Symptoms of internal inguinal hernia in men. The first signs of the appearance of an inguinal hernia. The pathogenesis of inguinal hernia

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Inguinal hernia- a disease that is diagnosed mainly in boys, but often the disease affects adult men. Many factors can lead to the appearance of a hernia in the groin: from malnutrition and abuse of bad habits to congenital developmental defects, in particular, congenital weakness of the connective fibers of the inguinal ring.

Treatment of an inguinal hernia without the use of surgical methods is possible, but a positive outcome of conservative and alternative methods is unlikely: in most cases (about 87%), the patient has to undergo surgery. The probability of successful treatment is high only if it was started at the initial stage of the disease. Therefore, it is important to be able to recognize the very first signs of a hernial protrusion in the groin.

What does a hernia look like

A hernia in the groin is a very insidious pathology, since in the initial stages the patient may not have any complaints about well-being. Visually determine the violation on early stage almost impossible. The exception is when the protrusion is initially large (see photo).

Inguinal hernia (photo): outside view

Inguinal hernia: inside view

It is possible to suspect the presence of a hernia in the groin, if the disease is just beginning to progress, according to certain signs. It should be borne in mind that these symptoms may be present in other pathologies not associated with the appearance of a hernial sac.

First symptoms

The first symptoms of the disease include:

Pain in the groin and abdomen. Pain at the initial stage of moderate intensity, as the pathology progresses, the pain syndrome becomes more pronounced and interferes with active life and do the usual things.
Pain in the lumbar and sacral regions. A rare symptom, manifesting mainly in men over 40 years of age, as well as those who are overweight.
Discomfort when walking. Even if the hernial sac is small, the patient may notice discomfort while moving, walking up stairs, etc. As the hernial sac grows, the discomfort increases and can lead to disability.
Difficulty urinating ( about the main causes of frequent tormenting in men Napsiano here ). It occurs in about ¼ of men who are unaware of the presence of the disease. Pain and inability to empty the bladder may be the result of part of the organ getting into the hernial sac. Burning and pain during urination may also indicate an infection of the organs of the reproductive system, so a visit to a doctor is mandatory for this symptom.
Constipation. They are frequent companions of this slaughter in men, especially in the early stages. Constipation must be treated by increasing the amount of fiber in the diet or using medications. Difficult defecation can lead to a significant deterioration in well-being and the development of pathology.

None of the symptoms can reliably indicate an inguinal hernia, since there is a high probability of the presence of internal pathologies or diseases that have a similar clinical picture. Only a doctor can accurately determine the cause and make the correct diagnosis.

Symptoms of a strangulated hernia

Infringement is the most dangerous complication, which can occur if the patient delays treatment.

When a hernia is incarcerated, the inguinal ring is compressed, squeezing the vessels going into the hernial sac. This leads to the necrosis of the organs located there (intestinal loops or part of the greater omentum).

This condition leads to the development of necrosis and peritonitis, manifesting symptoms of an acute abdomen. This condition leads to the development of necrosis and peritonitis, manifesting symptoms of an acute abdomen. Therefore, a pinched hernia in men is an indication for emergency surgical intervention.

Infringement is always accompanied by characteristic symptoms, the most reliable of which is acute pain in the abdomen (other causes of abdominal pain are described here), accompanied by cramps and spasms (in some cases). The pain appears as a result of compression of the nerves and blood vessels located in the strangulated part of the intestine.

In addition to pain, a pinched hernia can be recognized by the following symptoms:

tension of the abdominal muscles;
impossibility of reduction;
severe pain when trying to set;
lethargy, malaise;
nausea and vomiting (very rare).

Types of inguinal hernia in men

By location:

direct - passes directly through the abdominal cavity without touching the inguinal canal;
oblique - localized in the inguinal canal, pinching the vessels of the testicles and the spermatic cord.

According to the position of the hernial sac:

inguinal - the contents of the sac descend only into the inguinal ring;
inguinal-scrotal cord - descends down to the scrotum;
inguinal-scrotal testicular - affects the scrotum and testicles (or the area around them).

Diagnosis of the disease

Diagnosis of the disease is aimed at identifying and recognizing an inguinal hernia in a timely manner. When symptoms appear, you do not need to try to independently determine the nature of the disease, since the symptoms of the disease are similar to other pathologies (for example, inguinal lymphadenitis, dropsy of the testicle, etc.).

The first thing to do when noticing a protrusion in the groin area is to contact a surgeon or urologist.

The doctor will conduct a complete examination, collect the patient's history, prescribe the necessary set of diagnostic measures, if necessary.

For early diagnosis, the following methods are used:

palpation of the inguinal region and external genital organs;
visual examination (the doctor may ask the patient to perform several simple exercises to assess the nature of the protrusion, its size and shape);
Ultrasound of the scrotum (it can be used to determine what exactly the organ cavity is filled with;
diaphanoscopy (translucence of the scrotum with a lamp);
examination of urine and blood.

If the disease is confirmed, the doctor will recommend methods of treatment, as well as assess the need for surgical intervention.

Treatment of inguinal hernia in men

Completely cure such a violation in men can only be surgically. To eliminate, use one of two methods of operations:

Endoscopic - removal of a hernia is performed through tiny punctures in the anterior abdominal wall. The operation is possible only under general or local anesthesia. Endoscopy is suitable for small hernias. With endoscopic interventions on large hernias, the risk of re-formation of the anomaly is high.
Open - the surgeon cuts a part of the peritoneum and inguinal canal in the area of localization, completely excising the formation. To prevent relapses, plasty with local tissues is performed or a mesh implant is installed that strengthens the walls of the canal.

It is not always advisable to carry out the operation. At the discretion of the doctor or if the patient refuses surgery, the patient should adhere to the following recommendations:

Wearing a bandage - reduces the load on the painful area, prevents pinching and an increase in inguinal hernia. But it is forbidden to wear a bandage all the time, as the abdominal muscles gradually weaken and the patient's condition worsens.
Exercise therapy - only a specialist should be involved in compiling a set of exercises. Exercise therapy classes effectively help strengthen the abdominal wall and increase its resistance to physical. loads.
Ointments - the use of pharmacy gels helps to reduce the severity of the resulting bumps and relieve pain. Well-established drugs such as: Chondroxide, Dikul's ointment, Karipazim, etc.

Rehabilitation after surgery

Rehabilitation after an operation on an uncomplicated inguinal hernia begins in a hospital and continues after discharge, it takes no more than 2 weeks. If the manipulation was carried out under local anesthesia, then the patient is observed for at least a day and sent home. If the anesthesia was general, then stays in the hospital for 5 days.

In the hospital, the man observes bed rest (the duration depends on the volume of the operation, complications), and receives analgesics. Antibiotics are prescribed as indicated. When the doctor allows you to get up, you need to put on a bandage. This will help the muscles contract less and heal faster. If an operation was performed using a mesh polypropylene implant, then the bandage is not worn.

After discharge, the man should:

process seams;
do not lift more than 5 kg;
avoid foods that give excessive gas formation (cabbage, legumes, black bread, whole milk, carbonated water), give preference to protein foods;
relieve the need at the first urge, without delaying urination;
avoid constipation - excessive straining is not necessary:
be careful when sneezing, coughing, try to soften the movement, reduce its amplitude;
perform exercise therapy if prescribed by a doctor;
follow the bandage - in case of discharge, consult a doctor unscheduled;
know that moderate pain in the 1st week is normal.

The danger of inguinal hernia and the consequences of untimely treatment

Timely seeking the help of doctors, as well as a quick diagnosis, significantly increase the chances of curing a hernia without the use of surgical methods. This is one of the most important arguments in favor of an immediate visit to the surgeon when symptoms are observed.

To assess the full danger of this disease, it is worth knowing what consequences ignoring the hernial sac can lead to.

Infringement of a hernia. The most severe and most dangerous complication that occurs when the vessels going into the hernial sac are squeezed. The condition is dangerous for the life of the patient, therefore, if a pinched hernia is suspected, it is necessary to call an ambulance.

tissue necrosis. Represents tissue necrosis as a result of squeezing of blood vessels. Blood ceases to supply the strangulated organ with the necessary nutrients and oxygen molecules, which leads to necrosis and peritonitis.

Appendicitis. An acute attack of appendicitis can be triggered by prolonged clamping of the appendix (or rather, its vessels) in the inguinal ring. At the same time, the patient feels a sharp attack of pain in the right side of the abdomen, he has vomiting, the body temperature may rise.

Peritonitis. Inflammation of the abdominal organs that occurs with the progression of the inflammatory process. Most often, peritonitis occurs with a strangulated hernia.

Coprostasis. It is a sinking of the large intestine into the hernial sac. The condition is characterized by the inability to empty the intestines and pain during bowel movements. Coprostasis can lead to impaired blood circulation in the intestinal vessels, insufficient blood supply and partial dysfunction of the large intestine. Pathology is deadly in the absence of the necessary treatment.

Impotence. A frequent occurrence in patients who delayed the trip to the clinic or neglected the appointments of the attending surgeon.

Inguinal hernia in men is successfully treated - after the necessary therapy, the patient fully returns to normal life and professional activity. To avoid the most severe consequences, you should know the first symptoms of the disease and go to the hospital at the slightest suspicion of this diagnosis. This is the only way to maintain health and a fulfilling life.

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The site provides background information for informational purposes only. Diagnosis and treatment of diseases should be carried out under the supervision of a specialist. All drugs have contraindications. Expert advice is required!

general description

Inguinal hernia is the most common surgical pathology in childhood. It mainly occurs in boys, but can also be diagnosed in adult men. inguinal hernia in men, it is a hernial protrusion that descends into the inguinal canal and scrotum.

Most often there are unilateral inguinal hernias - on the right or on the left. But they can also be bilateral. In most cases, males suffer from pathology, although female inguinal hernias also occur. This is due to the fact that in the process of intrauterine development in boys, the testicles located in the abdominal cavity gradually descend into the scrotum.

Classification

All inguinal hernias are classified based on:
1. The size and position of the hernial sac:

actually inguinal hernia: the bag is located exclusively in the inguinal canal;
inguinal-scrotal cord hernia descends into the scrotum, but does not reach the testicle;
inguinal-scrotal testicular hernia descends into the scrotum and reaches the testicle, may be located around it.

2. Depending on the location and nature of the formation of a hernia:

direct inguinal hernia passes directly through the abdominal wall, bypassing the inguinal canal (it is formed during physical exertion, and is associated with weakness of the ligamentous apparatus);
an oblique inguinal hernia passes through the inguinal canal - a natural opening of the body, which is normally filled with the spermatic cord and testicular vessels.

3. Depending on the causes:

congenital inguinal hernia is a congenital malformation (the mechanism of its formation will be discussed below);
acquired inguinal hernia is most often the result of a combination of two factors: congenital weakness of the ligamentous apparatus and excessive physical exertion (this type of inguinal hernia is much less common).

4. Also, inguinal hernias are divided into:

male - occur in boys, the causes of their occurrence are discussed below;
female or, as surgeons call them, girlish - a much rarer occurrence.

5. Depending on the infringement:

strangulated inguinal hernia - an acute threatening condition that requires emergency medical care;
uninjured inguinal hernia.

Causes of inguinal hernias

A bit of anatomy

A prerequisite for the appearance of oblique inguinal hernias is the presence in a person of such an anatomical formation as the inguinal canal. It begins inside the abdominal cavity, on the inner surface of the anterior wall of the abdomen, then passes inwards and downwards, opening with an external opening slightly above the scrotum in men, and slightly above the labia majora in women.

The walls of the inguinal canal are formed by muscles and ligaments. Normally, this hole does not exist. It is filled with the spermatic cord in men and the round ligament of the uterus in women. But under certain conditions, it is the inguinal canal that can become the site of the exit of the hernial protrusion.

Why does this happen most often in boys?

In order to understand why boys are most often affected by pathology, consider the process of intrauterine development.

When a male fetus is still in its mother's abdomen, its testicles are located in the abdomen, close to the kidneys. Gradually, they go down, and by the time of birth they should take their usual place in the scrotum. But, descending, the testicle carries with it a piece of peritoneum - a film of connective tissue that lines the inside of the abdominal cavity. As a result, a small pocket from the peritoneum is formed in the scrotum. In a newborn boy, it should completely overgrow and turn into a strand of connective tissue.

However, this does not always happen. Sometimes the vaginal process of the peritoneum (that's what this pocket is called) remains open. It forms a hernial sac into which the internal organs located in the abdomen can fall out.

The ovaries in girls always remain in their place, so they do not have a vaginal process of the peritoneum - accordingly, inguinal hernias also occur much less frequently.

Acquired inguinal hernias

The origin of acquired inguinal hernias is very different from congenital ones.
In order for a direct inguinal hernia to form, or an acquired oblique one, two factors must be present:

congenital weakness of the connective tissue and inguinal ring;
excessive physical activity, in which there is a strong straining of the abdomen and an increase in intra-abdominal pressure.

As physical activity, capable of increasing intra-abdominal pressure, is most often weight lifting. In some patients, a hernia can form even with severe coughing and sneezing, indomitable vomiting, which increases pressure in the abdominal cavity.

What is inside the hernial sac in an inguinal hernia?

Most often, in boys, loops of the small intestine go into the hernial sac, which have the greatest mobility. At an older age, the greater omentum can act as the contents of the hernial sac - a sheet of connective tissue that hangs down inside the abdominal cavity in the form of an apron.

In girls, the fallopian tubes and ovaries often fall into the inguinal hernia.

Sometimes the large intestine of a child has increased mobility. In this case, the caecum enters the hernial sac. As a result, the hernia, as it were, lacks a back wall, and surgeons call it a sliding one.

Symptoms

Congenital inguinal hernia

Symptoms of a congenital inguinal hernia are usually detected immediately after birth. A newborn child has a protrusion located in the inguinal region:

if this is an ordinary inguinal hernia, then the protrusion has a rounded shape;
if the hernial sac descends into the scrotum, then the protrusion is elongated.

It has a dense elastic consistency, it can be easily felt on its own.

The following additional symptoms are characteristic of an inguinal hernia:

the protrusion can significantly decrease or even disappear when the child is in the supine position, and vice versa, appear and increase in the upright position;
if you press on the hernial protrusion, then it can often be corrected, and a characteristic rumbling will be heard;
when a child coughs, sneezes or strains, the hernia increases in size and becomes more intense - you can easily feel it if you put your hand on it;
when the inguinal hernia is in a reduced state, an expanded inguinal ring can be easily felt through the skin;
if the hernial sac descends into the scrotum, then its corresponding half increases in size.

A girl's inguinal hernia almost always has a spherical shape. But sometimes it is so large that it descends into the labia on the corresponding side, leading to its increase in size.

Usually, inguinal hernias are not accompanied by any other symptoms. Sometimes the child may be disturbed by pain, digestive disorders, bloating. In children under the age of one year, it is generally difficult to say what caused such symptoms - an inguinal hernia, or some other reasons.

Can an inguinal hernia go away on its own without surgery?

Very often, the umbilical hernia, which is present in a newborn child, goes away on its own. It occurs due to the weakness of the umbilical ring, and as soon as it strengthens, the hernial protrusion completely disappears. This usually happens by 3-5 years of age.

In this regard, some parents are interested in whether an inguinal hernia can pass on its own, without surgical intervention, in this way?

Congenital inguinal hernias never go away on their own. After all, their occurrence is associated with the presence of the vaginal process of the peritoneum, which normally should overgrow and turn into a strand. Without surgical treatment, it will not go anywhere and will not disappear.

Symptoms of an acquired inguinal hernia

With an acquired inguinal hernia, all the same signs take place as with a congenital one. The patient himself finds a protrusion in the inguinal region, which disappears in the supine position, reappears and increases in the standing position, and when straining.

Before the appearance of a hernia, as a rule, there is intense physical activity.

If the hernia is small, the patient is not bothered by any additional symptoms.
If the inguinal hernia in men exists for a very long time, and greatly increases in size, the following symptoms may occur:

constant aching pain in the area of the hernial protrusion, in the lower abdomen, in the lumbar region, due to compression of a large number of intestinal loops or other organs;
constipation - also due to compression of the intestine in the hernial sac;
other symptoms of indigestion may occur, such as bloating.

If part of the bladder gets into the hernial sac, which is extremely rare, problems with urination may occur.

Sometimes falling into the bag of the cecum leads to the development of acute appendicitis. In this case, characteristic symptoms arise: severe abdominal pain, nausea and vomiting, diarrhea and constipation, fever, and general well-being.

Infringement of inguinal hernia in men

This condition is the most common complication of an inguinal hernia. If the intestinal loops or parts of the omentum are pinched in the inguinal ring, due to which blood circulation is disturbed in them, and subsequently necrosis (necrosis) may develop.

Infringement of an inguinal hernia is facilitated by intense physical activity, severe coughing, sneezing, vomiting, various digestive disorders, and bloating.

Symptoms of strangulated inguinal hernia

At the moment of infringement, severe pain in the lower abdomen immediately occurs due to compression of the nerves and vessels of the strangulated intestine. Older children and adults usually self-identify this symptom and tell the doctor when it occurs. In a small child, this is manifested by signs of general anxiety. He kicks his legs and cries loudly.

If at this moment you feel the patient's stomach, it turns out to be very tense. When pressed, the hernia is not reduced inward, but the pain increases significantly.

After a while, the pain may subside. However, the patient becomes lethargic, complains of weakness, feeling unwell. He is missing a chair.

Despite the fact that the infringement of the inguinal hernia is manifested by such vivid symptoms, it is not always possible to accurately establish the diagnosis. Sometimes lymphadenitis (inflammation of the inguinal lymph node) or an acute cyst of the spermatic cord can be masked under similar manifestations. Nevertheless, the infringement of the inguinal hernia is too dangerous a condition, therefore, in all doubtful situations, the surgeon still decides to have surgery.

It is very difficult to make a diagnosis with strangulated inguinal hernias in girls and women. If the fallopian tube and ovary are infringed in the hernial sac, then this condition is not accompanied by severe pain. The patient's condition seems to be quite satisfactory. But, while the patient feels well, the strangulated ovary may become completely dead. Therefore, if the girl has at least a slight suspicion of infringement of the inguinal hernia, surgical intervention is immediately performed.

Strangulated inguinal hernia in children has some features compared to adults. The blood flow in the children's intestines is more intense, and the inguinal ring cannot squeeze the organs that have fallen into it too much. However, the child may react to the infringement of a hernia with very violent symptoms: fever, impaired consciousness, nausea and vomiting.

Be that as it may, a strangulated inguinal hernia is an emergency, very dangerous condition. It requires immediate medical attention. The operation should be carried out as early as possible, otherwise complications such as necrosis of the strangulated organ and peritonitis (inflammation in the abdominal cavity) may develop.

Complications of inguinal hernia

Many complications of inguinal hernia have already been described above. The main ones are:

infringement of a hernia - occurs most often, and requires emergency surgical intervention;
necrosis (necrosis) of intestinal loops, parts of the omentum, ovary or fallopian tube that have fallen into the hernial sac - all these conditions are complications of infringement of the inguinal hernia;
the development of peritonitis - inflammation of the entire abdominal cavity, is also a consequence of a long-term infringement;
acute appendicitis - inflammation in the appendix, which develops as a result of compression of its vessels in the inguinal ring;
less formidable complications of inguinal hernia: indigestion, constipation, bloating, etc.

Diagnosis of inguinal hernia

Medical examination

Diagnosis of congenital inguinal hernia in children, or acquired inguinal hernia in adults, begins with an examination by a surgeon. The doctor evaluates the inguinal region visually, assesses the symptoms, feels the patient's inguinal ring through the scrotum with a finger. To verify the correctness of the proposed diagnosis, the doctor may ask the patient to lie down and stand up, strain, examine him after physical exertion.
Diagnosis of inguinal hernia in children is carried out by a pediatric surgeon, in adults - by a surgeon and urologist. If there is a suspicion of a strangulated inguinal hernia, it is urgent to call an ambulance team. She can deliver the patient to the hospital, where he will be examined by the doctor on duty on an emergency basis.

What diseases should be distinguished from inguinal hernia in children and adults?

Often the diagnosis of an inguinal hernia is very simple. After a short examination of the patient, the doctor can accurately diagnose the disease and prescribe the appropriate treatment.

But sometimes there are difficulties.
Inguinal hernia in children and adults must be distinguished from conditions such as:
1. Dropsy of the testicle - hydrocele. Pathology has the same origin as the inguinal hernia. But in this case, the vaginal process of the peritoneum has a narrower lumen, it contains not intestinal loops, but liquid. An inguinal hernia in women can never be confused with a hydrocele, because such a disease simply does not occur in girls. The treatment of both pathologies is very similar, so the ambiguity of the diagnosis before the operation is not critical. Sometimes only by making an incision and reaching the testicle, the surgeon can accurately distinguish a hydrocele from an inguinal hernia.
2. Inguinal lymphadenitis- inflammation of the lymph node, which is located in the groin. In this case, severe pain, fever and other signs of the inflammatory process are not always noted. The lymph node in the groin may simply be enlarged. Compared to an inguinal hernia, an enlarged lymph node has a firmer texture.

What additional research methods are used during the diagnosis of symptoms of inguinal hernia?

With an inguinal hernia, the following types of studies are prescribed:
1. Ultrasound of the scrotum. When conducting an ultrasound examination, it is possible to find out what is inside the scrotum: fluid or intestinal loops. Based on these data, it is possible to distinguish an inguinal hernia in men from a hydrocele - dropsy of the testicle.

2. A less informative, but easier to carry out method is diaphanoscopy - transillumination of the scrotum with a conventional lamp. Moreover, if there is liquid inside, light rays pass very easily. Dense structures do not let them through, making the transmitted light uneven.

Also, before planning surgery, with inguinal hernia, the following general clinical studies are carried out:

general blood analysis ;
general urine analysis ;
if necessary, a blood clotting test is performed.

Treatment of inguinal hernia

Is surgical treatment of an inguinal hernia always required?

As a rule, congenital inguinal hernias are treated only surgically. There are exceptions for adults. The final decision is made by the surgeon who examined the patient and prescribed the diagnosis.

Is it necessary to treat an inguinal hernia?

Yes, an inguinal hernia must necessarily be subject to treatment, which was prescribed by a doctor. Above, the complications of this disease were considered, which determine the need for therapeutic measures.

A strangulated inguinal hernia is a condition that can even threaten the patient's life. Therefore, its surgical treatment should be carried out urgently, as soon as possible.

Conservative methods of treatment of inguinal hernia

History reference
At the beginning of the last century, American doctors assured world medicine that they had found a conservative method for treating inguinal hernia. Drugs have been developed that, when injected into the hernial sac, cause it to collapse and turn into scar tissue. The technique was quite complicated, had a high cost and required a long preparation in the form of wearing special bandages. It was used for some time, and then was forgotten, as it often had severe complications:

the development of an inflammatory process, peritonitis in response to an injection;
scarring not only of the hernial sac, but also of the spermatic cord;
damage during the procedure of arteries and veins.

After a series of failures, all doctors were forced to admit that the only effective method The treatment for inguinal hernia is surgery. Conservative methods are still used today, but their use is the exception rather than the rule.

Wearing bandages for inguinal hernias
The only conservative technique currently used to treat inguinal hernias is the wearing of special bandages.

Indication for use this method are:

postoperative large inguinal hernia, when a second operation cannot yet be performed;
postoperative hernia, when a second operation cannot be performed due to the development of a suppurative process;
redness recurrence after surgical treatment;
inguinal hernia in patients who have contraindications to surgery: elderly age, diseases of the heart and blood vessels, a significant violation of blood clotting, etc .;
in children who cannot be operated on due to any medical conditions, a bandage may also be used.

The bandage is not a radical method of treating inguinal hernias. It only alleviates the patient's condition, prevents the increase in hernia and its infringement. But as soon as the patient stops wearing the bandage, all the symptoms of an inguinal hernia return.
However, the bandage also has many positive effects:

hernial protrusion at the time of wearing ceases to disturb the patient;
ability to work is restored to the previous level;
internal organs are securely held inside the abdominal cavity, the hernia is not able to increase in size or infringe.

The bandage should always be worn in the prone position, only on the naked body. At first, wearing it may cause some inconvenience, but over time the patient gets used to it. In this case, the correct selection of the bandage plays an important role. It is usually removed at night, but it can be left on when coughing and sneezing in a dream.

When wearing a bandage, it must be removed at least once a day to wash and wipe the skin in those places where it came into contact with the fabric.

If you wear a bandage for a very long time, gradually the muscles of the lower abdomen and groin may atrophy. Therefore, with rare exceptions, surgical removal of an inguinal hernia is still inevitable. Wearing a bandage should be carried out under the supervision of the attending physician, for example, a surgeon in a clinic.

How is a hernia repair performed for congenital inguinal hernias in children?

There are several techniques for removing inguinal hernias in children, but for the most part they all come down to one scheme:

a small incision is made under general anesthesia in the inguinal region, the doctor dissects the tissues and gets to the inguinal ring - the place where the hernial sac descends into the scrotum;
then the surgeon carefully separates the hernial sac from the testicle: it seems as if the testicle is right in the sac, but in fact it is not - they are just a little glued together;
after that, the surgeon cuts the hernial sac and checks: are there any intestinal loops or other organs left inside?
if something is inside the inguinal hernia, then it is set back into the abdominal cavity;
then the hernial sac is cut off, and that part of it that comes out of the inguinal canal is tied up;
this operation ends, the surgeon sews up the wound.

In itself, surgical intervention, in the absence of complications, is quite quick and simple. Sometimes it only takes 15 minutes.

Surgical interventions for congenital hernias in children have some features:

The inguinal ring of the child is not completely formed, with age it may narrow. Therefore, in children, surgeons are always limited only to cutting off the hernial sac, and never strengthen the inguinal ring during the operation. This makes intervention easier.
In children, such operations are always performed under general anesthesia, while in adults, local anesthesia may be used. Anesthesia is given light, short, because the operation is performed quickly.
In children, the operation can be performed through a very small incision, sometimes 1-1.5 cm. In this case, the operation is considered practically endoscopic. The scar after it is almost invisible.
Inguinal hernia in girls is even easier to operate than in boys, because it is not associated with the testicle. This operation is so simple that maiden hernia repair almost always becomes the debut of young surgeons.

Hernia repair in adults

If we put together all the options for operations that are used to remove inguinal hernias in children and adults, men and women, we get about a hundred options. This diversity suggests that there is no perfect methodology. But there are several types of operations that are most effective and are used by surgeons much more often. Here are their names according to the names of the authors who developed them: Bassini, Kimbarovsky, Ivanisevich, Martynov, etc.
Removal of inguinal hernias in men and women consists of the same stages, and has the same essence as in children.
However, there are some differences and features:

in adults, the intervention can sometimes be performed not only under general anesthesia, but also under local anesthesia;
in men, after excision of the hernial sac, additional strengthening of the inguinal ring (plasty, stitching with threads) is always performed in order to exclude recurrence of the inguinal hernia.

With inguinal hernias, planned surgical treatment is always carried out. This means that after establishing the diagnosis, the doctor prescribes a standard examination. Then the patient takes a turn for treatment in the hospital. The operation is carried out in a pre-planned time frame. There is no urgency in this case.

Surgical removal of strangulated inguinal hernia

Incarcerated inguinal hernia is an emergency condition that requires immediate attention. The operation must be performed as soon as possible. The patient is rushed to the surgery department.

During infringement, there is always a possibility that the loops of the intestine or part of the omentum that are in the hernial sac have become dead. Therefore, opening a hernia, the surgeon must carefully examine the contents of the bag.
Following are three options:
1. If the bowel looks completely normal and has all the signs of life, the surgeon simply sets it inside the abdomen and completes the operation as usual.
2. If there are initial signs of necrosis of the organ, the doctor tries to restore the viability of the intestine with the help of medicines.
3. Part of the intestine or omentum has finally died, then it is excised.

Sometimes infringement of an inguinal hernia occurs in premature and debilitated children, in patients who, for one reason or another, cannot be operated on.
In such a case, the infringement is first tried to be eliminated by conservative methods:

drug administration;
warm baths;
lying position with raised legs and pelvis.

If the above measures do not bring effect within 2 hours, the doctor decides on an operation.

How is recovery after inguinal hernia surgery?

After surgery for an inguinal hernia, the patient remains in the hospital for a few more days under the supervision of a doctor. Bandaging of the postoperative wound is performed.

Usually the sutures are removed from the wound on the 7th - 10th day. On the same day, the patient is discharged from the hospital. Children today are increasingly trying to apply cosmetic sutures from absorbable threads that do not need to be removed, and after which there are practically no scars.

For 2 to 4 weeks, children are advised to avoid physical activity, and adults are advised to wear a special bandage.

Full recovery of working capacity after surgery for inguinal hernia occurs 3–6 months after surgical treatment.

Before use, you should consult with a specialist.

Inguinal hernia is a common disease in which there is a noticeable protrusion of the peritoneum into the cavity of the inguinal canal.

This disease is most common in men: among the total number of patients with inguinal hernias, representatives of the stronger sex account for 90 to 97 percent. Such a frequent manifestation of the disease in men is associated with the anatomical characteristics of the inguinal region.

As a result of certain reasons related to lifestyle, the specifics of work or due to hereditary predisposition, specific weaknesses can form in the walls of various cavities of both men (inguinal) and women (abdominal, umbilical). These areas in medical terminology are called hernial gates, through which various internal organs can protrude into the subcutaneous region, thereby forming a hernia.

In almost all cases of inguinal hernia, treatment requires surgery, regardless of the symptoms and location. In men, it often descends into the scrotum, thereby forming an inguinal-scrotal hernia.

Causes

All inguinal hernias are divided into congenital and acquired. Congenital hernias are usually diagnosed in children and account for approximately 90% of all childhood hernias. In adults, only 10-12% of congenital hernias are diagnosed.

This type develops in violation of intrauterine development. They can appear already in the neonatal period or (more often) gradually increase with age. Sometimes congenital inguinal hernias can be combined with other malformations.

Approximately 85% of all hernias are acquired. The occurrence of a hernia is associated with predisposing causes and producing ones.

Predisposing causes This:

genetic predisposition to the occurrence of this problem;
age, the older, the more likely the occurrence of the disease;
body features;
the degree of fatness and weight stability, if a person quickly loses weight, this increases the likelihood of pathology;
paralysis of the nerves responsible for the innervation of the muscles of the abdominal wall.

And all the factors that cause an increase in pressure in the abdominal cavity are considered to be producing, which leads to the appearance of a hernia.

These factors include:

hard work, sports;
constipation;
difficulty urinating;
frequent cough.

And of course, for the occurrence of this trouble, the very presence of the inguinal canal is a prerequisite.

oblique and straight

Inguinal hernia in men can be of two types: a spit and a straight line. The names speak for themselves.

Oblique - passes obliquely along the inguinal canal, protruding through the inguinal opening. Such a hernia in men can descend into the scrotum.
Direct - directly related to the weakening of the posterior wall of the inguinal canal. It passes only through the external opening of the inguinal canal.

The cause of all these problems are weak muscles of the posterior 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 posterior wall of the inguinal canal.

Inguinal-scrotal hernia

An inguinal-scrotal hernia is a prolapse of internal organs into the scrotum due to 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 descends into the scrotum, which leads to a stretching of the corresponding type, concentrated on one side and leading to visual asymmetry.

Symptoms of an inguinal hernia in men

In the case of an inguinal hernia, symptoms may appear immediately after birth or throughout life. The primary signs of acquired and congenital inguinal hernia are the same.

Most often, a man himself discovers a swelling or protrusion in the groin area. In most cases, this swelling increases with exercise and even with coughing. To the touch, the appeared formation is soft, elastic, painful sensations are not observed.

Inguinal hernias in men decrease when moving to the prone position and increase in the standing position. When pressed, the protrusion is easily reduced, and a characteristic rumbling is heard. In the reduced state, a wide inguinal ring is easily felt 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 inflammation of the hernia, in addition, in some cases, ischemic orchitis begins (the testicles become inflamed), intestinal obstruction due to the fact that stool masses stagnate.

When organs are infringed may need immediate assistance. By the way, you can recognize this condition by the following symptoms:

inability to go to the toilet for the most part;
nausea to vomiting;
groin pain;
non-reduction of prolapse even lying down.

In some cases, the symptoms of an inguinal hernia are confused with a disease such as testicular dropsy. But it is easy to distinguish them by the location of the testicle: with dropsy, it is located in the dropsy, and with a hernia - outside it. In addition, with dropsy, the formation has a tight surface, and with a hernia, it is soft.

The consequences of an inguinal hernia, if you do not have surgery

If a strange protrusion is found, even if there is no pain, the man should see a doctor. Otherwise, the consequences will be more serious.

A timely visit to a specialist will save the patient from such possible consequences:

inflammation of a hernia or testicle;
transformation from ordinary to infringed, which is of the most dangerous nature, leading to death;
intestinal obstruction, the appearance of constipation and stagnation of feces.

If the doctor notices characteristics pathology, then he offers the only option - to carry out the removal. How to treat an inguinal hernia, and what type of operation to choose should be decided by the surgeon together with the patient, in each specific case tactics surgical intervention may be different.

Inguinal hernia in men: treatment without surgery

If an inguinal hernia is found in men, treatment must be performed promptly, but sometimes situations arise when the operation has to be postponed for some time. 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 relieve a man of the disease, but can only maintain a hernia in a stable condition. It is more of a preventative than a cure.

With increased training and increased physical activity. Bandages should be worn by men who are engaged in power sports (wrestlers, weightlifters).
The bandage must be worn if there are sharp pains and there is a risk of infringement.
In the postoperative period, this device is attributed to patients to reduce the load on the sutures and restore the normal tone of the muscular system.

The bandage must not be used if the hernial sac is already strangulated and cannot be reduced.

Treatment of inguinal hernia

The presence of an inguinal hernia does not require emergency surgical intervention, so the operation is planned in advance (if there is no infringement).

Unfortunately, conservative methods, treatment folk remedies, various drugs or wearing bandages will not be able to save you from the disease. It is caused due to the human anatomical structure. In the case of an inguinal hernia, treatment in men is possible only by surgery.

The main task of surgical intervention is to return the contents of the hernial sac to its place, as well as to close the hernial orifice so that there is no recurrence of the disease.

Surgery to remove an inguinal hernia is of two types:

Complete removal of the neoplasm with closure of the inguinal opening;
Removal of the hernial sac, strengthening the area where the hernia occurred with a special mesh to avoid recurrence of the disease. Most often, this operation is performed endoscopically.

The operation is characterized classical scheme, according to which the doctor gains access to the inguinal canal, after which the hernial sac is isolated and cut off by the surgeon and the inguinal opening is sutured. Providing access is possible endoscopically, in which a small puncture is made in the abdominal wall.

Doctors also use the Liechtenstein method, in which an incision of 10-12 centimeters is made, which is necessary to remove the hernial sac. To strengthen the area and prevent recurrence, a special mesh is hemmed.

In addition to these 2 methods of treating inguinal hernia in men, today the use of obturation plastics is common, during which a 3-4 cm incision is made, after which the hernial sac is reduced into the abdominal cavity and inguinal canal. For the purpose of strengthening, the mesh is also hemmed.

The operation of an inguinal hernia in men occurs under local anesthesia, but there are times when they resort to a general one. Depending on the method of treatment, the rehabilitation period has a different duration. If obturation plastic is used, it lasts only a few hours. With the complete removal of the inguinal hernia, the rehabilitation period can be extended to several days.

How long does the operation take?

The operation to remove a hernia lasts up to an hour and a half. How long it 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 the operation, strict adherence to the diet is required. You can not eat foods that cause the formation of gases: fruits, yoghurts, sweets. Two days of bed rest are shown, and subsequently a strict restriction of any physical activity. A few days after surgery, dressings begin to be made, and sutures are removed ten days later.

Inguinal hernia is an ailment that affects men much more often than women, causing considerable discomfort to the stronger sex. In addition, you should know that this disease is fraught with serious consequences, so you need to know the enemy in person and control the situation, not letting it take its course.

What is pathology in men

So what is a hernia? This term means protrusion or protrusion of internal organs or their segments through the weak points of the body. They can be both natural openings and weakened muscles. In the case of an inguinal hernia in men, there is a protrusion of a loop of intestine through the inguinal canal, resulting in a painless pasty swelling that may increase or decrease depending on the circumstances.

The inner surface of the abdominal cavity is lined with connective tissue called the peritoneum. The falling out fragments of the intestine are enveloped by the peritoneum, forming the so-called hernial sac. As already noted, inguinal hernia in most cases is recorded in men. This is dictated by the anatomical features of the male inguinal canal - it is less strengthened by tendons and muscles than in women. In addition, it is much wider and shorter.

Scheme of the formation of an inguinal hernia

Since at the beginning of the disease an inguinal hernia does not cause much discomfort to the patient, he is in no hurry to see a doctor, especially here it is necessary to take into account the special “love” of men for various medical procedures. However, this initially harmless swelling can be significantly complicated if its "owner" neglects medical care.

Types of inguinal hernia

Basically, surgeons distinguish between two types of inguinal hernia - oblique and direct. In the first case of the onset of the disease, the segments of the intestine fall out through the spermatic cord and are located inside it, and in the second case, the intestinal loops go directly into the inguinal canal without affecting the spermatic cord. In surgical practice, direct inguinal hernias are much more common.

Direct inguinal hernia, a loop of intestine protrudes into the inguinal canal

An oblique hernia can be either congenital or acquired, and a direct hernia can only be acquired. The main reason for the development of a direct hernia is a violation of the tone of the musculoskeletal apparatus, which may be the result of muscle damage, the result of a surgical operation or age-related changes.

In some cases, experts talk about a combined inguinal hernia, which combines both types of pathology. In this case, the patient develops several independent hernial protrusions of a different nature.

There is another classification of inguinal hernia in the medical literature:

cord (the hernial sac is located in the scrotal region, but does not reach the level of the testicle);
inguinal (hernial sac protrudes into the inguinal canal);
inguinal-scrotal (hernial sac descends into the scrotum and is located on the same level with the testicle).

What causes the development of the disease

Both congenital pathologies and a steady increase in intra-abdominal pressure can lead to the development of the disease, as a result of which, over time, a hernia gate is formed - a muscle defect through which segments of internal organs are pushed out. The following factors may lead to such a scenario:

strained chronic cough or frequent sneezing;
persistent constipation;
excess body weight;
weight lifting;
age-related weakening of the musculoskeletal system.

How to identify and recognize: symptoms and signs

An inguinal hernia has the following symptomatic picture:

the appearance in the groin of a soft to the touch and, as a rule, painless tumor at rest, which can increase with straining, coughing, etc., and spontaneously disappearing with a horizontal position of the body;
pain in the groin when straining and straining;
discomfort in the lower abdomen when moving, walking;
frequent constipation.

Inguinal hernia manifests itself as a feeling of discomfort in the lower abdomen

Is it dangerous

If the treatment of inguinal hernia is not started in a timely manner, the disease can be significantly complicated. Possible options complications:

infringement of the intestinal loop - compression of the prolapsed part of the hernial sac by the hernial ring;
hernia inflammation;
orchitis (inflammation of the testicle);
coprostasis (intestinal obstruction).

A strangulated hernia needs urgent surgical care. Infringement can occur both in case of overflow of the intestinal segment with fecal masses (fecal incarceration), which does not allow it to be drawn back, and due to a sharp increase in intra-abdominal pressure at the moment when a large volume of the hernial sac is outside (elastic incarceration). Both types of infringement are accompanied by severe pain, as a result of which the muscle spasm intensifies and the hernia is compressed even more. If the patient is not provided with immediate surgical care, necrosis of the compressed tissues will occur.

Pinching of the intestinal loop by the hernial gate threatens the development of inflammation with subsequent tissue necrosis

Symptoms that require immediate surgical attention:

indomitable vomiting;
sharp pain in the groin and / or scrotum;
the presence of a hardened hernial protrusion;
bloating, fecal retention;
blood in the stool;
weak pulse, tachycardia.

You should know that in no case should you try to set a strangulated hernia!

Which doctor can help the emergence of pathology

The surgeon is involved in the diagnosis and treatment of an inguinal hernia. This does not mean that the only way to treat the disease is only a surgical operation. If you consult a doctor in a timely manner, you can completely do without it for a long time.

How is the diagnosis carried out

First of all, the doctor will conduct an external examination of the patient, invite him to strain, cough, and assess the degree of reducibility of the hernial protrusion and its structure. If, after such an examination, the surgeon has unexplained circumstances that prevent an accurate diagnosis, he will resort to ultrasound diagnostics.

In rare cases, herniography may be needed - an x-ray examination with a preliminary injection of a contrast agent into the abdominal cavity.

How to treat non-surgical

It must be understood that complete disposal of a hernia is possible only with the help of a surgical operation, and all conservative methods of treatment can only slow down the development of the pathology and help the patient avoid complications. In the early stages of the disease can be managed with conservative methods treatment, while being under the supervision of the attending physician.

Physiotherapy

Therapeutic gymnastics is designed to help strengthen the muscular-ligamentous apparatus of the abdominal press. You need to do the exercises without excessive zeal, and with an increase in discomfort, you should immediately reduce the load.

Attention! All exercises and other physical activities must be agreed with the doctor, otherwise pinching can be caused during exercise!

An exercise	How to do it
With a bag of sand (1 kg)	Place a sandbag on your belly near your navel. Inflate your stomach - pull your stomach in. Repeat the same, placing the sandbag on your stomach just above your pubis. Perform 10-12 repetitions of each variation of the exercise.
On the chair	Sit on a chair, arms along the body, knees together in front of you. Raise left hand up and tilt to the right without getting up from the chair. Repeat the exercise on the other side. Do 10-12 repetitions.
With a ball	Lie on the floor, arms along the body. Hold the ball with the insides of your feet and lift it up to a height of 10-15 cm from the floor. Hold for a few seconds - lower. Repeat 8 times.
standing	Spread your legs shoulder width apart. Alternately do inclinations to the left and right legs, trying to reach the toes with the tips of the fingers of the opposite hand. Take your other hand back and up at this moment. Repeat 10-12 times.

Drug therapy and folk remedies

Such therapy can be considered only as an auxiliary. With the help of drugs and natural remedies, you can fight chronic constipation, straining cough, frequent sneezing - factors that contribute to the development of inguinal hernia. The use of such funds will avoid the causes leading to a sharp increase in intra-abdominal pressure.

Wearing a bandage

The bandage is also unable to save the patient from a hernia, but with its help you can stop its development and avoid complications. A specially designed device, consisting of belts and pads (overlays for the area of hernial protrusions), compensates for the function of weakened muscles, preventing the hernia from falling out.

Properly selected bandage allows you to compensate for the function of weakened muscles of the abdominal wall

A bandage is also used in cases where, for some reason, it is impossible for the patient to perform a surgical operation.

Operational treatment

As already mentioned, surgery is the only method that can completely rid the patient of a hernia. Herniotomy can be performed as traditional way, with the use of surgical incisions, and endoscopically, by conducting punctures under the control of special equipment.

Each of these methods has its own advantages and disadvantages. The choice of the method of operation is the prerogative of the surgeon, who will take into account all the circumstances and individual characteristics patient.

Traditional surgical removal

During a traditional surgical operation, the tissues and peritoneum located in the area of the hernial sac are dissected, after which the intestinal loops are returned to their place in the abdominal cavity. The peritoneum, which formed the shell of the hernial sac, is cut off, and the tissues are sutured.

To prevent the recurrence of the disease, the walls of the inguinal canal are strengthened either with the patient's own tissues or by installing a polymer mesh, which significantly reduces the likelihood of re-protrusion of the organs.

When performing an operation using the method of obturation hernioplasty, a small incision is made - no more than 3–4 cm, the hernia is reduced into the abdominal cavity, and the inguinal canal is strengthened with an obturation mesh, which practically excludes the possibility of recurrence.

Endoscopic surgery is more gentle, since it does not require surgical incisions, which reduces the period of rehabilitation of the patient. Such a hernia repair is performed using 4 punctures of the anterior abdominal wall, carried out under the control of an endoscope, which displays a detailed image of the operation on the monitor.

Removal of an inguinal hernia with endoscopic surgery

Moreover, this method has certain disadvantages:

the impossibility of a thorough revision of the operating area;
the need to use general anesthesia, while traditional surgery often uses local anesthesia;
higher risk of complications and recurrence.

In the case of necrosis of the inguinal hernia, the necrotic segment of the intestine is removed when strangulated. Such an operation is performed not in a planned, but in an urgent (urgent) manner, so you should not bring the situation to such a scenario.

A visual course of the operation for hernia repair (video)

Before the operation to remove the inguinal hernia, the patient will undergo a set of laboratory tests:

BAK-sowing;
coagulogram;
general blood analysis;
Analysis of urine.

A few days before the surgical operation, you can not take psychotropic and narcotic drugs, drink alcoholic beverages. The last meal on the eve of hernia repair should be no later than 18.00. If there are no contraindications, the patient is recommended to put a cleansing enema. In case of insomnia caused by anxiety, you can take a soothing herbal tea. In preparation for the operation in the morning, you can neither eat nor drink.

If the patient is constantly taking any drugs, it is necessary to tell the anesthetist about this.

Recovery period: how long does recovery take

The duration of the rehabilitation period will depend on the method of the operation and the type of anesthesia. With local anesthesia, the patient can leave the clinic a day after herniotomy, and with general anesthesia, he must be under the supervision of medical personnel for at least 2-3 days. After obturation hernioplasty, the patient can go home in a few hours. Surgical sutures are removed after 8-9 days.

Diet after hernia removal

During the rehabilitation period, which lasts several weeks, weight lifting and any physical exertion are prohibited. The diet should consist mainly of vegetable and dairy foods that prevent the development of constipation, it is better to prefer bread with bran and slightly stale. In addition, the list of food products should include lean meats - chicken, turkey, veal, preferably boiled.

Possible consequences of the operation

Any surgical operation is associated with trauma to the tissues of the body, and therefore there is always the possibility of developing postoperative complications. The probable consequences of the operation of hernia repair can be considered as follows:

infection of the surgical wound;
violation of the integrity of the abdominal organs - intestines, Bladder etc.;
damage to the hip joint;
thrombosis of the veins of the lower extremities;
damage to the spermatic cord;
hematoma;
recurrence of an inguinal hernia.

In order to minimize the risk of developing postoperative complications, you need to carefully select the clinic where the operation will be performed, get acquainted with the reputation of the surgeon, and strictly follow the recommendations of the attending physician in the postoperative period.

An inguinal hernia is a pathological condition in which the organs of the abdominal cavity bulge, forming a hernial sac in the lower abdomen in the groin area. Due to the anatomical features of the body, hernias in the groin are more common in men than in women.

Depending on the place of protrusion, several types of hernia are distinguished:

Oblique - a type of disease when the hernial sac passes through the deep and upper inguinal rings next to the spermatic cord. In this case, the protrusion may be in the region of the upper inguinal ring, or descend into the scrotum.
Direct hernia is formed when the contents of the intestine protrude through the deep inguinal ring.
The combined form is observed if several protrusions are found at the same time.

Causes

The main cause of the development of the disease in men is the weakness of the muscles and fascia of the inguinal canal. Concomitant factors also contribute to the development of pathology, namely:

heredity;
heavy physical labor;
intense physical exercise;
atrophy of the muscles of the peritoneum due to hypodynamia and poor physical development;
severe chronic cough;
chronic constipation and regular abdominal tension;
injuries in the groin area;
obesity,
drastic weight loss.

Symptoms of an inguinal hernia in men

A hernia in the groin is a tumor-like protrusion, soft to the touch, which can be easily (at first) set back into the peritoneum. At the initial stage of the development of the pathology, the tumor increases with an increase in pressure in the abdominal cavity (with coughing and laughter).

Symptoms of the disease appear gradually: sometimes at the beginning of the disease, a man cannot determine the cause of discomfort and pulling sensations in the lower abdomen.

As a rule, the development of a hernia in the groin area is manifested by the following symptoms:

discomfort in the groin when walking;
recurrent abdominal pain after exercise, heavy lifting;
the appearance of a hernial sac in the groin area is noted, disappearing in the supine position;
heaviness in the abdomen;
pain in the lumbar region;
an increase in the size of the scrotum;
bowel dysfunction (constipation, flatulence, rumbling).

When part of the bladder enters the hernial sac, urination disorders (too frequent or rare), pain in the lower abdomen above the pubic bone and pain in the urethra occur.

Diagnostics

In most cases, the disease is diagnosed after visual examination and palpation. To confirm the diagnosis, additional diagnostic methods are used:

1. Ultrasound examination. An ultrasound of the inguinal canal, scrotum, and abdominal cavity is performed, which allows you to determine the size, shape, and exact location of the pathology.

2. Herniography is an examination of the abdominal cavity using a contrast agent that is injected directly into the abdomen. After the contrast agent enters the hernial sac, an x-ray is taken.

Herniography is used for additional diagnosis if the hernia is internal and manifests itself only with severe pain in the groin and discomfort when walking and straining.

3. Irrigoscopy - X-ray examination, when a contrast agent is injected into the abdominal cavity using an enema.

4. Cystography - a study in which a contrast agent is injected into the bladder, and then x-rays are taken. Cystography is used when it is suspected that part of the bladder is in the hernial sac.

If a hernia is suspected (at the initial stage of development), additional examinations are carried out to identify diseases with similar manifestations: lymphadenitis, hydrocele, varicocele.

Possible consequences

Inguinal hernia in men is a dangerous disease of the abdominal cavity, which must be eliminated after detection. In the absence of treatment of pathology, a number of complications can occur.

Inflammation occurs as a result of the appendix getting into the hernia area and after an injury to the protruding part. In this case, there is redness and swelling of the skin, acute pain in the lower abdomen, fever.

Development of irreducibility occurs when protruding tissues adhere to the peritoneum. This condition increases the likelihood of pinching and fecal stasis.

Coprostasis(fecal stasis) - a violation of intestinal patency due to blockage of the hernia with feces. At the same time, the hernial protrusion increases and the following symptoms are observed: nausea, abdominal pain, vomiting, dehydration.

Infringement of inguinal hernia is the most common complication when part of the intestine is compressed by the inguinal ring.

When a hernia is infringed in the lower abdomen, pain and redness are observed, the tumor cannot be reduced, and there is also no symptom of a cough shock - bulging of the bulge when coughing. A pinched hernia causes a general infection of the body, which is manifested by weakness, fever, and apathy.

Peritonitis- the most serious complication that occurs when the contents of the hernial sac enter the peritoneum. Complication manifests itself acute pain stomach, vomiting, muscle tension of the abdominal wall and a decrease in pressure.

Surgery

Surgical treatment is the only way to eliminate the inguinal hernia and its causes, as well as to prevent future recurrences. Surgery for a hernia (hernioplasty) is performed in two ways: open surgery and laparoscopy.

Open (laparotomy) surgery is a type of surgical intervention that is used for emergency hernia repair, in cases of infringement and for large and irreducible hernias.

During an open operation, an incision is made in the lower abdomen, the hernial sac is removed and the wall of the inguinal canal is strengthened.

There are two ways in which the inguinal canal can be strengthened: tension and tension-free options.

Tension method consists in the fact that the body's own tissues are used to strengthen the back wall. The surgeon tightens the edges of the hernial opening and puts a special suture on them.

The use of a tension method to eliminate inguinal hernias is practiced in the early stages of the development of the disease in young people, when the muscle and connective tissue is sufficiently elastic.

Tension-free (obturation) method consists in the use of a special nylon (polypropylene) mesh, which is sewn into the hernial orifice. After restoration, the mesh fuses with the connective tissue, providing reliable protection against relapses.

Laparoscopic surgery is a surgical method to eliminate the disease with minimal intervention. The operation is carried out with the help of special endoscopic instruments that are inserted into the abdominal cavity through 3 small holes in the skin. During laparoscopy, the hernia is removed and the wall is strengthened using polymer meshes.

Using a bandage

The main means to prevent further increase in the hernia is a bandage - a belt with strong inserts in the groin area, excluding the possibility of protrusion. A hernia fixed with a bandage does not have the ability to progress.

With the help of a bandage for inguinal hernia, you can:

practice safely physical therapy, sports and physical labor;
prevent the progression of the disease;
exclude infringement.

There are double-sided and single-sided bandages that support the right or left groin. The supporting part of the bandage is resistant to the pressure of the hernial sac, since it consists of a dense plate (pelote) lined with soft material.

The use of a bandage is necessary under the following conditions:

with conservative treatment of the disease;
in preparation for surgery;
during the recovery period after surgery to prevent the recurrence of the disease;
during intense physical activity.

Despite the advantages of the bandage, the duration of use of the support agent is strictly regulated. Wearing a bandage around the clock negatively affects blood circulation and leads to stagnation of blood and lymph in the pelvic organs.

It is contraindicated to use a bandage if:

dermatological diseases are observed in the area where the bandage is placed;
have oncological diseases of the abdominal organs;
if the hernia is inflamed or strangulated.

Physiotherapy

Physiotherapy exercises are used at the stage of exacerbation of the pathology and after the operation. The purpose of the complex is to strengthen the muscles or ligaments of the anterior abdominal wall and groin area, restore and improve blood flow, improve lymph outflow.

As a result of exercise, tissue nutrition improves and pain syndrome is eliminated.

Basic exercises:

Plank. From a prone position, it is necessary to stand on the bar: raise the torso, leaning on the feet and elbows. After 10 seconds, lower yourself to the floor.
Scissors. Lie on your back, place your hands along the body. Raise your legs to 45 degrees and cross your legs, imitating scissors, 15-20 times.
A bike. Starting position, as in the previous exercise. Raise your legs and simulate cycling for 15-20 seconds.
Leg lift. In the supine position, grab the ball with your feet and, holding the object, raise your legs 45 degrees. Lower your legs after 10 seconds.

Physical education is contraindicated if the hernia is pinched, inflamed, or there are sharp pains.

Prevention

To avoid the appearance of an inguinal hernia with a high predisposition to the disease, as well as the occurrence of a relapse after surgery, the following recommendations must be followed: