An inguinal hernia occurs when fatty tissue or intestines protrude due to a weakness in the abdominal wall. An inguinal hernia appears as a bulge in the inguinal region of the lower abdomen. In this article, learn about the causes of inguinal hernia and its most common types, symptoms in children and adults, and treatment in Turkey.
A hernia is a common condition in which part of an internal organ or fatty tissue bulges through a muscle due to weakness. An inguinal hernia occurs when the intestine or fat bulges from the abdomen as a bump or push through the lower abdominal wall into the inguinal region or groin.
What is an inguinal hernia?
A hernia is a common condition in which part of an internal organ or tissue protrudes through a muscle due to weakness. Hernias can occur around the belly button (navel), through a surgical scar in the diaphragm or in the inguinal region (the area between the abdomen and groin on either side of the body).
What are the types of inguinal hernia?
There are two types of inguinal hernia:
- Indirect inguinal hernia: This type of hernia occurs as a result of a congenital defect in the muscles (muscles) of the abdominal wall.
- Direct inguinal hernia: which occurs in adult males. It often results from weakness in the muscles of the abdominal wall that develops over time, or as a result of stress or weight lifting.
The hernia can be on one or both sides of the abdomen. Direct inguinal hernias are more common in adults because the abdominal wall muscles weaken with age.
An inguinal hernia is usually not dangerous. However, it can be painful, especially when lifting, bending, straining or coughing.
Who gets an inguinal hernia?
Adult men over the age of 40 are more likely to have a direct inguinal hernia than females. 25% of men, and only about 2% of women, will develop an inguinal hernia in their lifetime.
A family history of an inguinal hernia, smoking, and men who have had previous abdominal surgery are risk factors.
What are the symptoms of inguinal hernia?
An inguinal hernia may be painless or cause no symptoms, especially when it first appears. Symptoms of infection that may develop include:
- A bulge in the thigh, which appears when standing and disappears when lying down.
- Thigh pain, especially when lifting, coughing, or exercising.
- Feeling of weakness, heaviness, or burning in the groin.
- Protrusion (mass) in the scrotum at the testicles.
How is an inguinal hernia diagnosed?
If you suspect that you or your child has an inguinal hernia, you should seek medical advice. If the hernia is not treated, an inguinal hernia can develop serious complications.
Your health care provider may ask about your family history, as inguinal hernias tend to run in families. He or she may then do a physical exam to palpate the hernia. You may be asked to cough or strain to see if the hernia has come out.
An abdominal X-ray or CT scan may be ordered to diagnose strangulation or entrapment.
Do all types of inguinal hernias require surgery?
Sometimes a health care provider can push or "reduce" a small inguinal hernia back into the abdomen with a gentle massage. If that doesn't work, surgery may be needed.
An inguinal hernia does not improve or go away on its own. If you've been diagnosed with an inguinal hernia, your doctor will likely recommend surgery.
These complications are rare, but the hernia can strangle or become trapped if left untreated.
- Trapped hernia: Incarceration occurs when a portion of fat or intestine from inside the abdomen gets stuck in the groin or scrotum and cannot return to the abdomen.
- Strangulated hernia: Strangulation can occur when a trapped hernia is not treated. The blood flow to the intestine is cut off, causing the intestine to 'strangle or die'. This is a very serious and emergency condition.
How is an inguinal hernia repaired?
Inguinal hernia repair is a common surgical procedure. Inguinal hernia surgery is also called hernia repair. There are three ways to repair an inguinal hernia:
- Open hernia repair: A surgical procedure that requires an incision in the groin area. The surgeon places the herniated intestine back into the abdomen and strengthens the muscles of the abdominal wall with a patch and stitches. It is performed under local anesthesia in the abdominal area, or general anesthesia.
- Minimally invasive or laparoscopic repair: A less invasive surgical procedure in which the surgeon makes small half-inch incisions in the lower abdomen and inserts a laparoscope (a thin tube with a small video camera). The doctor can perform this surgical procedure through small incisions.
- Robotic hernia repair: Like laparoscopic surgery, robotic surgery uses a laparoscope, and is performed in the same way (small incisions in the abdominal wall, small camera).
Robotic surgery differs from laparoscopic surgery in that the surgeon sits at a console in the operating room, and operates surgical instruments from the console. While robotic surgery can be used in some cases of smaller hernias, or weak areas, it can now also be used to reconstruct the abdominal wall.
Inguinal hernia in children
Hernias in children need surgical repair to prevent intestinal asphyxia or other complications. The procedure takes about an hour and is usually done on an outpatient basis (which means the patient can go home the same day of the procedure).
How is the child prepared for the inguinal hernia operation? What are the steps of the procedure?
Your child should not eat for 6 hours before the operation to reduce the risk of vomiting and inhalation of fluids under anesthesia.
- The operation is performed under general anaesthesia. Your child will not feel pain during the procedure.
- Make a small incision (2 to 3 cm) in the lower abdomen near the thigh.
- Identify the hernia 'sac' that contains part of the small intestine.
- The surgeon pushes the contents of the hernia sac (intestine) into position behind the muscles of the abdominal wall.
- Hernia sac removal.
- Strengthening the muscles of the abdominal wall with stitches to prevent another hernia from developing.
- If your child is less than one year old, the chance of a hernia on the other side of the thigh is very high. Therefore, it is recommended to fix both inguinal regions. If there is no hernia present on the other side of the groin area, the wall muscles are strengthened with stitches.
What after inguinal hernia surgery?
Most children will be able to go home a few hours after the procedure. However, premature babies and newborns with special medical conditions may need to spend one night in the hospital for monitoring.
Your child feels better the morning after the inguinal hernia operation. Once your child is able, he can resume normal eating habits and activities.
The child is allowed to take a shower two days after the operation. And the antibiotics prescribed by the doctors must be adhered to.
A follow-up appointment will be scheduled 7 to 10 days after the inguinal hernia surgery. Your health care provider will assess and heal the wound.
When should I contact the doctor after an inguinal hernia operation?
You may notice some slight swelling around the wound or in the scrotal area. It's normal. However, Call your doctor In case:
- inability to urinate
- severe bloating
- increased pain
What are the risks of an inguinal hernia operation?
Risks of inguinal hernia repair include:
- Pain that cannot be controlled with medication
Long-term complications are rare, but they can include nerve damage or hernia recurrence.
Recovery after inguinal hernia surgery
Recovery from open surgery usually takes several weeks to treat post-operative pain. It is also advised not to lift anything heavy or engage in strenuous activities.
Laparoscopic surgery usually takes a shorter recovery time. However, it may not be an option for patients with large hernias or those who have had previous abdominal surgery.
Infants and children recover faster than adults from inguinal hernia repair.
How is the prevention of recurrence of inguinal hernia?
After surgery, you may be advised to maintain a healthy weight and avoid lifting heavy objects or straining during a bowel movement. These steps can help prevent inguinal hernia recurrence.
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