Symptoms and types of inguinal hernia
Inguinal hernia in men is more common than in women, and its appearance is already in adulthood. But it can also occur at a young age under certain conditions. What kind of disease it is, and whether an inguinal hernia can be cured, is of interest to many patients, since swelling in the inguinal region prevents many from living a full life.
How does an inguinal hernia manifest?
This disease is a protrusion of the skin outward due to the ingestion of this swelling of fragments of internal organs . The intestines, parts of the greater omentum can enter this area, in women it can be filled with the ovary or fallopian tubes. A hernia is called an inguinal hernia, since the peritoneum with organs protrudes into the inguinal canal. In women, the disease is extremely rare, while men quite often resort to conservative or surgical help from specialists.
The degree of manifestation of the disease determines the decision of specialists how to cure an inguinal hernia. Complaints in patients differ, as the size of the hernia, its contents and the age of the patient differ.
- The patient notices that the skin protrudes , and pressing or grazing this area is accompanied by pain. With any muscle tension, this protrusion can increase in size.
- Inguinal hernias are often accompanied by constipation .
- pain may increase during menstruation .
- When prolapsed into the cavity of the hernia of the bladder, a person will experience frequent two-stage urination.
As a rule, an inguinal hernia is accompanied by such symptoms. But with an untimely appeal to a specialist, the following complications of the patient's well-being are possible.
- Incarcerated hernia - it is located in an area where infringement can occur. This is dangerous in the presence of fragments of the abdominal organs, since they are not protected from external influences in the skin sac. This may adversely affect their functioning.
- Formation of intestinal obstruction - if part of the intestine is in this skin area, then this can cause its obstruction.
- Inflammation of the sheets of the peritoneum - the constant presence of internal organs in the hernia leads to peritonitis, bleeding.
- The spread of the inflammatory process further - inflammation can go to the testicle and other nearby organs.
- Unreducible hernia - if conservative treatment of an inguinal hernia is not started in time, the skin is stretched, and it is no longer possible to set it. In this case, only surgery will help.
Formation of congenital pathology
Inguinal hernias are not only acquired, but this diagnosis is sometimes made for baby boys. This is preceded by a certain process of pathology formation.
Up to 4 months of embryo development, the testicles in future boys form and develop in the abdominal region, behind it. When the fetus is about five months old in utero, the testicles descend and slowly approach the inguinal canal. By seven months of pregnancy, the future boy continues to form: the testicles move along the inguinal canal, and after them the "vaginal process" is formed. By the end of pregnancy, by the 9th month, the testicles should enter the scrotum, and the abdominal "pocket" is sent there. When the baby is born, this "pocket" gradually overgrows.
But with unfavorable development, this “pocket” does not close, the gap between the abdomen and the scrotum remains open. Such a structure is not the norm, so this is a weak point in which a hernia may then appear. With any tension, when intra-abdominal pressure increases, parts of the intestine and certain organs that are located nearby can “go out” into the process.
Diagnosis of congenital inguinal hernia begins immediately after the birth of the baby. This is a malformation of the crumbs, depending on its degree and other determining factors, the doctor prescribes a further course of treatment, since the symptoms and treatment are interrelated.
Reasons for the development of a hernia
We figured out the mechanism of formation of congenital pathology, but why does a hernia occur in the adult population?
The development of this pathology occurs for the following reasons:
- Early birth of a child, prematurity. In this case, all organs and systems have not yet fully formed. The vaginal process at the time of birth was still open, which can provoke a hernia.
- The hereditary factor plays an important role. If there is this disease in relatives, it can develop in the baby.
- Pathology occurs when the anatomical weakness of the muscles of the anterior wall of the abdomen.
- If a person is overweight , this is also a disposing factor, since the abdominal organs experience a constant load.
- With injuries in the groin area , which caused weakness of the ligamentous apparatus, a hernia develops.
- A rapid and large loss in weight leads to the appearance of empty cavities in the inguinal canal, then these cavities are filled with fragments of internal organs, and a hernia occurs.
- Pregnancy can provoke pathology.
- A sedentary inactive lifestyle sometimes leads to illness. Muscles do not train, the peritoneum descends into the inguinal canal.
- Constant physical activity and overload lead to such a disease.
- With weakness of the muscles of the peritoneum, a strong and prolonged cough creates an additional load, which leads to the appearance of pathology.
- An increase in pressure on the peritoneum also provokes the intestines with constant constipation . This condition can lead to a hernia.
Types of pathology
Only a specialist can answer the question of how to treat an inguinal hernia, given the type of hernia.
There are several types of inguinal hernia:
- Oblique - differs in that the contents of the hernia cavity passes through the inguinal canal. It can be from childhood, as well as acquired. In men, vessels, spermatic cord and ducts often enter this cavity.
- Direct - this type implies the passage of a protrusion of the skin into the inguinal canal. At the same time, its internal opening is not affected, the abdominal wall is involved. This type often occurs as a result of physical overexertion.
- Combined - this is a rather rare type of hernia, the entire pathology consists of several hernial sacs, a combination of direct and oblique protrusion of the skin is possible.
- Subcutaneous - the formation of a cavity with contents occurs on the external oblique muscle. The bag itself can be on the thigh or in the perineum. The tumor-like formation does not descend into the scrotum.
- Sliding - this type is not common, but is the most dangerous. Here, not only the outer layers of the abdominal cavity are involved in the formation of the cavity, but also the visceral tissues that cover the internal organ, sliding into the hernial sac. In this form, many more organs can enter this cavity: the uterus, ovaries, bladder structures, caecum, and so on.
With an inguinal hernia, treatment should begin immediately. The more time it takes from the moment of its formation, the greater the likelihood of complications of the disease.
If symptoms of the disease occur, it is necessary to consult a surgeon. The first and most reliable way to diagnose pathology is examination . The doctor asks the patient to stand near him, examining the tumor formation. Then palpation , during which the size and density of the formation is determined.
An important component of the examination is a cough test and a strain test . An assessment of the symptom of a push is carried out. Search for the outer opening of the channel.
A mandatory component of the diagnosis is ultrasound of the scrotum, pelvic organs, abdominal cavity, canals. With an ultrasound examination, the doctor sees the internal picture of the disease: what is in the hernial sac, what are the dimensions of the pathological formation, the condition of the inguinal canal, and so on.
For a more detailed study, an x-ray with the introduction of a contrast agent is sometimes prescribed.
To examine which parts of the intestine got into the bag and its condition, irrigoscopy . This study allows you to examine the large intestine. Cystoscopy makes it possible to see the condition of the bladder.
Ways to treat a hernia in the groin
It is impossible to get rid of congenital and acquired forms of pathology on your own. Permanent reduction of a hernia also does not give a result. Only surgical treatment is used here.
To date, there are various methods of treatment and prevention of the disease.
Only the attending physician determines by what methods it is necessary to treat a hernia in the inguinal region. Often this is a classic operation that gives 97-100% efficiency. Modern surgery no longer uses an abdominal incision to remove a protrusion. Many patients got rid of the disease by undergoing endoscopic therapy. Let's take a closer look at these two methods of operation.
The open method of surgical intervention involves the dissection of tissues above the peritoneum and inguinal canal. In this section, the organs that occupied the hernia cavity are visible. If they all continue to function fully, are not infringed, then the surgeon returns them to their place in the abdominal cavity. The stretched mucosa, which was the hernial sac, is removed, and the peritoneal tissues are sutured.
Often, with poor-quality surgery, a recurrence of an inguinal hernia occurs. To avoid it, the doctor must strengthen the walls of the inguinal canal. This is done in several ways. Strengthening materials are taken from natural or artificial grafts. In the latter case, the likelihood of a recurrence of the disease is almost zero.
These are small punctures in certain places for the hernia to be reduced surgically. Endoscopic treatment is preferred for patients as the recovery period is shorter. Such an operation is carried out using 4 punctures, instead of an incision in the tissues of the peritoneum.
But along with all the advantages of such a method, the development of negative phenomena is also possible:
- there is a risk of complications, which is greater with this method than with open surgery.
- recurrence may develop.
- a prerequisite for the operation is general anesthesia, while with an open operation it is not necessary;
- during laparoscopy, there is a risk of adhesions and vascular injury.
Preparing for the operation
Do not increase intra-abdominal pressure before surgery. Therefore, heavy sports, pumping up the press is strictly prohibited. Men and women can lift weights up to 5 kg before surgery. Otherwise, the hernia may be infringed or become irreducible.
Before the operation itself, it is necessary to clean the intestines and bladder. For this, an enema is used or a catheter is placed in the urethra (if necessary).
In the groin area for the operation, it is necessary to remove the hair. This can be done in advance. During laparoscopy of an inguinal hernia, it is forbidden to eat before general anesthesia.
Treatment with a laser
Hernia repair in difficult cases is performed with a laser. Recently, laser technologies have become increasingly widespread due to the rapid and bloodless removal of the protrusion.
Laser treatment has its advantages:
- the safety of the operation, which occurs without the release of blood.
- return to the normal pace of life within 40-60 minutes after the operation.
- the recovery period passes without pain.
- recovery is fast.
- high cosmetic value.
- the operation is very efficient.
Various means are used to prevent the disease, but the most famous therapeutic and prophylactic agent is a bandage. For the treatment of inguinal hernia, it is used when there are certain contraindications to the operation.
The bandage holds the abdominal organs and the hernia itself, reducing the pressure inside the abdominal cavity. It helps for some time to have a therapeutic effect, to protect the disease from complications. If a bandage is worn for a long time, the abdominal muscles are weakened, which negatively affects the patient's condition. This is not a cure, but a prophylactic.
Gymnastics and drugs do not give a therapeutic effect in the formation of an inguinal hernia. They are also prescribed as maintenance therapy.
All these funds are used even before the appearance of a hernial sac. With weakness of the abdominal muscles and heavy physical exertion, for prevention, you need to do special gymnastics and wear a bandage. The best effect is achieved when performing preventive exercises three to four times a day.