This disease is most common in men: among the total number of inguinal hernia patients, the stronger sex is between 90 and 97 percent. Such a frequent manifestation of the disease in men is associated with anatomical characteristics of the inguinal region.
As a result of certain reasons related to lifestyle, specific work or due to genetic predisposition, specific weaknesses can form in the walls of the most diverse cavities of both men( inguinal) and women( abdominal, navel).These areas in medical terminology are called hernial gates, through which different internal organs can protrude into the subcutaneous area, thereby forming a hernia.
Virtually in all cases inguinal hernia treatment requires surgical, regardless of the symptoms and location of the dislocation. In men, it often descends into the scrotum, thereby forming an inguinal and scrotal hernia.
Causes of
All inguinal hernias are divided into congenital and acquired. Congenital usually diagnosed in children, they account for approximately 90% of all children's hernias. In adults, only 10-12% of congenital hernias are diagnosed.
This type develops when intrauterine development is impaired. They can appear already in the period of newborns or( which happens more often) gradually increase with age. Sometimes congenital inguinal hernia can be combined with other developmental malformations.
Approximately 85% of all hernias are acquired. The emergence of a hernia is associated with predisposing causes and producing.
Predisposing causes of are:
- genetic predisposition to the occurrence of this problem;
- age, the older, the appearance of the disease is more likely;
- features physique;
- degree of fatness and stability of weight, if a person quickly grows thin, it increases the likelihood of a pathology;
- paralysis of the nerves responsible for the innervation of the muscles of the abdominal wall.
And all the factors that cause pressure increase in the abdominal cavity are considered to be productive, which leads to the appearance of a hernia.
These factors include:
- hard work, sports;
- constipation;
- labored urination;
- frequent cough.
And of course, for the emergence of this trouble, the presence of the inguinal canal is an indispensable condition.
Slanting and straight
Inguinal hernia in men can be of two types: spit and straight. The names speak for themselves.
- Slanting - runs obliquely through the inguinal canal, protruding through the inguinal opening. Such a hernia in men can fall into the scrotum.
- Direct - directly related to weakening of the back wall of the inguinal canal. It passes only through the external aperture of the inguinal canal. The cause of all these problems are the weak muscles of the back wall of the inguinal canal. Conservative treatment of inguinal hernia is impossible. To eliminate the causes of its occurrence, an operation is performed to strengthen the back wall of the inguinal canal.
Inguinal-scrotal hernia
Inguinal-scrotal hernia is the prolapse of internal organs to the scrotum, due to the failure of the connective tissue of the inner or outer inguinal ring, which are natural openings in the abdominal wall. It is formed for various reasons. In children, congenital or hereditary factors play a decisive role. In adults, these are acquired factors.
This hernia is oval. In this case, the protrusion is lowered into the scrotum, which leads to a stretching of the corresponding species, concentrated on one side and leading to a visual asymmetry.
Symptoms of inguinal hernia in men
In the case of inguinal hernia, symptoms can manifest immediately after birth or during life. The primary signs of acquired and congenital inguinal hernia are the same.
Most often the man himself discovers a swelling or protrusion in the groin area. In most cases, this swelling increases with physical activity and even with coughing. To the touch appeared soft, elastic, painful sensation formation is not observed.
Inguinal hernia in men decrease when going to the prone position and increase in standing position. When pressed, the protrusion can easily be adjusted, and a characteristic rumbling is heard. In the corrected state, a wide inguinal ring is easily probed through the skin in the groin. If the hernia is in the scrotum, it will not be symmetrical.
This pathology can be complicated by infringements and inflammations of the hernia, in addition, in some cases, begins ischemic orchitis( inflamed testicles), intestinal obstruction due to stagnant stool.
When is infringed on the organs of , emergency care may be necessary. By the way, this condition can be recognized by the following symptoms:
- blood in the feces;
- impossibility to go to the toilet on a large;
- nausea before vomiting;
- inguinal pain;
- does not fall even when lying down.
In some cases, inguinal hernia symptoms are confused with a disease such as dropsy. But to distinguish them easily by the location of the testicle: when dropsy it is located in the dropsy, and with hernia - beyond its limits. In addition, when dropsy at the formation of a tight surface, and with a hernia - soft.
Consequences of inguinal hernia if you do not perform the operation
If a strange bulge is found, even if the pain is absent, the man should see the doctor. Otherwise, the consequences will be more serious.
A timely visit to a specialist will relieve the patient of such possible consequences:
- inflammation of a hernia or testis;
- transformation from the usual to the restrained, which is the most dangerous character, leading to death;
- obstruction of the intestine, the appearance of constipation and congestion stool.
If the doctor has noticed the characteristic signs of the pathology, then he offers the only option - to carry out the removal. How to treat inguinal hernia, and what type of surgery should be chosen by the surgeon along with the patient, in each case, the tactics of surgery may be different.
Inguinal hernia in men: treatment without surgery
If an inguinal hernia is found in men, treatment should be performed promptly, but sometimes there are situations when the operation has to be postponed for a while. In this case, patients are prescribed to wear a special bandage, which helps prevent the development of the disease and infringement of internal organs.
You should know that the bandage does not save the man from the disease, but only can maintain a hernia in a stable condition. It is rather a preventive tool than the treatment itself.
To apply a bandage it is recommended in such cases:
- With enhanced training and increased physical activity. Bandages should be worn by men who are engaged in power sports( wrestlers, weightlifters).
- The bandage should be worn if there are sharp pains and a risk of infringement.
- In the postoperative period, this device is attributed to patients to reduce stress on the seams and restore the normal tone of the muscular system
. The bandage is forbidden to use if the hernial sac is already infringed and not refilled.
Treatment of inguinal hernia
The presence of inguinal hernia does not require urgent surgical intervention, so the operation is planned in advance( if there is no infringement).
Unfortunately, conservative methods, treatment with folk remedies, various medications or wearing bandages can not save you from the disease. This is due to the anatomical structure of the person. In the case of inguinal hernia, treatment in men is possible only by surgery.
The main task of surgical intervention is to return to its place the contents of the hernial sac, as well as close the hernial gates so that there is no relapse of the disease.
The operation to remove the inguinal hernia is of two types:
- Complete removal of neoplasm with suture of inguinal opening;
- Removal of the hernial sac, strengthening the area where the hernia has arisen, a special mesh to avoid recurrence of the disease. Most often, such an operation is performed endoscopically.
The operation is characterized by a classical scheme according to which the physician gets access to the inguinal canal, after which the hernial bag is excised and cut off by the surgeon and the inguinal opening is sutured. Provision of access is possible by the endoscopic way, in which a small puncture is made in the abdominal wall.
Physicians also use the Liechtenstein method, which makes a cut of 10-12 centimeters, which is necessary for the inference of the hernial sac. To strengthen the area and prevent relapse, a special net is sewn.
In addition to these 2 methods of treatment of inguinal hernia in men, the use of obturation plastic is widespread today, during which a cut is made 3-4 cm in size, after which the hernial sac is guided into the abdominal cavity and inguinal canal. In order to strengthen, the net is also sewn.
Inguinal hernia operation in men occurs under local anesthesia, but there are cases when resorting to general. Depending on the treatment method used, the rehabilitation period has a different duration. If applied obturative plastic, it lasts only a few hours. With the complete removal of the inguinal hernia, the rehabilitation period can increase to several days.
How long does the operation take?
The operation to remove a hernia lasts up to an hour and a half. How much time this will take will depend on the size of the hernia, the presence of infringement, as well as the chosen method of surgical intervention.
In addition, the type of anesthesia used will depend on the choice of operation - general, local or combined.
Rehabilitation after surgery
After surgery, strict adherence to the diet is required. Do not eat foods that cause the formation of gases: fruits, yoghurts, sweets. Showing two days of bed rest, and later - a strict restriction of any physical activity. A few days after the surgery, they begin to make dressings, and after ten days they remove the stitches.
Sometimes, immediately after surgery, doctors recommend wearing an inguinal bandage. If there is excess weight, you need to try to reset it, since obesity gives you an extra burden on weakened muscles.