What men need to know about inguinal hernias

What men need to know about inguinal hernias

We have all heard of a hernia but may not know exactly what they are.  Hernias happen when an internal part of the body such as an organ or fatty tissue, push through a weakness in the muscle or surrounding tissue wall called fascia.   There are many different types of hernias – inguinal, incisional, femoral, umbilical, and hiatal - but it is inguinal hernias (inner groin) that account for up to 70 percent of all cases of this rupture with over 500,000 Americans, primarily men, who will require surgical repair of this hernia. 

Inguinal hernias affect men 10 times more often than women with up to 25 percent of men and only 2 percent of women who will develop this type of hernia in their lifetime.  Men are more susceptible to inguinal hernias due to a natural weakness along the inguinal canal after the testicles descend into the scrotum before a baby boy is born.

What is an inguinal hernia?

An inguinal hernia happens when fatty or intestinal tissues push through the inguinal canal in the groin area between the pubis and the top of the thigh.  Both men and women have an inguinal canal that resides at the base of the abdomen.  When a hernia occurs in this area it results in a protruding bulge or lump that can be painful with movement.

There are two types of inguinal hernias:

1.     Indirect inguinal hernia – This happens when there is a defect or weakness in the abdominal wall that is congenital or present at birth.

2.     Direct inguinal hernia – This usually occurs in adult men and can result from a weakness in the muscles of the abdominal wall that develops over time.

Symptoms of inguinal hernia

Usually the first symptoms a person will notice is a bulge or lump along the pubic or groin area that may appear larger when a person stands up or coughs.  They can also be painful or sensitive to the touch.

Other symptoms associated with an inguinal hernia include:

·      Pain when coughing, exercising, or bending over

·      Burning sensations

·      Sharp pain

·      A heavy or full sensation in the groin

·      Swelling of the scrotum in men

Causes of inguinal hernia

For an inguinal hernia there is no one apparent cause of them.  However it is believed that weak spots within the abdominal and groin muscles could be contributors.  Other contributors could be due to:

·      Heavy lifting

·      Straining when using the bathroom

·      Constipation

·      Excessive coughing or sneezing

·      Vigorous exercise or sex

·      Frequently standing for long periods of time

·      Being overweight or obese

·      Being male

·      Hereditary

·      History of hernias

How inguinal hernias are diagnosed

If a person is not having any symptoms, they may not seek getting diagnosed or treatment.  However, to prevent further protrusion of the hernia, discomfort or complications, it is highly recommended to go to a doctor to get a definitive diagnosis of an inguinal hernia.

All that is needed is a physical exam in order to diagnosis an inguinal hernia.  The doctor will check for a bulge in the groin area and will also have the person stand asking them to cough to check to see when the hernia is at its largest.  If for some reason, there are any questions as to whether it is an inguinal hernia, then the doctor may order an imaging test such as an abdominal ultrasound, CT scan, or MRI.

Treatment for inguinal hernias

Depending on the size and symptoms will determine what course of action will be taken to treat an inguinal hernia.  If the hernia is small and has no symptoms, then the doctor may recommend watchful waiting. 

If the hernia is painful or becoming larger then surgery is usually required to relieve discomfort and prevent serious complications.

There are two types of operations to repair an inguinal hernia:

1.     Open hernia repair

This procedure is done under local anesthesia and sedation or general anesthesia.  The surgeon will make an incision in the groin pushing back the protruding tissue into the abdomen.  The weakened area is sewn back up and is reinforced with a synthetic mesh.

2.     Laparoscopy

This is a minimally invasive procedure that requires general anesthesia.  The surgeon will have several small incisions in the abdomen and will use a tiny camera (laparoscope) that is inserted into an incision that will guide him in repairing the hernia using synthetic mesh.

Anyone with an inguinal hernia requiring surgery will need to thoroughly discuss with their doctor the pros and cons of both types of surgery to determine which one will result in the best outcome having the least complications and prevent the hernia from returning.