Inguinal Hernia: Types, Treatment Methods, Rehabilitation
What is an inguinal hernia?
An inguinal hernia is a condition in which the main organs of the digestive tract protrude through the abdominal cavity into the inguinal canal. One of the most visible signs of inguinal hernia in both children and adults is a large formation in the area of the inguinal organs. Interestingly, the hernia may not be visible when the patient is lying down.
If we look at the statistics, this condition is more prevalent in men, regardless of age. Women suffer less from this disease due to differences in body anatomy. In men, the inguinal canal is shorter, with fewer muscles and tendons, making it more vulnerable.
Inguinal hernia can occur due to heavy lifting and intra-abdominal pressure in the inguinal region. This leads to a defect known as "abdominal gates," through which organ protrusion occurs, forming an inguinal hernia.
Types of inguinal hernia
There are three main types of inguinal hernia: direct, indirect, and combined hernias.
- Direct inguinal hernia:
In this type of condition, organs protrude directly into the inguinal canal, bypassing the spermatic cord. Direct inguinal hernia is usually acquired, and according to statistics, it mostly affects older patients. The disease manifests due to the weakening of muscles and ligaments that occurs with age.
Indirect inguinal hernia:
In this type, the hernia passes directly into the inguinal canal along with the mechanism of the spermatic cord in men and the round ligament in women. Indirect inguinal hernia can be acquired with age or present from birth.
Combined inguinal hernia:
This type combines features of both direct and indirect inguinal hernias. In combined inguinal hernia, multiple hernia sacs may appear. These formations are usually not connected and develop on both sides simultaneously, leading to a condition called bilateral inguinal hernia.
Inguino-scrotal hernia:
This type occurs only in men when a direct hernia, over time, enlarges and descends into the scrotum.
Causes of inguinal hernia: What can cause an inguinal hernia?
Inguinal hernia can be a hereditary condition. If a close relative of the patient has had an inguinal hernia, it may predispose the individual to the development of the disease.
The most common cause of inguinal hernia is weak muscle ligaments and sudden pressure on this area, such as during heavy lifting. Therefore, it is always advisable to assess the capabilities of one's body rationally. If Superman didn't have superpowers, he would undoubtedly have acquired more than one inguinal hernia. It's better to call a team of movers than to move a chest of drawers alone.
According to statistics, excessive physical strain mainly affects the development of hernias in men. This includes not only undue stress on the muscles but also their unpreparedness for physical exercise and lifting heavy weights. According to data, this method of acquiring inguinal hernia occurs in 70% of cases.
Inguinal hernia, in one form or another, can occur in women who have given birth with short intervals between pregnancies. Changes in the body during pregnancy can cause part of the intestine to protrude through the abdominal cavity into the inguinal area. Pregnancy is the most common cause of inguinal hernia in women. In one-tenth of patients with inguinal hernia, the pathology occurs due to the non-closure of the vaginal process.
Excess weight, both in men and women, can provoke the development of inguinal hernia pathology.
Other less obvious causes of inguinal hernia include chronic cough and frequent constipation.
The predisposition to inguinal hernia in children may be due to incorrect anatomical development even in the mother's womb. Premature birth is also among the main reasons for the development of the condition in children.
Signs of inguinal hernia
Inguinal hernia is hard to miss. However, its symptoms are often confused with those of hydrocele and spermatic cord cyst. To avoid confusion, let's delve into the symptoms of inguinal hernia in more detail.
One of the most common symptoms of a mild form of inguinal hernia in men and children is the protrusion of a formation in the groin accompanied by discomfort.
A swelling forms in the groin area, changing in size. For example, patients lying down may not see the hernia—it seems to disappear.
Even before the visible formation appears, patients may feel a dull or aching pain in the abdominal muscles during physical exertion. Generally, the manifestation of the disease is accompanied by regular pain during movement, whether it be walking or other activities.
A feeling of heaviness in the abdomen or sharp stabbing pain in this area can also indicate inguinal hernia.
Other standard symptoms include hiccups, vomiting, and nausea, along with simultaneous abdominal pain.
Indications for inguinal hernia treatment
Indications that require urgent medical intervention:
- Sudden spasmodic pain in the abdominal area.
- Severely distended abdomen.
- Frequent vomiting.
- Rapid deterioration of the patient's condition, severe weakness.
Risks of inguinal hernia
Inguinal hernia is a dangerous condition that will not resolve on its own. If left untreated for a long time, the disease will progress, leading to complications.
Complicated inguinal hernia leads to inflammation in the inguinal area. Entrapment of the hernia sac is the most dangerous type of disease regression. This increases pressure and narrows blood vessels.
An anatomical disturbance in this area is accompanied by the rapid development of the hernia within a few days. This scenario requires emergency surgery.
Therefore, at the first symptoms, it is advisable to contact the attending physician immediately, get a referral to a surgeon, and undergo the necessary diagnostics.
How is inguinal hernia diagnosed
First, the surgeon determines the severity of the disease. A direct examination of the patient is performed, followed by diagnostic tests.
Classic diagnostic methods for the disease include ultrasound and X-ray contrast analysis.
Ultrasound diagnosis of the inguinal canal and hernia sac allows determining the degree of hernia formation. This examination helps identify the specific organs present in the hernia sac.
X-ray contrast analysis is a more accurate method than ultrasound for determining the condition of inguinal hernia. During this procedure, a contrast substance is introduced into the hernia area.
The type of hernia is determined directly during the operation.
Rehabilitation of inguinal hernia: Is surgery necessary
Unfortunately, for successful and most effective inguinal hernia removal, surgical intervention is required.
Surgery completely removes the hernia sac and eliminates the possibility of further progression of the disease.
Surgical removal of the hernia prevents complications that may occur with unsuccessful therapy.
Sometimes patients neglect surgical intervention, trying various treatment options for inguinal hernia. Self-treatment is not recommended, as it can only waste time and worsen the situation.
Inguinal hernia surgery is performed under general anesthesia. On average, such surgical intervention takes 30 to 60 minutes for men and only 15 minutes for women due to anatomical differences.
When should inguinal hernia surgery be done urgently
The most important indicator in this matter is the age of the hernia sac.
There is no need to wait for the hernia sac to "resolve" on its own. The longer you wait, the higher the risk of starting an inflammatory process. When inflammation begins, planned surgery becomes urgent, that is, immediate.
Also, in case of entrapment of the hernia sac, surgical intervention should be resorted to within 10 hours.
Ways of Treating Inguinal Hernia
There are various methods for removing an inguinal hernia. The method is always chosen individually by the surgeon based on the indications and the patient's characteristics. The surgeon may also offer the patient a choice of several methods.
Endoscopic Surgery
Endoscopic equipment allows for the least traumatic operation. During the endoscopic method, small incisions are made, where the surgeon inserts special instruments.
After endoscopic surgery, the patient typically stays in the clinic for an average of one day before being discharged home.
The operation allows for the precise removal of the hernia while minimizing the trauma of the procedure.
Lichtenstein Method Surgery
The Lichtenstein method also involves small incisions, approximately 6 cm in length. This operation is recommended for those who do not tolerate general anesthesia well or for whom endoscopic therapy is contraindicated.
To reduce the risk of recurrence, a special abdominal prosthesis, a mesh, is used. The Lichtenstein method minimizes the possibility of inguinal hernia recurrence, with statistics showing recurrence in only 1% of patients, especially effective for older patients.
Shouldice Method Surgery
For many specialists, the Shouldice method is the most effective technique without using prosthetics. This technique does not involve the use of a mesh or prosthesis to support the abdominal wall.
It is worth noting that this treatment method is contraindicated for those diagnosed with diabetes or those on steroid therapy.
Laparoscopic Treatment Method
The laparoscopic method is recognized as the least invasive way to treat inguinal hernia and is used in the early stages of the disease.
The operation is performed using a laparoscope, a special instrument that allows the surgeon to perform the operation through small openings without making incisions.
In most cases, the underestimation of the severity of the disease by surgeons is the cause of inguinal hernia recurrences. Therefore, finding a good specialist becomes a crucial aspect of inguinal hernia treatment.
Many private clinics in Switzerland specialize in treating inguinal hernias of all types and complexities. Additionally, patients can undergo rehabilitation in an exclusive environment, surrounded by the beauty and tranquility of Swiss landscapes.
Rehabilitation Recommendations
After any type of operation, the consumption of alcohol and coffee is strictly prohibited for the first 7 days. In addition to these beverages, sweets and fried food should also be avoided.
The duration of rehabilitation after inguinal hernia surgery is determined individually and depends on the severity of the disease, the method of the operation, and the patient's characteristics.
If all the doctor's recommendations are followed, the process of full recovery on average takes up to six months.
Take care of yourselves!