How can you recognize an inguinal hernia? A protrusion in the groin area, sometimes with mild pain – this is indicative of an inguinal hernia. Unlike the umbilical hernia, it never spontaneously regresses. Therefore, for inguinal hernia in children, as for inguinal hernia in adults, the following almost always applies: inguinal hernia = surgery. In addition to signs and symptoms, the following article discusses the causes, development and treatment of an inguinal hernia.
Inguinal hernia: causes and development
In the body, there are natural weak points where the connective tissue is thin, for example, because vessels and nerves pass through there, or areas where existing connections in the development of the unborn child have not formed back later. There, the peritoneum can push through together with the intestinal loops – a hernia develops. A hernia is said to occur when the contents of the hernia push outward in the groin area.
- Congenital inguinal hernia (hernia congenita): inguinal hernia in children is usually due to the fact that the protrusions existing during childhood development do not close properly. This congenital form occurs more often in boys than in girls. About 1-4% of children or 20% of premature babies are affected; there is often a hereditary predisposition. The intestinal loops extend from the hernial orifice through the inguinal canal (in which the spermatic cord runs in boys) under the inguinal ligament. In boys, this hernia can extend into the scrotum (scrotal hernia) and affect the testicles there; in girls, the hernia can extend into the labia (vaginal hernia). In boys, if fluid from the abdominal cavity reaches the scrotum instead of the intestinal loops, this is called a testicular hydrocele. However, this usually forms back by itself, unlike the inguinal hernia.
- Acquired inguinal hernia (hernia acquisita): in adults, an inguinal hernia is caused by a constant increase in pressure, for example, by playing wind instruments, chronic coughing or heavy physical work, but also as a result of pregnancy or a tumor at congenital weak points of the abdominal wall. Women are far less often affected by a hernia than men.
Inguinal hernia: symptoms and signs
A soft protrusion on one side or both sides in the groin area, easily visible and pushable away: This is how an inguinal hernia can be recognized. Inguinal hernia symptoms are particularly pronounced when crying, coughing, and sneezing or having a bowel movement. In other words, whenever the pressure in the abdominal cavity increases and the moving intestines are forced out. Inguinal hernia in children, as well as inguinal hernia in adults, is sometimes also accompanied by pulling abdominal pain or groin pain, which occurs mainly with exertion. More severe pain is critical, especially if it makes the abdomen feel very hard and causes nausea and vomiting. These symptoms may indicate a life-threatening incarceration (incarceration) of the inguinal hernia. Usually, the hernia can then be felt as a bulging lump that cannot be moved.
Inguinal hernia: recognize and act
If you discover a bulge in your groin in your child or yourself, seek medical attention in a timely manner. Sometimes the pain resembles that of a groin strain (an overstretching of the thigh muscles) – though in the latter, there is no palpable protrusion in the groin. Unlike an umbilical hernia, an inguinal hernia never spontaneously regresses. Since the risk of incarceration is relatively high, especially in the first year of life, inguinal hernias must be closed during hernia surgery. Only in exceptional cases, for example if the affected person has an enormously high surgical risk, inguinal hernia surgery is not performed. In the case of an incarceration, a doctor must be consulted directly and surgery must be performed as soon as possible so that the incarcerated tissue does not die. In other cases, inguinal hernia surgery can be planned at rest.
Inguinal hernia surgery: surgical methods
Once the diagnosis of inguinal hernia is made, the further procedure is prepared and discussed. In the case of an inguinal hernia in children, it is usually standard to operate on the inguinal hernia on an outpatient basis. However, if the inguinal hernia is incarcerated, hospitalization is to be expected. In adults, surgery is usually not performed on an outpatient basis.Depending on the type and extent of the hernia, there are different methods of surgery to close the hernia. Often, laparoscopic surgery is possible, which means accessing and closing the hernia through a very small incision using laparoscopy.
Inguinal hernia: duration of healing
The duration of healing after a power hernia depends on age, previous illnesses, type of hernia and type of surgery. It is important to know that the skin wound heals much faster than the internal wound. Therefore, light physical activities such as swimming or sexual intercourse may be started at the earliest three to four weeks after inguinal hernia surgery; jogging and cycling must be suspended for six weeks, and heavy physical activities even for several months.
