Dr. Ertan Beyatlı

Inguinal Hernia and Inguinal Pain

(Update: ) - Hernia

Very common in society in this article Inguinal hernia I will try to give detailed information about you.

What is Inguinal Hernia?

Hernia (hernia), abdominal wall from your weak points occurs. The inguinal area is a clinically very important area, especially in men, because the testis is connected to the abdominal cavity and herniation It is a potential site for (hernia). English for inguinal hernia Inguinal Hernia'Dr

Inguinal hernia is one of the most common general surgical operations.

Spermatic cor- cord is seen inside the inguinal canal.

Symptoms

  • Swelling. In general, patients have swelling in the groin area (especially increased by straining with coughing and sneezing). Swelling is usually detected by patients and they can push back the swelling with their hands.
  • Ache. There may be complaints of groin pain, pain in the lower abdomen and legs.
  • Constipation. Constipation and flatulence may occur when some of the intestines enter the hernia sac.
  • Complication. In these cases, strangulation in the hernia sac and bowel rot develops. Following this, severe groin pain, painful tender swelling in the groin, skin discoloration, fever, nauseaComplaints such as vomiting, sweating may occur. This situation requires immediate medical attention.

Causes

  • Congenital (congenital) hernia. There is a potential congenital hernia sac in congenital areas. This pouch is a part of the abdominal membrane that covers the entire abdomen. The loosening of this membrane manifests itself as a hernia years later or after birth.
  • Acquired hernia. Among the acquired causes of inguinal hernia, there may be all kinds of events that increase the intra-abdominal pressure:
    • previous surgeries
    • being overweight (obesity)
    • tumors
    • acid agglomeration
    • heavy lifting
    • prostate diseases
    • chronic cough, bronchitis, and asthma
    • trauma, accident, impact, sports, etc.

Incidence

Inguinal hernias are generally divided into three:

  • Indirect inguinal hernia (those formed by passing through the inguinal cord canal) 50%
  • Direct Inguinal Hernia (those that do not pass through the inguinal cord canal) 25%
  • Femoral Hernia 6% and others…

Inguinal hernias 85% are men is seen. The reason is that the testicles in males are located outside the abdomen, unlike the ovary, which are female eggs, and the path they follow (inguinal canal) can weaken and herniate at any time.

Treatment method

Here hernia As in the case of inguinal hernias the only treatment is surgery. Inguinal ligament, corset, etc. Such methods are only efforts for temporary relief. The herniated tissue is repaired and strengthened by various methods.

What are the surgical techniques?

Operations for hernias can be grouped under two main headings.

Classical surgical methods
Laparoscopic surgical interventions

Classical surgical method; It is performed as "with the incision made in the groin area, the herniated part is found and rejected into the abdomen and the upper part is reinforced by using a patch with some surgical techniques". The medical name of this surgery is "Tension Free Mesh Hernioplasty”Is. Laporoscopy, on the other hand, is the patching of the hernia area with the help of some tools by entering through small holes opened in certain areas in the abdominal wall.

What are the advantages and disadvantages of the surgeries?

Inguinal hernias are diseases that must be treated surgically. If classical surgical methods are performed under local anesthesia, the patient can be sent home that night. After laparoscopic surgery, the patient feels little pain due to the small incision site and returns to work early. There is no big difference between the two methods. The method is chosen by the joint decision of the patient and the surgeon.

Sexual life after inguinal hernia surgery

In this regard, patients are recommended to pay attention for at least 20 days after surgery and not to have sexual intercourse as much as possible. During this time, the tension to be applied to the muscles and ligaments in the groin area, the stitches made during the surgery and the placed patch (mesh) may be damaged.

Bathing after inguinal hernia surgery

It is appropriate not to get the wound wet for the first 72 hours in order to protect the operation area from infections. Bathing can be done when waterproof dressing is applied.

Does inguinal hernia will recur after surgery?

The likelihood of recurrence of the disease after inguinal hernia surgery ranges from 1 to 10 percent. This usually depends on the experience of the surgeon and the accuracy of the method used for the patient. With the patch technology used in recent years, the recurrence rates have decreased to 1% gold.

What should be considered in order not to have a hernia?

In order not to have a hernia; excessive weight should not be lifted, events that increase intra-abdominal pressure should be avoided, excessive weight should not be lost, smoking should not be used, should be fed with vegetables and fruits, constipation and long-term lung diseases should be fought.

Do children have a hernia?

Inguinal hernia (inguinal hernia) in about 100 out of every 5 newborns, especially in boysInguinal Hernia) is seen. Often it is not detected due to lack of detailed examination and occurs in the following months or years. Since irreversible damages sometimes occur in untreated inguinal hernias, mothers and fathers should be more conscious and serial about the issue.

How and Why Does Inguinal Hernia Occur in Children?

Testicles (eggs) are normally found in the abdomen of children (babies) during pregnancy. In the last 2 months of pregnancy, the testicles pass through a long and thin canal (inguinal canal) and descend from the abdominal cavity towards the testicles (scrotum) and settle there before birth. Immediately after this migration period, the canal is completely closed and the testicles are prevented from going back.

In some babies, this channel does not close for an unknown reason (ideopathic) and continues to remain open after birth. The fluid coming from the abdominal cavity passes through this channel and collects in the testicles. Water Hernia It causes the formation of (hydrocele). As a result of the expansion of the canal over time, some of the intestines in the abdominal cavity pass through this channel and settle into the testicles and cause an inguinal hernia.

Many factors may play a role as to why the canal is not closed, for example, preterm birth, underweight babies, number of babies, medication use… etc.Scrotum Anatomy

What are the Symptoms of Inguinal Hernia in Children and How to Understand?

It is possible to make a diagnosis in a detailed physical examination performed by an experienced physician after birth. At this stage, overlooked and undiagnosed hernias are usually detected by parents. Inguinal hernias cause restlessness, constant crying, straining and constipation in children. Swelling in the groin area and testicles and a careful unevenness in the skin folds over the right and left testicle area are seen. The final diagnosis is made by the clinical examination performed by the physician.Inguinal hernia in children

What should be done in children with inguinal hernia?

It is necessary to intervene without delay because it can cause irreversible complications (testicular atrophy, infertility, etc.) due to the pressure on the testicles and damage to the outgoing vessels. In some cases where the channel is narrow, it can be closed by itself. 1-1.5 years can be expected However, this situation can only be decided by the physician. The canal is closed with a surgical operation to be performed, and the intestinal segments, if any, are placed back into the abdomen.


Other causes of groin pain

There may be pain or aches in the groin for many reasons. Other complaints accompanying groin pain may indicate what the disease is.

Causes of groin pain sometimes simple sometimes enough to require emergency surgery it can be serious. Therefore, a definite or preliminary diagnosis should be made before the necessary medical treatment is performed.

Causes of groin pain

The most common situations that can cause groin pain are:

  • Digestive system: gas bloating, constipation, hemorrhoids, fissure, large intestine tumors (benign or malignant), intestinal obstruction (ileus), appendicitis, colitis, colon diverticulum, etc.
  • Genitourinary system (Urinary and Reproductive Tract): urinary tract infection, kidney or urinary tract stones, testicle (hydroceleovarian cyst, uterine fibroids, endometriosis, pregnancy.
  • anterior abdominal wall: inguinal hernia (inguinal hernia), femoral hernia, spigel hernia, hematoma, desmoid tumor, etc.
  • skeletal system and other: Muscle, bone, soft and connective tissue and tendon: myalgia, arthralgia, osteoarthritis, osteomyelitis, lymphadenitis etc.

Groin Pain Diagnosis Stage

A detailed diagnosis at the stage of diagnosis history It is very important to take it. The patient should rest. To be done by the physician detailed examination Some post-imaging and laboratory tests may be requested, such as:

  • Hemogram (whole blood)
  • ADBG (standing direct abdominal radiography)
  • abdominal ultrasound, superficial tissue ultrasound
  • BT, MR
  • Endoscopic procedures: ColonoscopyCystoscopy, Hystroscopy
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