What is an Inguinal Hernia?
A hernia occurs when there is a protrusion of the internal contents of the abdomen onto the skin surface at an area of abdominal muscle wall weakness. This manifests as a lump or a bump on the skin.
An inguinal hernia refers to a common hernia occurring at the region of the groin, also known as the inguinal region. An inguinal hernia occurs much more commonly in males than females.
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Why do Inguinal Hernias happen?
Inguinal hernias will occur at areas of weaknesses in the muscle wall of the groin region. The weakness in the muscle wall is divided into Congenital (present from birth) and Acquired (occurs in later life) causes.
Individuals with congenital weakness often develop inguinal hernias in their childhood to early thirties. The hernias can occur on both sides in more than 30% of cases. The congenital cause is due to a connective sac between the groin and the scrotum known as the processus vaginalis that did not close off as it normally should. This open sac then allows the internal abdominal contents to protrude out inside the sac.
Individuals with acquired weakness of the groin region usually develop inguinal hernias from their late 40s. This is caused by the gradual weakening of the muscles in this region as a result of growing age and the chronic lifting of loads and straining. Some of the risk factors include occupations or lifestyle that include daily lifting of heavy loads at work or weight lifting gym work.
How do I know if I have an Inguinal Hernia?
The most common symptom of an inguinal hernia is the development of a lump or protrusion at the inguinal region. The inguinal region is located on either side of the pubic bone at the lowermost frontal portion of the abdomen/tummy. In late stages, the hernia can develop to very large sizes and ‘drop down’ to the scrotum in males.
The lump of an inguinal hernia usually has some accompanying heaviness, discomfort or pain. In the early stages of an inguinal hernia, the lump usually disappears/resolves on lying down and becomes prominent on standing up or coughing/sneezing or on carrying heavy loads.
In early stages of an inguinal hernia, there may not be an obvious lump and the only symptoms may be some heaviness at the groin region.
Inguinal Henia Treatment Options
Dr Aaron Poh’s advice is that all inguinal hernias should be repaired in healthy patients.
Inguinal hernias will not resolve with medications and the possibility of serious complications like obstruction of the intestines can occur. Besides, the discomfort from the inguinal hernia often impedes the individual in carrying out activities like lifting loads, long walks and hiking, gym exercises and even travelling.
There are two approaches to the repair of an inguinal hernia, namely an open surgery or a laparoscopic/keyhole surgery. Both approaches utilise the same principles of repair that involves the placement of a non-absorbable medical-grade mesh over the area of weakness to prevent further protrusion of the hernia.
The open surgery is usually performed for one-sided hernias while the laparoscopic/keyhole surgery can be performed for one and two-sided hernias. The open surgery involves a 6-8cm incision over the inguinal region that is usually closed up with absorbable sutures. The laparoscopic/keyhole surgery involves three small 1.5cm incisions located at the level of the belly button away from the inguinal region.
A hernia repair surgery is a relatively minor surgery with low complication rates. It is often performed as a day surgery though some patients do prefer to stay overnight after surgery.