Inguinal hernias are much less common in women than in men. For every female patient with an inguinal hernia there are 8 male patients with the same clinical picture. There are direct and indirect inguinal hernias that enter the inguinal canal at different locations, but both leave the inguinal canal at the so-called outer inguinal ring.
In women, the indirect (or also lateral) inguinal hernia is more common. The hernial sac enters the inguinal canal at the inner inguinal ring, a muscle weak point of the abdominal wall, and then runs together with the uterine ligament (Lig. teres uteri) to the outer inguinal ring and then exits together with this ligament at the outer inguinal ring and can then be palpated as a protrusion in the inguinal region. The hernial sac may contain organs of the abdominal cavity such as parts of the intestine.
Causes
The muscle layer of the abdominal wall in the groin region is always under pressure from the organs in the abdominal cavity. When carrying heavy things or when coughing, sneezing or going to the toilet, the pressure on this muscle wall increases. Normally, the muscle wall can withstand these pressures without any problems.
However, if either the pressure is too great or the muscle wall is too weak, an inguinal hernia can occur. During pregnancy, the pressure on the muscle wall in the groin region is particularly high, which is why inguinal hernias occur more frequently during pregnancy than usual. Inguinal hernias in women can also be promoted by weak connective tissue or hormonal influences that lead to a breakdown of the connective tissue.
Symptoms and complications
A complete inguinal hernia in women is usually manifested by a bulge or thickening in the lower abdomen, which can be painful. The pain of an inguinal hernia occurs mainly during lifting or when the abdominal press is used. The size of the hernia does not correlate with the extent of the pain.
An incomplete inguinal hernia also causes pain in the groin, but in most cases it is not possible to palpate a bulge. The pulling or pressing pain is the only symptom. The hernia sac may contain organs of the abdominal cavity, especially intestines.
An inguinal hernia can become dangerous if these intestinal parts remain trapped in the inguinal hernia, because the intestine swells due to this trapping and is cut off from the blood supply. This complication is called incarceration, the affected intestinal section may die or an ileus (intestinal obstruction) may develop. Another possible complication is the inflammation of the fracture contents.
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