Stating that inguinal hernia can occur very quickly in some occupational groups and those who stay standing for a long time, Op. Dr. Hasan Uzer gave information about inguinal hernias and treatment methods.
Inguinal hernias make up 80% of abdominal wall hernias and are 3 times more common in men. Surgery, which is the only treatment of inguinal hernia, which manifests itself with swelling and pain, can be performed with closed and open methods. Stating that inguinal hernia can occur very quickly in some occupational groups and those who stay standing for a long time, Op. Dr. Hasan Uzer gave information about inguinal hernias and treatment methods.
It is more common in men
Inguinal hernias are when organs in the abdomen (such as small intestines, intestinal fat) come out of weak areas in the abdominal wall and cause swelling under the skin. Throughout life, 27% of men and 3% of women have this problem. It is known that an average of 20 million people in the world have inguinal hernia surgery every year. Generally, causes that increase intra-abdominal pressure such as straining, coughing, sneezing, and straining make the swelling prominent. If the hernia is not compressed, it disappears when lying down.
There are 3 types of inguinal hernia
Although classified as direct, indirect and femoral hernias, obturator hernias can also be seen. Indirect hernias are common in the community, are seen at any age and can go down to the testicles. Direct hernias, as can be understood from the name, are hernias that arise directly from the weak area of the abdominal wall and the risk of being seen increases with age. Femoral hernias are less common. It is more common in women and the risk of choking is higher than other types.
Why do inguinal hernias occur?
Causes of inguinal hernia can be congenital or acquired (later). It can develop from openings that need to be anatomically closed immediately after birth, or it may occur as a result of heavy lifting, constipation, straining, old age, excessive weight gain or weakness, chronic cough, urinary and defecation difficulties. In addition, pregnancy may develop acquired due to many reasons such as decreased collagen synthesis, movements that force the abdominal muscles and smoking.
It is more common in people who lift heavy and work by standing for a long time (such as hairdressers and waiters). Inguinal hernia can occur very easily, especially in weight-lifting athletes and occupational groups that have to lift weights.
Pay attention to the symptoms of inguinal hernia
Inguinal hernias may not cause any symptoms at the initial stage. The person may not be aware of the inguinal hernia until it is noticed in the physician's examination.
The most common symptom of inguinal hernia is swelling in the inguinal region and testicles. There may be pain and burning in the swelling area. In cases where intraabdominal pressure increases, complaints increase and decrease when lying down.
The pain may appear as cramps after meals, causing constipation. All these complaints actually occur when the intestines temporarily enter and exit the hernia sac. If the hernia comes out but does not go inside, it means that the intestinal and intestinal oils in it are overwhelmed. This condition is defined as 'strangulated hernia', 'pinched hernia', 'incarcerated hernia', 'strangulated hernia'.
Symptoms such as nausea, vomiting, anorexia, gas and inability to defecate, abdominal distension, fever, redness and bruising in the hernia area may occur. It is an emergency situation, the hernia should be repaired with emergency surgery and the intestine should be re-blooded, otherwise the intestinal rotting, perforation, peritonitis (inflammation of the peritoneum) will start due to insufficient blood supply to the intestine.
The only treatment is surgery
When the inguinal hernias are left to their natural course, there will be no shrinkage or improvement and there is no medical treatment, the only treatment is surgery. The purpose of hernia surgery is to place or remove the hernia sac in the abdomen where it should be. The aim is to close the partial defect (defect) that causes herniation and to strengthen it with mesh so that it does not happen again. It can be applied in the form of local anesthesia, general anesthesia or lumbar anesthesia (spinal anesthesia) before surgical treatment. Repair can be done by open or closed method. Closed methods can also be performed by methods made between the peritoneum and the skin (TEP) or intraabdominal (TAPP).
Closed surgeries are advantageous
In recent years, hernia surgeries have been performed closed. If there is no contraindicated situation, laparoscopic surgery may be preferred. Patients can eat, drink and stand up 5-6 hours after surgical treatment. They are followed up in the hospital overnight and discharged the next day. Since there will be patch adhesion in 3-6 months after the operation, patients are recommended not to lift more than 3 kilograms of heavy weight, not be constipated, take a break from heavy exercises, and support the area while coughing and sneezing. Rare complications such as hematoma, mesh infection and bruising in the testicles can also occur in the operation area after surgery.
Since the recovery time is faster with closed surgery, the risk of infection is low.
While scars remain in open surgeries, the amount of scars is much less in closed surgeries.
While the pain level is low after closed surgeries, the level of pain that occurs after open surgeries is high.
The recurrence rate of the hernia is the same in closed and open surgeries. The technique applied by surgeons is important for the recurrence of the hernia. Surgery should be performed by expert and experienced surgeons.
Since recovery is faster after closed surgeries, returning to normal life is earlier.
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