Inguinal Hernia

What is an inguinal hernia?

Huge Inguinal Hernia

The inguinal region is the lowest part of the abdominal wall on either side. It is where the cord passes from the abdomen to the testicle in the scrotum. Hernias around the spermatic cord are called inguinal hernias.

An Inguinal hernia is the most common type of hernia.

If you have a hernia chances are that it is an inguinal hernia.

A hydrocele, a varicocele and testicular cancer can mimic an inguinal hernia.

This is why self diagnosis is discouraged. To be sure of what you have you need to speak with a physician.

All clinical inguinal hernias should be fixed.

An Inguinal hernia is a hernia that occurs in the groin or more precisely in the inguinal canal. The inguinal canal is a passage from the abdomen to the scrotum that carries the blood supply for the testicle and the vas deferens which carries sperm from the testicle to the prostate. An indirect hernia is a hernia that follows the spermatic cord through the internal ring. The internal ring is supposed to be just wide enough to accommodate the spermatic cord. A direct inguinal hernia enters the inguinal canal anywhere other than the internal ring.

The internal ring is a congenital weakness of the abdominal wall that all people are born with, men and women alike. The weakness is more severe in some patients and over time develops into a full fledged indirect inguinal hernia. Transversalis fascia comprises the floor of the inguinal canal. Weakness here may be due to the internal ring interrupting the transverse fibers within the fascia. This weakness can worsen with time and develop into a direct inguinal hernia.

Inguinal hernias cause pain or swelling in the groin just above the fold where the thigh bends. As the hernia grows in size it moves towards the scrotum and in the worst cases may actually fill the scrotum. With small hernias pain may be the only symptom. This pain may be anywhere from the kidney to the testicle. Some patients get crampy abdominal pain, nausea and vomiting or constipation. Abdominal pain, nausea and vomiting are alarming symptoms because they may be a sign of an immediately life threatening complication such as bowel strangulation.

We do not believe subclinical inguinal hernias should be fixed. We have taken care of many patients who recieved mesh hernia surgery for subclinical inguinal hernias and then developed the dreeded complication of chronic pain.

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"Milan—Chronic groin pain after hernia surgery is now considered the most important issue facing inguinal hernia surgeons and their patients. Yet, there is still much uncertainty surrounding what causes the pain and how to prevent it." - Victoria Stern, General Surgery News

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