Complications of inguinal hernia and their prevention
An inguinal hernia is a more male disease that occurs at any age and can be congenital. Pathology also occurs in women, but much less frequently, due to anatomical features. In men, there is a physiological weakness of the inguinal canal, and the expanded vaginal process, which is formed during the descent of the testicles from the abdominal cavity during embryogenesis, also acts as a risk factor.
Complications of an inguinal hernia are the main factor in the need for surgery. Without removal of the defect, there is a risk of infringement of organs and their death, and this can already cause infertility and other pathologies from the genitourinary system and gastrointestinal tract.
To understand why an inguinal hernia is dangerous and why it should be treated, one should understand the mechanism of its development and the consequences for internal organs. Hematoma, damage to the spermatic cord, varicocele, intestinal perforation are the most common, but not the only consequences of inguinal hernia in men.
How does an inguinal hernia form?
The formation of an inguinal hernia in men occurs due to congenital or acquired muscle weakness. The direct exit of organs from the abdominal cavity occurs during an increase in intra-abdominal pressure. In men, the inguinal canal is less strengthened by tendons and muscles, it is wide, but short, and such features will already be factors in the appearance of the disease.
When the pressure inside the peritoneum rises, the formation of a hernia gate (muscle defect) occurs, through which the intestinal loops, omentum, bladder and other organs exit.
contribute to the development of an inguinal hernia in men:
- frequent cough due to smoking or chronic respiratory pathologies;
- constipation, bloating;
- excess weight, constant high loads on the abdominal muscles;
- overeating, sedentary lifestyle;
- undergone abdominal surgery.
The hernia can be unilateral and bilateral. In men, an oblique type of acquired protrusion on one side is more often diagnosed. This form is characterized by the passage of organs through the spermatic cord. Combined formations can be diagnosed when there are simultaneously oblique and direct hernias that have arisen independently of each other. The straight line enters the inguinal canal, bypassing the spermatic cord.
Symptoms of the disease
An uncomplicated hernia has typical clinical manifestations :
- Discomfort and heaviness in the abdomen.
- Bulge in the groin area.
- Reduction of formation in the prone position and when pressed.
- Absence of pain.
- Discomfort when walking.
- Increased protrusion with muscle tension, during physical work.
- Constipation, nausea, vomiting are less common.
A hernia in men appears suddenly, and rarely develops gradually. Small defects do not cause any discomfort, there is no pain, and its appearance will already speak of a complication. Large hernias have more pronounced symptoms, men have problems with urination, defecation, erectile dysfunction can be observed.
The severe course of the disease is accompanied by constant constipation, bloating, lack of appetite, and general weakness.
When the bladder enters the hernial sac, urinary retention or frequent urination, cramps along the urethra, pain in the pubic area join. Such manifestations weaken when the hernia is reduced. In older men, an inguinal hernia is almost always accompanied by urinary retention.
Complications without surgery
What can happen if an inguinal hernia is not treated:
- infringement - squeezing organs in the hernial sac with their subsequent death;
- peritonitis - inflammation of the abdominal cavity due to organ rupture;
- coprostasis - retention of feces in the intestinal loop located in the hernia sac;
- ischemic orchitis - inflammation of the testicle due to insufficient blood circulation.
of complications:
- nausea, vomiting with blood;
- the appearance of blood with feces or lack of bowel movements;
- acute pain in the lower abdomen with irradiation to the lower back and leg;
- hernia irreducibility, absence of cough shock.
The risk of complications is higher with a giant hernia, when all the organs of the abdominal cavity are contained in the hernial sac. But even small defects can be infringed during a sharp increase in intra-abdominal pressure. Pinching can occur at any time, for example, during a cough, with a sharp movement and lifting a heavy object.
From the moment the hernia appears, the condition should be monitored by the attending physician, who will prescribe an operation and give recommendations on the prevention of complications until the moment of hernia repair.
How is a hernia treated?
Treatment consists in removing the hernial sac and returning the organs to their place. This can be done only surgically - by the method of open or laparoscopic hergioplasty. The operation is scheduled, and preparation is needed for it: sanitation of inflammatory, infectious foci in the body, weight loss.
During this period, conservative methods are prescribed that will stop the pathological process, preventing various complications. The goal of non-surgical treatment will be to eliminate the symptomatic complex, thereby improving well-being and using the body's reserve forces for the normal transfer of the operation.
Conservative therapy
A groin bandage is a mandatory measure before and after surgery. It is needed to fix the hernia in the abdominal cavity and evenly distribute the load on the muscles, which will prevent pressure drops. The latter can lead to pinching of organs.
Diet - dietary restrictions are needed to exclude conditions that increase pressure on the hernia area . We are talking about constipation, bloating, accumulation of feces in the large intestine, overflow of the stomach. The hernia diet is not strict, but it involves frequent meals in small portions, which many people ignore due to being busy.
Therapeutic gymnastics a - physical activity is permissible, but dosed. It is allowed to perform light exercises, but only in the inguinal bandage when the hernia is set. Exercise therapy is prescribed after the operation, and then therapeutic exercises will be an important measure to prevent the recurrence of the pathology.
Medical drugs - drugs are prescribed only when the patient is worried about soreness, constipation, problems with digestion and urination. The doctor may prescribe NSAIDs, muscle relaxants, antispasmodics, diuretics and laxatives.
Hernioplasty
Surgery for a hernia in men involves creating an access through the abdominal cavity, isolating the hernial sac, removing it and returning the organs to their place. This is performed by open or laparoscopic inguinal canal plasty.
The first option of the operation is prescribed when there is an urgent need for surgical intervention. Indications will be inflammation, intestinal obstruction, infringement.
Laparoscopic surgery is a less traumatic option for removing a hernia. It involves access to the defect through small punctures on the abdominal wall. After such an operation, there are no wide scars, recovery is faster, and the risk of recurrence is much lower.
During hernia repair, a mesh implant can be installed, which closes the area of the muscle defect, which prevents organs from exiting through it into the inguinal canal.
Hernia removal can also be carried out Marcy method , when the canal is narrowed, that is, the inguinal ring is closed. This technique is indicated for oblique forms of pathology. The Marcy method allows you to restore the anatomy of the inguinal ring with minimal tissue damage.
About Bassini operation can be performed for oblique and direct hernias. The operation involves strengthening the inguinal ring and Hesselbach's triangle by sewing the rectus muscle to the inguinal ligament.
Mesh hernioplasty is the preferred hernia repair option for women and men . Prosthetics eliminate the effect of tissue tension, which gives the best result. This variant of the operation with the use of permanent prostheses is an indication for the removal of large and giant recurrent hernias. laparoscopic hernioplasty with the installation of a mesh implant is considered the optimal method of treatment .
Consequences of hernia repair
Possible complications after surgical removal of a hernia:
- Violation of the spermatic cord - occurs during the isolation or removal of the hernial sac. The reasons are inexperience or negligence of the surgeon. Consequences - hormonal imbalance, infertility.
- Hematoma - hinders normal recovery after surgery . Prevention - a cold compress for 1-2 hours immediately after suturing.
- Injury to the intestine - occurs when careless processing of the hernial sac.
- Wound infection is a serious complication of the operation, the infection gets in the process or after hernia repair. Treatment is antibiotic therapy.
- Odyanka is the most common consequence of the removal of an inguinal hernia, and a second operation is required for treatment . Pathology can affect two testicles at the same time.
- Joint damage is the result of rough sutures, which can damage the hip joint. To prevent such a complication, careful preparation for the operation with examination of all risk areas is important.
Hernia recurrence is another complication that can be encountered at any time after surgery. Re-disease occurs due to muscle weakness or when mistakes were made during the operation.
For prevention, the doctor prescribes a special regimen. Strict dietary restrictions and general contraindications will be needed in the first month. In the late period of rehabilitation, prevention consists in strengthening the muscles of the anterior abdominal wall and preventing conditions that lead to pressure drops inside the abdominal cavity.
