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Inguinal hernia

Symptoms | Causes | Types | Diagnosis | Treatment | Recovery

What is an inguinal hernia?

An inguinal hernia (or hernia inguinalis) is a bulge of the peritoneum or abdominal fat through a weakening in the lower abdominal wall. It is a very common phenomenon that mainly occurs in men. It is estimated that 1 in every 4 men will at some point in their life be affected by an inguinal hernia. In contrast to this high percentage, only 3% of women are affected by inguinal hernias. Many people do not seek treatment for their inguinal hernia because it often does not cause direct complaints. However, rapid medical intervention can prevent further bulges and / or complications from occurring.

Inguinal hernia symptoms

Inguinal hernias are striking because of the characteristic bulges. They cause a bulge in the groin or along the pubic area, and may increase in size when coughing or assuming a standing position. The bulge can be painful or sensitive to touch. In most cases, one or more of the following symptoms can be observed if you have an inguinal hernia:

  • In most cases the bulge is easy to push back. When you stand, cough or press, the bulge often reappears. When you lie on your back or push back, the bulge is often less visible.
  • The bulge sometimes continues until/in the ball sack or labia.
  • Pain or a burning sensation.
  • A heavy or full feeling in the groin
  • Swelling of the scrotum in men

Causes and risk factors of an inguinal hernia

An inguinal hernia can occur for various reasons. First of all, it may be that you were born with the weakening of your abdominal wall. Abrupt or continuous stress or pressure on the abdominal wall can also cause a hernia, for example heavy work or exercise. In both cases, a number of factors play a role in the occurrence of the hernia:

  • Heredity
  • Overweight or obese
  • Pregnancy
  • Often standing for a long time
  • Smoking (smoking makes the connective tissue weaker)
  • Excessive coughing
  • Regular pressing (constipation)
  • The (often) lifting of heavy objects
  • Making sudden explosive movements during sport (with a lot of pressure on the stomach)

Different types of inguinal hernias

Indirect inguinal hernia
An indirect inguinal hernia is the most common type of inguinal hernia. It often occurs in premature babies, where the inguinal canal has not fully developed. However, this type of inguinal hernia can also occur at any other stage in life and occurs mainly in men.

Direct inguinal hernia
A direct inguinal hernia usually occurs in adults. Often it is wrongly thought that weak muscles during the adulthood lead to a direct inguinal hernia. This type of inguinal hernia is also more common in men.

Risks
Tissue from the abdominal cavity can sink through the weakening that is caused by the inguinal hernia. This produces certain risks: for example, a piece of the intestine can become trapped. Due to the entrapment, the blood supply to that part of the intestine is obstructed, allowing the constricted part of the intestine to die off. If this happens, you must be operated urgently, otherwise you risk death.

Diagnosis of an inguinal hernia

The diagnosis can be made in two ways:

Echo
An ultrasound gives a better image of the inside and is usually used when the inguinal hernia can not be seen with the naked eye.

Examination
An experienced doctor can make a diagnosis of an inguinal hernia without the use of medical aids. The doctor does this by putting your body in various positions and consequently letting you cough.

Treatment of an inguinal hernia

An operation is the primary treatment in the case of an inguinal hernia. The inguinal hernia operation is one of the most commonly performed procedures in general surgery and a very successful procedure when performed by an experienced surgeon. The operation can be performed in two ways: using an ‘open’ operation or laparoscopic operation.

If an open operation is used, a small cut (2 to 3 cm) is made in the groin after which the bulge is pushed back into the abdomen. The hernia is then repaired using your own tissue or by using a mesh. A laparoscopic operation uses several very small cuts to bring in a camera and equipment, and repair your hernia from the inside. A laparoscopic operation laparoscopy, the recovery time is shorter, but the operation is always carried out using a plastic mesh.

With or without mesh?

We always recommend an operation without the use of mesh, and only by an experienced surgeon. If you still have doubts about the difference between operation methods with or without a mesh, we have made an overview of the advantages and disadvantages of both types of inguinal hernia operations.

Hernia repair: with or without mesh?

Recovery after inguinal hernia surgery

An inguinal hernia operation is a fairly minimal procedure, which does not bother you much after the operation. Read more about the recovery and aftercare that we offer you on the following page:

recovery & after care

Do I need surgery?

An inguinal hernia can only be repaired by undergoing surgery. However, In most cases it is not necessary to undergo the operation directly, and you can easily walk around for months (even years) without being bothered by your hernia. However, it is true that the inguinal hernia becomes larger with time and this has some accompanying risks:

  1. An operation without mesh has the best results if the hernia is small. The greater the inguinal hernia, the greater the risk of recurrence after surgery.
  2. A large inguinal hernia brings the risk of constriction: a part of the intestine can become trapped in the hernia, causing the blood flow to decrease and even tissue death (necrosis) can occur.
    * If there is an entrapment, this is accompanied by extremely severe pain and an emergency operation is required (usually this will be done with mesh).
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