An inguinal hernia is an opening in the abdominal wall that separates the abdominal cavity from the legs. A piece of the peritoneum and sometimes also a part of the intestines can sink through the opening into the groin. In the groin will arise a swelling under the skin then. When pressure is applied in the abdomen, for example by coughing, lifting and pressing, the swelling bulges outward.
There are several causes known of inguinal hernia:
- Congenital. This is the most common cause, particularly in boys. The channel through which the balls have descended, has not yet been closed then.
- Weakening of the abdominal wall. When too much pressure is exerted on the abdominal wall, it will become weaker and more susceptible to a hernia. The abdominal wall can weaken by overweight, too heavy lifting, pressing (for example due to constipation) and prolonged coughing.
- Smoking and overweight increase the risk of an inguinal hernia. Smoking leads to a collagen shortage, a type of protein found in connective tissue and making the abdominal wall stronger. Moreover, smokers often have a chronic cough. Excessive abdominal fat in case of overweight causes the abdominal wall to be stretched and weakened.
The signs and symptoms of an inguinal hernia can be:
- A bulge in the groin. This bulge may disappear when lying down.
- A nagging, burning or painful sensation in the groin.
Patients don’t always have symptoms. Some people with inguinal hernia only suffer from a bulge, but no pain. And conversely, a person can have (pain) symptoms without a bulge in the groin.
The diagnosis of inguinal hernia is based on the symptoms, the medical history and physical examination. Physical examination reveals where the hernia is located and what kind of hernia it is.
If a bulge in the groin or scrotum becomes more obvious when coughing, it’s very likely an inguinal hernia. If the bulge is in the scrotum, it may be an inguinal hernia or a hydrocele. The scrotum is sideways being illuminated with a light beam then. Is the bulge the result of an inguinal hernia, then a part of intestine is present in the scrotum and it is not transparant to light. In case of a hydrocele, swelling in the scrotum is caused by abnormal accumulation of moisture. Here, light can get through. Apart from physical examination, additional examination is sometimes needed in the form of ultrasound, to make a definitive diagnosis.
In children younger than one year, an inguinal hernia can close by itself. In all other cases, an inguinal hernia doesn’t heal on its own and surgery is required to close the opening. The procedure is fairly simple and the patient can often go home the same day.
During the operation, the bulging portion is put back into the abdomen and then the abdominal wall is strengthened. This operation usually takes place in the form of keyhole surgery.
Recovery of an inguinal hernia operation usually progresses well. In a small percentage of the operated patients, a hernia may occur again at the same place after some time. In order to remedy this situation, a new operation is needed then.
It’s wise to minimize factors that may cause a hernia as much as possible:
- Don’t lift too much or too heavy, because this causes a lot of force to the abdominal muscles.
- Avoid pressing during bowel movement. For example, drink plenty of water and eat enough fibers.
- Make sure not to become too heavy.
- The term ‘hernia inguinalis’ is derived from the Latin words hernia (break) and inguinalis (groin).
- The prevalence of inguinal hernia is 5%.
- Men are at higher risk of having this condition than women. This is because the abdominal wall in men is often less strong than in women.
- An inguinal hernia can occur at any age.