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Home » Columns » Have a bulge in your groin…it could be an inguinal hernia!

Have a bulge in your groin…it could be an inguinal hernia!

Publishing Date : 05 December, 2017

DR BOIMA
HEALTH ISSUES


Groin hernias are quite common and the main focus today is an inguinal hernia which is the most common hernia of all hernias in the body (about 70%). They occur when tissue pushes through a weak spot in the groin muscles causing a bulge in the groin or scrotum as a result. Inguinal hernias can occur on either side of the groin though they tend to occur more on the right side.


Why do inguinal hernias occur?



Inguinal hernias occur through the inguinal canal, a passage where the testes and spermatic cord descend through during development of boys in-utero. Men and women develop from the same basic pattern so there are anatomical similarities between them, meaning that women also have the inguinal canal. But in women the inguinal canal is much smaller; as a result inguinal hernias are much more uncommon in women than in men.


In many people, the abdominal wall weakness that leads to an inguinal hernia occurs right at birth when the abdominal lining (peritoneum) does not close properly. Other inguinal hernias develop later in life when muscles weaken or deteriorate due to aging, strenuous physical activity, coughing for a long time or abdominal surgery. Depending on the defect where the hernia protrudes, inguinal hernias can be further classified into direct and indirect hernias.


How do I know if I have an inguinal hernia?

The main symptoms of an inguinal hernia include;
A bulge in the groin (or scrotum) which becomes more obvious when one is upright, coughing, sneezing, laughing, bending or exerting any form of strain on the lower abdomen (the swelling will often disappear completely when one lies down, as the contents of the hernia sac slip back through the hole into the abdomen). The bulge would have formed over a period of weeks or months or appeared suddenly after heavy weight lifting or straining


Pain at the bulge though some hernias may be painless (even if a hernia does not cause pain at all, it does not mean it is not there or that it does not need of attention)
Burning sensation or discomfort in the groin
A feeling of heaviness or pulling or pressure in the groin (even if no lump can be seen)
Sudden pain accompanied by nausea and vomiting, are signs that part of the intestines may have become trapped in the hernia (this is an emergency!)
What puts one at more risk of developing an inguinal hernia?
Gender - Men are eight times more likely to develop an inguinal hernia than women
Age - muscles weaken as one ages
Being white (Caucasian)


Heredity – if one has a close relative, such as a parent or sibling with the inguinal hernia they are more likely to develop the  hernia too
Straining – people with chronic cough (either from smoking or with Tuberculosis), people with chronic constipation, and weight lifters are more at risk of developing inguinal hernias
Pregnancy - being pregnant can weaken the abdominal muscles and cause increased pressure inside your abdomen
Obesity
Prematurity - premature birth and low birth weight
Previous inguinal hernia - even if one’s previous hernia occurred in childhood, they're at higher risk of developing another inguinal hernia

What should I do if I suspect a hernia?

See a doctor! The doctor will examine you (normally very simply) to confirm the diagnosis. If there is an obvious swelling that disappears when you lie down, or bulges out when you cough it is pretty conclusive that you have an inguinal hernia.  No special tests are usually needed! A doctor can easily push the hernia back into your abdomen when you are lying down (reducible hernia). However, if this is unsuccessful, you may have an incarcerated or strangulated inguinal hernia.


An incarcerated inguinal hernia happens when tissue or intestines become stuck in the groin and can’t go back. Strangulated versions are more serious medical conditions that restrict blood flow to the small intestine. They are life-threatening and require emergency surgical intervention.

 How would my hernia be treated?

Surgery is the primary treatment for inguinal hernias though hernias that do not cause symptoms usually do not prompt urgent repair. It is a very common operation and a highly successful procedure when done by a well-trained surgeon. Your doctor will recommend either herniorrhaphy (“open” repair) or laparoscopic surgery (done through a small scope).

Open repair which is mostly done in Botswana involves making an incision into the groin and returning the abdominal tissues to the abdomen and repairing the abdominal wall defect. Laparoscopy uses small keyhole incisions rather than a single, longer incision. This surgery may be preferable for cosmetic reasons and because of a shorter recovery time.


For comments or questions related to the hernias please email agboima@yahoo.com

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