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Inguinal hernias, or groin hernias, make up about 75% of all abdominal hernias. They are roughly 25 times more likely to occur in men than in women. These hernias are divided into two groups: direct inguinal hernias, and indirect inguinal hernias. We will concern ourselves here with the first of the two groups – the direct inguinal hernia. Making a decision on hernia treatment options is easier when you are well informed. You may be able to delay surgery if your doctor says this is a viable option.
 The direct inguinal hernia occurs in a place in the lower abdomen where the abdominal wall is naturally thinner. It is very rare for it to protrude into the scrotum, though on occasion it will. Direct inguinal hernias most commonly occur in middle-aged and elderly adults. The abdominal wall tends to weaken with age, increasing the likelihood of a hernia.
Direct inguinal hernias occur when contents of the abdomen (such as fat, an intestinal loop, a part of the bladder, etc.) push through a weakened area of the abdominal wall into the inguinal canal.
Symptoms of a Direct Inguinal Hernia
1. Initial symptoms may be nothing more than a feeling of pressure or heaviness in the groin.2. Symptoms are most likely to appear during an activity such as lifting, coughing, or straining, or after standing on one’s feet for a long period of time. 3. As the hernia increases in size, it will eventually create a bulge under the skin in the groin area. 4. If a piece of intestine becomes trapped inside the hernia, the blood supply may be cut off to it and cause severe pain in the groin area.
Diagnosis
Doctors can usually diagnose an inguinal hernia through an interview with the patient and an examination of the affected area. On rare occasions, an ultrasound may be necessary to make an accurate diagnosis. Your physician may not know whether the hernia is direct or indirect until surgery is performed. This is not really consequential, though, since the treatment of each is generally the same.
Treatment
Inguinal hernias will not heal on their own. They cannot be corrected medicinally. At this time, the only way to repair them is through surgery. Though surgery may not be immediately necessary, depending on the size and severity of the hernia, if the hernia is symptomatic, it is likely to grow larger and create more severe symptoms over time. If a patient is a poor candidate for surgery because of health issues or because of advanced age, a truss may be used permanently in an effort to keep the hernia from enlarging.
Surgical options break down into two categories:
Open surgery remains the most common approach. It is performed under general or local anesthesia. The surgeon makes an incision in the groin, pushes the herniated material back into place, and repairs the breach in abdominal wall with stitches. A small piece of mesh material may be used to prevent the hernia from reoccurring.
Laparoscopic surgery is where the surgeon makes three small incisions in the abdominal wall and then inflates the abdomen with a harmless gas. Using a laparoscopic instrument and tools thin and long enough to be used through the small incisions, the surgeon makes the repairs.
Hernia operations are among the most common and successful procedures. Recovery time can be two weeks or less, although the patient should avoid heavy lifting for six to eight weeks after surgery. |
