What is an inguinal hernia?

An inguinal hernia is an abnormal protrusion of a sac through the muscular layers of the abdomen in the groin area, located just above the root of the thigh. Inguinal hernias are one of the most common surgical problems. The most common symptom is the presence of a mass in the groin or scrotum, associated with mild discomfort or pain, which may worsen with exertion. In some cases, other symptoms such as tingling or numbness in the leg, a burning sensation or heaviness may also appear.

 

Inguinal Hernia: Symptoms

Symptoms of an inguinal hernia include swelling in the groin that varies in size at different times of the day. For example, when you get up in the morning, you may not notice it. However, if the patient has been working, walking, or is tired, the swelling becomes more pronounced. Furthermore, massaging the affected area reduces the swelling. If this is not the case, it is advisable to consult your family doctor, who can refer the patient to specialized clinics or the emergency room, depending on the severity of the case. Groin pain may appear and, in some cases of inguinal hernia in men, symptoms may affect the testicle.

 

What are the most common causes of an inguinal hernia?

The causes of inguinal hernias are divided into two categories: congenital, i.e., present from birth, and acquired, i.e., appearing later. Congenital causes underlie the majority of inguinal hernias. The main congenital cause is a defect in the prenatal development of the inguinal canal, a duct that connects the abdomen to the testicle in men. Prematurity and low birth weight are established important risk factors. Other rare congenital causes include pelvic or bladder deformities or collagen abnormalities.

The main acquired cause is rather given by the wear and tear of daily stress, with abnormal and excessive efforts at the abdominal level. Straining to urinate or defecate, coughing, and lifting weights are also documented acquired causes, causing trauma and weakening of the inguinal floor. Other risk factors that increase the likelihood of developing a hernia are smoking, malnutrition, and vitamin deficiencies.

 

What are the triggers for inguinal hernia?

There is a tendency to believe that inguinal hernia is caused by repeated physical exertion over time. But a hernia can also occur because of a persistent cough. Constipation is another condition that can trigger the symptoms of inguinal hernia. There are also risk factors to watch out for, such as obesity, smoking, asthma, and diabetes. These are all conditions that increase the likelihood of suffering from this disorder. In women, repeated pregnancies as well as excessive thinness can predispose to female inguinal hernia. In men, the presence of the spermatic cord, which allows the descent of the testicle from the abdominal cavity to the scrotal sac during fetal development, increases the possibility of inguinal hernias. But if we look at current statistics, the problem is also increasingly affecting women. This is certainly linked to the increase in average life expectancy and the change in lifestyles, such as the habit of practicing intense sport or smoking.

 

Surgical intervention for inguinal hernia

When should an inguinal hernia be operated on?

Surgical intervention is necessary in all cases where the symptoms of inguinal hernia appear or when these symptoms become particularly disabling or bothersome. A scheduled intervention helps avoid the possible complications of an untreated hernia, such as strangulation, which requires emergency intervention.

Common symptoms of a strangulated hernia are the presence of an irreducible inguinal mass that is very painful, warm and/or red, sometimes associated with increasing abdominal pain, fever, vomiting, and difficulty evacuating. In these cases, you should immediately go to the emergency room.

 

How is the procedure to treat inguinal hernia performed?

Surgical intervention for inguinal hernia repair is currently the only treatment capable of remedying this problem. Normally, it is an elective procedure, i.e., planned, but sometimes it must be performed urgently, in case of an incarcerated hernia that cannot be reduced or that is strangulated.

The operation consists of reducing the contents of the sac inside the abdomen and repairing the orifice through which it has passed. Finally, the placement of a non-absorbable or partially absorbable prosthetic mesh ensures the correct closure of the hernial orifice over time.

The operation can be performed traditionally (open), with an incision of about 7-8 cm in the groin, or by minimally invasive laparoscopic surgery, through three small incisions of 1 cm each in the abdomen.

The latter is particularly indicated in young people, athletes, in cases of bilateral inguinal hernia or in recurrences, i.e., in cases where the hernia reappears after it has already undergone surgical repair.

 

What to expect after inguinal hernia surgery?

After inguinal hernia surgery, the patient may not experience pain, but if present, it can be easily managed with analgesic medication. In addition, for the following 3 weeks, it is important to wear a support with an elastic band or special underwear, which facilitates recovery after the operation. You cannot exercise for about a month, you can resume driving after 48-72 hours of the operation. The return to work depends on the job. If it is office work, the average waiting time is 10 to 15 days. For activities requiring physical exertion, the waiting time is a little longer, about 3 weeks. This is generally the average recovery time for an inguinal hernia.