In the article, we will consider the causes of inguinal hernia in men.
This is a partial or complete prolapse of the organs of the peritoneal cavity into the inguinal canal. It includes the hernial orifice, which forms at the site of the most weakened muscles that surround and protect the groin area, and from the hernial sac (abdominal parietal tissue), and internal organs fall directly into it.
The most common type of abdominal hernia is the inguinal hernia, accounting for more than 80% of cases. Most often, pathology occurs in men (both in young boys and adults). This fact is due to the anatomical features of the body structure and weakened abdominal muscles. The inguinal region and the muscular corset in women are stronger, which allows you to bear children and give birth to them, but the disease can occurand the fairer sex.
Causes of inguinal hernia in men
Under the inguinal hernia is understood the bulging of the organs of the peritoneal cavity beyond its limits due to the fact that the size of the inguinal canal increases. In accordance with the structure of the body of a man, it passes through a gap located between the muscles and tissues. This makes her a particularly vulnerable area.
What are the main causes of inguinal hernia in men?
It often occurs due to the loss of certain parts of the internal organs. There is a prolapse due to the emerging lumen of the groin canal into the peritoneal cavity. Sometimes it can happen in the scrotum, in which case it is diagnosed as an inguinal-scrotal hernia.
The causes of inguinal hernia in men should be determined by a doctor.
Inguinal hernia is a neoplastic neoplasm, it can be either congenital or acquired. In men, congenital formations appear due to genetic predisposition and heredity. In addition, the appearance of education is affected by the underdevelopment of connective and muscle tissue. Congenital pathology manifests itself very quickly in the form of various symptoms. There are such reasons for the appearance of an inguinal hernia in men:
- Overweight and obese.
- Frequent constipation and poor digestion.
- No required activity.
- Prolonged physical activity.
- Processes of inflammation in the prostate gland, for example, prostatitis.
- Strong and frequent cough against the background of chronic pathology of the respiratory organssystem.
- Changes in the tissues of the peritoneal cavity with age.
There are enough provoking factors, but the main cause of inguinal hernia in men is weak abdominal muscles (passive lifestyle or hereditary predisposition). In sports and active people, even under the influence of any factor, pathology is much less common.
Classification and stages
There are 2 types of inguinal hernias in men:
- Inborn. Appear in those cases when the abdominal process, located in the inguinal canal in early childhood, does not overgrow, its cavity communicates freely with the peritoneum.
- Purchased. They mainly develop in adult men and are divided, in turn, into the following types:
- Internal, or direct hernia. A direct hernia has a short course, it is not connected with the human reproductive system and is acquired anyway.
- Outer, or oblique. With this type of hernia sac is very tightly connected to the membrane of the spermatic cord and testis, which often leads to complications of the genital organs.
Inguinal oblique hernias have, in turn, several stages:
- Hernia beginning. At this stage of inguinal hernia in men, the hernial sac is palpated only at the entrance to the groin canal. It is almost impossible for the patient to identify. The hernial sac in this case is located in the inguinal canal, but does not affect the abdominal wall, and can only be diagnosed with a strong tension of the anterior wall of the peritoneum.
- Rope shape. The hernia sac descends towards the scrotum along the seminal duct.
- Scrotal form. The most severe type of oblique hernia, which occurs quite often in our country. The hernial sac in this form with all its contents (internal organs, peritoneum, intestinal loops) descends into the scrotum and thereby increases its size several times.
Main symptoms
Symptoms of an inguinal hernia in men at the initial stage of the disease are hardly noticeable. Outwardly, it looks like a small swelling in the groin. The amount of swelling can be different and even be large, making it difficult for a person to move. The size and shape of the protrusion can change, much here depends on the position of the body and physical activity. Also, the dimensions change when straining or coughing heavily.
Swelling is most often rounded (inguinal type) and slightly oval (inguinal-scrotal hernia).
When an inguinal hernia occurs, a man feels aching, dull, pulling pain. It is localized in the lower abdomen and in the groin. The symptoms are especially noticeable during physical exertion.
What are the other symptoms and signs of an inguinal hernia in men? Patients often complain of discomfort and burning in the groin. There is also frequent urination, vomiting, nausea, intestinal disorders due to infringement of the organ. Similar manifestations are observed if the disease is in a neglected state.
Diagnostics and treatments
Manywondering how to identify an inguinal hernia in men.
The doctor at the reception can visually diagnose this pathology in the patient. The patient is examined using two methods before preparing the treatment:
- Ultrasound of the hernial sac and peritoneum allows you to determine what is inside, determine the number of intestinal loops and their location.
- Irrigoscopy is carried out by introducing a special solution into the anus, which can be clearly seen in X-rays, and the contents and dimensions of the bag become clear.
In the absence of treatment and diagnosis of inguinal hernia in men, over time, the organ is infringed, which is very dangerous. Because of this, the organ dies, peritonitis occurs, it poses a threat to life. The patient in such cases needs to undergo urgent surgery. If the inguinal hernia has been strangulated, the following complications may occur:
- negative effect on potency, due to which infertility may subsequently occur;
- intestinal dysfunction with bloating and constipation;
- dysuric phenomena, sometimes to the absolute retention of urine.
All the unpleasant symptoms of inguinal hernia in men are visible in the photo.
Treatment methods
The treatment of inguinal hernias in all developed countries is only surgical, regardless of the age of the patient and the cause of the appearance. This is due to the fact that a hernia diagnosed and operated on in the early stages in a planned manner very rarely causes relapses and complications. Large hernias and especially strangulatedreappear in almost 50% of situations. A strangulated hernia is operated on an emergency basis, which causes many complications in the gastrointestinal and genitourinary systems. Because of this, the patient becomes disabled for a long time, with prolonged infringement, it can lead to death. Conservative treatment is used in more rare cases, more will be discussed below. Only the surgeon decides in each individual case how to treat such a disease, assessing the patient's condition and the timing of the surgical intervention.
Surgical treatment
The "gold standard" in the surgical field regarding inguinal hernias has now become hernioplasty according to Liechtenstein. For all types of hernias, this operation is applied. During its implementation, plastic surgery of the groin canal is made, strengthening it with a special mesh made of polymeric materials, which prevents the likelihood of relapses. However, in some cases it is necessary to use other types of hernia repair: if the hernia is small, especially in young people, hernioplasty according to Girard-Spasokukotsky is used. Recurrent direct groove and large oblique hernias are eliminated by the Kukudzhanov or Bassini method. The same types of operations are desirable in the treatment of elderly patients with strangulated hernias, and if the operation was done in a timely manner, without removing the strangulated organ, it is not much different from a simple hernioplasty.
Pain after intervention
Any surgical intervention is associated with one orother pain syndrome. The patient after hernia repair will feel unpleasant, but still tolerable pain. It disappears as it heals and then disappears completely. Depending on the specific pain threshold, the patient may be prescribed medium-acting painkillers. After about a week, sharp pain becomes intermittent, aching, and may worsen while walking.
It is very important that pain that is tolerable for the patient is considered the norm after surgery, and cannot be avoided. But the presence of severe and constant pain may indicate the divergence of the seams (including internal ones) or the process of inflammation. In this case, you should definitely consult a doctor and undergo an additional examination.
Consequences of the operation
All complications can be caused by a doctor's mistake during surgery or appear in the healing process:
- bleeding (may appear after or during surgery);
- damage to any organ of the genitourinary system;
- hematomas;
- nerve damage;
- suppuration due to infection of the seam;
- hydrocele;
- appearance of blood clots;
- inflammation of the peritoneal cavity (peritonitis);
- difficulty urinating;
- possibility of relapse.
Conservative treatment
Under the supervision of a doctor, treatment without surgery is acceptable with both medicinal and folk remedies, if there are currently contraindications to the plannedsurgical intervention. Relative contraindications are:
- severe pathologies of the cardiovascular system: heart failure IV FC, acute stage of a heart attack or stroke, hypertension with a crisis;
- pathologies of the lung system: pulmonary emphysema, exacerbation of chronic glomerulonephritis or pyelonephritis, severe bronchial asthma;
- cirrhosis of the liver or acute hepatitis;
- leukemia, anemia and other blood coagulation disorders;
- decompensated type diabetes mellitus – in many surgical institutions, operations are allowed for patients with a sugar level of less than 9-10 mmol per liter.
If a hernia is incarcerated, the intervention is carried out urgently, according to the indications of life, that is, to preserve it, and surgeons no longer pay attention to relative contraindications. In this case, conservative treatment is strictly prohibited. It can only eliminate the symptoms of dyspepsia that appear when the loops of the small or large intestine are in the hernial sac, and to reduce discomfort during exercise and walking. First of all, it should be noted the need to follow a diet for groin hernia, especially if the intestinal loops are in the hernial sac. The main requirements for the diet are as follows: limit or exclude (in the presence of recurrent, giant, scrotal hernia) foods that cause gas formation and fermentation in the intestines - cabbage, legumes, beer, kvass, fresh pastries with yeast, a lot of meat, eggs. You also need to cut down on foods that contain dietary coarse fibers, it is difficultdigested and can cause constipation. With such a disease, this condition is undesirable, since it causes an additional rise in pressure inside the peritoneum, increases the likelihood of infringement. Before use, it is recommended to grind or chew the products very carefully to avoid constipation. Another good way to prevent pain and the growth of a neoplasm before the intervention, the development of relapses after it, is to use a special bandage.
Drugs
Medicines that can be used for hernia are as follows:
- Antacids: "Almagel", "Maalox", "Phosphalugel" are used to prevent disorders of the mucous membrane of the digestive tract.
- Anspasmodics: "Papaverine", "No-Shpa" are used for discomfort and excessive peristalsis. It is not recommended to use non-steroidal anti-inflammatory drugs for all types of hernias of the anterior wall of the peritoneum. This is due to the fact that these drugs not only eliminate the inflammatory process, but also pain (especially Ketorolac and Analgin). Using these pills, you can not notice when the infringement of the hernia of the groin will occur, which is deadly for the patient.
Folk recipes
Treatment of inguinal hernia in men by folk methods is also aimed at eliminating some of the symptoms and improving the digestive process. For this purpose, the following proven recipes can be used:
- Protection of the intestinal mucosa (similar to Maalox and others). Canuse a decoction of burdock root in milk. You need to take one tablespoon, crushed through a meat grinder, pour this gruel with a glass of milk, boil for 20 minutes. Take this decoction three tablespoons before meals for 30-40 minutes.
- An infusion of cumin and coriander seeds also improves digestion and helps to avoid constipation. These seeds are available in most stores. To prepare the infusion, you need to take one teaspoon of seeds (it is recommended to crush them), pour boiling water over them and leave for ten minutes, take after each meal.
There are a lot of folk recipes for the treatment of hernias in the form of ointments, lotions and compresses. Such methods are ineffective, since the active ingredient not only does not penetrate through the epidermis and subcutaneous fat into the muscles and hernial sac, but can also cause irritation and flicker. The same applies to various ointments based on bark, herbs and fat.
Recovery and rehabilitation
Important rehabilitation after inguinal hernia in men. Immediately after the operation, a person usually feels minor pain for a couple of days and discomfort at the site of the intervention. Much here is determined by the size of the inguinal hernia. If the pain is more intense, the patient may be prescribed pain medication. In some cases, antibiotics are required. To eliminate swelling in the suture area, special ointments and gels are required, which improve its resorption.
The entire period of rehabilitation after an inguinal hernia, men are prohibited from physical activity. The specialist will prescribe to the patienta special diet that will be aimed at preventing intestinal gas and constipation.
Already two weeks after surgery, the patient can return home (when there are no complications). The period of rehabilitation will depend on the type of operation performed, possible complications and the condition of the person. The patient is prohibited from working in hazardous working conditions for a month after the intervention. If the patient follows all the recommendations of the doctor, then relapses, as a rule, practically do not occur.
After a man's inguinal hernia surgery, diet is of the utmost importance.
Food
With an inguinal hernia, it is imperative to follow a special diet that is aimed at eliminating the main problems:
- the main "evil" of an inguinal hernia is constipation;
- fermentation in the intestines and stomach (only natural products are allowed);
- reducing body weight if necessary;
- gas formation.
The list of prohibited products is as follows:
- cabbage;
- smoked, fried and greasy;
- milk;
- mushrooms;
- legumes;
- sweets;
- corn;
- chewing gum;
- bow;
- fast food, convenience foods, store-bought sausages or sausage;
- buffets and white bread;
- carbonated drinks;
- figs, dried apricots, prunes;
- s alts;
- potato;
- pears, cherries, peaches, apples (fresh).
Basis of the patient's diet:
- lean fish and meat;
- cottage cheese and other fermented natural products that do not contain additives;
- rosehip broth;
- whole grain bread;
- natural fruit jelly;
- oatmeal and buckwheat;
- eggs;
- bananas;
- baked apples;
- bran;
- fiber-rich vegetables (carrots are highly recommended), lettuce.
Preventive measures
Groin hernia is the most common male disease. There are many preventive measures that will help avoid this pathology and prevent the recurrence of a hernia. Patients can do special exercises after the rehabilitation period. With an inguinal hernia for men, such a complex is quite effective if it is repeated every day. Each exercise should be done 50-60 times.
Prophylaxis rules will also help to avoid the appearance of a groin hernia. If a person is actively engaged in physical labor, then he must control the degree of load, not lift too heavy weights. To avoid illness, you need to strengthen the abdominal muscles.
It is important to maintain an active lifestyle, avoid overeating and bad habits. It is necessary to monitor the condition of other organs, especially respiration and digestion. Persistent constipation and chronic cough are the most common causes of inguinal hernia.
As soon as the first symptoms of the disease appear, you need to see a doctor to determine the cause and prescribe treatment. In the absence of anyeither measures can cause serious complications of inguinal hernia in men. Next, we will find out what is the prognosis for this pathology?
Forecast
Is an inguinal hernia dangerous in men?
If you turn to the surgeon in a timely manner and perform the operation, the prognosis is favorable. The recurrence rate after hernioplasty according to Liechtenstein is very low, from 0.3 to 0.5%. If older techniques are used, relapses may occur more frequently. Strangulated hernias, which are carried out with resection, that is, the removal of contents due to the development of peritonitis or necrosis, can have a variety of consequences. Patients die from complications (from 8 to 15%) - most often weak elderly men due to infection of the peritoneal cavity, the intervention does not end with hernia repair, and the number of relapses as a result ranges from 16 to 25%.
