bending over, coughing or lifting
A heavy or dragging sensation in your groin
Weakness or pressure in your groin
Occasionally, pain and swelling around the testicles when the protruding intestine descends into the scrotum
Signs and symptoms in children
Inguinal hernias in newborns and children result from a weakness in the abdominal wall that's present at birth. Sometimes the hernia will be visible only when an infant is crying, coughing or straining during a bowel movement. He or she might be irritable and have less appetite than usual. In an older child, a hernia is likely to be more apparent when the child coughs strains during a bowel movement or stands for a long period.
Signs of trouble
If you aren't able to push the hernia in, the contents of the hernia may be trapped (incarcerated) in the abdominal wall. An incarcerated hernia can become strangulated, which cuts off the blood flow to the tissue that's trapped. A strangulated hernia can be life-threatening if it isn't treated.
Signs and symptoms of a strangulated hernia include:
Nausea, vomiting or both
Sudden pain that quickly intensifies
A hernia bulge that turns red, purple or dark
Inability to move your bowels or pass gas
A physical exam is usually all that's needed to diagnose an inguinal hernia. Your doctor will check for a bulge in the groin area. Because standing and coughing can make a hernia more prominent, you'll likely be asked to stand and cough or strain. If the diagnosis isn't readily apparent, your doctor might order an imaging test, such as an abdominal ultrasound, CT scan or MRI.
If your hernia is small and isn't bothering you, your doctor might recommend watchful waiting. Sometimes, wearing a supportive truss may help relieve symptoms, but check with your doctor first because it's important that the truss fits properly. In children, the doctor might try applying manual pressure to reduce the bulge before considering surgery. Enlarging or painful hernias usually require surgery to relieve discomfort and prevent serious complications.
In this minimally invasive procedure, which requires general anesthesia, the surgeon operates through several small incisions in your abdomen. Gas is used to inflate your abdomen to make the internal organs easier to see. A small tube equipped with a tiny camera (laparoscope) is inserted into one incision. Guided by the camera, the surgeon inserts tiny instruments through other incisions to repair the hernia using synthetic mesh.
People who have laparoscopic repair might have less discomfort and scarring after surgery and a quicker return to normal activities. However, hernia recurrence may be more likely with laparoscopic repair than with open surgery. Having a surgeon who is very experienced in the laparoscopic procedure may reduce this risk. Laparoscopy allows the surgeon to avoid scar tissue from an earlier hernia repair, so it might be a good choice for people whose hernias recur after open hernia surgery. It also might be a good choice for people with hernias on both sides of the body (bilateral). As with open surgery, it may be a few weeks before you can get back to your usual activity level.
You can't prevent the congenital defect that makes you susceptible to an inguinal hernia. You can, however, reduce strain on your abdominal muscles and tissues. For example:
Maintain a healthy weight. Talk to your doctor about the best exercise and diet plan for you.
Emphasize high-fiber foods. Fruits, vegetables and whole grains contain fiber that can help prevent constipation and straining.
Lift heavy objects carefully or avoid heavy lifting. If you must lift something heavy, always bend from your knees — not your waist.
Stop smoking. Besides its role in many serious diseases, smoking often causes a chronic cough that can lead to or aggravate an inguinal hernia.
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An inguinal hernia usually occurs when fatty tissue or a part of your bowel, such as the intestine, pokes through into your groin at the top of your inner thigh. It pushes through a weak spot in the surrounding muscle wall (the abdominal wall) into an area called the inguinal canal.
Incarceration or strangulation of inguinal hernias is rare, but serious complications can develop if a hernia is left untreated. Incarcerated hernia: Incarceration occurs when part of the fat or intestine from inside the abdomen gets stuck in the groin or scrotum and cannot go back into the abdomen.
A bulge in the area on either side of your pubic bone, which becomes more obvious when you're upright, especially if you cough or strain. A burning or aching sensation at the bulge. Pain or discomfort in your groin, especially when bending over, coughing or lifting.
In most cases, the area will be sore as you heal. But some people develop chronic, long-lasting pain after surgery for a groin hernia, for example. Experts think the procedure may damage certain nerves. Laparoscopic surgery may cause less pain than an open procedure.
A hernia repair returns the organ or structure to its proper place and fixes the weakened area of muscle or tissue. A hernia repair is a common but major surgery with significant risks and potential complications. You may have less invasive treatment options available.
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