What is Inguinal Hernia, Its Causes, Symptoms, and Treatment Methods?

An inguinal hernia can be defined as the protrusion of abdominal organs through an opening in the abdominal wall in the groin area. The opening in the abdominal wall can be congenital or can occur due to age-related muscle degeneration. If left untreated, the hernia can lead to more serious health issues such as the enlargement of the opening in the abdominal wall, the protrusion of more tissue through this opening, and intestinal obstruction. Questions such as “What is an inguinal hernia, how does it occur?”, “What are its symptoms?” are detailed in the following sections regarding hernias that occur in the groin.

What is Inguinal Hernia?

Hernias that occur in the groin are one of the most commonly encountered types of hernias worldwide. Research shows that approximately 27% of men and about 3% of women encounter inguinal hernia at some point in their lives. A hernia can be defined as the protrusion of a part of an organ or tissue into a cavity nearby.

Among the types of hernias that can occur in any part of the body, the most frequently seen are those in the abdominal region. Abdominal hernias are classified into two categories: internal and external hernias. Hernias such as hiatal hernias are evaluated within internal hernias. In this type of hernia, the organ protrudes into a cavity inside the abdomen. Consequently, there is no visible swelling outside the abdomen. However, external hernias, such as inguinal hernias, occur when there is an opening in the abdominal wall.

Research indicates that inguinal hernias account for approximately 75% of all abdominal hernias. There are two passages known as the inguinal canal located on both sides of the groin in both men and women. Hernias that occur in the inguinal canal are referred to as inguinal hernias. Inguinal hernias are generally classified into two types: indirect and direct. Indirect hernias are usually seen from birth and occur due to the failure of the inguinal canal to close properly during fetal development. In these types of hernias, the small intestine or intra-abdominal fat tissue enters the inguinal canal from above. Direct hernias, on the other hand, usually occur due to the weakening of the inguinal canal wall with advancing age, and the herniated tissue passes directly through the wall of the canal.

What are the Symptoms of Inguinal Hernia?

Hernias that occur in the groin may not always show symptoms. In some cases, a temporary pain sensation may occur with sudden movements. In some cases, inguinal hernias may present with complaints. The main symptoms can be listed as follows:

• Swelling seen next to the groin bone, especially after strenuous actions like coughing,
• Burning and pain in the swollen area,
• Pain when bending or lifting something,
• Feeling of pressure in the groin,
• Burning sensation radiating down the leg.

In addition to the above, in some cases, a piece of tissue may become trapped in the abdominal wall. This can lead to more serious complications. The main symptoms that may be seen due to the trapping of the hernia are as follows:

• High fever,
• Progressively worsening pain,
• Nausea and/or vomiting,
• Color change in the swelling next to the groin,
• Disruption in bowel movements.

If you notice one or more of these symptoms, do not hesitate to make an appointment with a specialist doctor and have the necessary checks done without wasting time.

What are the Causes of Inguinal Hernia?

Inguinal hernias can occur due to many reasons. The most common causes of hernias seen in the groin area are as follows:

• Failure of the inguinal canal to close properly while still in the womb,
• Remaining openings in the abdominal wall due to previous abdominal surgery,
• Chronic cough and sneezing,
• Straining during bowel movements,
• Engaging in heavy exercises,
• Pregnancy,
• Working in jobs that require standing for long periods,
• Increased pressure in the abdomen, especially due to being overweight,
• Weakening of muscles due to aging.

In addition to the causes listed, some scientific studies have shown that certain individuals are at a higher risk of developing inguinal hernia. Some known risk factors are as follows:

• Gender: Some studies indicate that the risk of hernia in the groin area is 8 times higher in men compared to women.
• Genetic factors: Individuals with a family history of inguinal hernia have a higher risk of developing a hernia.
• Premature birth: Infants born prematurely or with low birth weight may be more frequently observed to have hernias compared to those born at term.

Chronic constipation, coughing, smoking, and having previously undergone hernia surgery can also increase the risk of developing a hernia.

How Does Inguinal Hernia Occur?

The inguinal canal, located in the lower front part of the abdominal wall, serves as a passage between structures inside and outside the abdomen. Due to an opening in the inguinal canal or the gradual weakening of the muscles, a part of an organ or intra-abdominal fat tissue can protrude into the inguinal canal, creating a bulge under the skin. This bulge that protrudes from the inguinal canal is referred to as an inguinal hernia.

How is Inguinal Hernia Diagnosed?

To diagnose hernias that occur in the groin, the specialist doctor first listens to the patient’s complaints and evaluates any symptoms present. A physical examination is usually sufficient for the diagnosis of inguinal hernias. During the examination, the specialist doctor checks for swelling in the groin area. In some cases, the patient may be asked to cough or strain. However, hernias may not always be clearly understood from an external examination. In this case, imaging methods such as ultrasound, computed tomography (CT), or magnetic resonance (MR) may be utilized. Additionally, these imaging methods can provide detailed information about the location and size of the hernia.

How is Inguinal Hernia Treated?

In patients with inguinal hernia, the doctor first evaluates the size of the hernia and the severity of the symptoms associated with it. For small, asymptomatic hernias, routine check-ups can be performed to periodically assess the condition of the area. However, growing hernias that show symptoms such as pain and pressure may require surgical treatment.

Hernia surgeries can be performed using open and closed (laparoscopic) surgical techniques. Nowadays, due to the fact that it can mostly be applied with closed methods, the risk of complications is lower. Inguinal hernia operations are performed by general surgeons. Some patients may prefer female surgeons for the operation for various reasons. Today, there are also very successful female surgeons who perform hernia surgeries. The main surgical techniques used in the operation are as follows:

• Open surgical method: This operation is usually performed with the assistance of local or general anesthesia. During the operation, the general surgeon makes an incision in the groin area to reach the hernia and removes the organ, organ part, or tissue from its sac and places it back. The operation area is then stitched with self-dissolving surgical thread.
• Closed (laparoscopic) method: In laparoscopic hernia surgery, general anesthesia is used. During the operation, the surgeon makes several small incisions in the groin area. These incisions are much smaller than those in open surgery. The surgeon obtains images with a camera through one incision while inserting special tools to help repair the hernia through the other incisions. After laparoscopic surgery, there is less scarring and stitch marks. Patients can generally return to their daily lives on the same day after the operation.

Inguinal hernia surgeries are among the most commonly performed surgeries today. As with any surgery, there are risks such as infection, bleeding, and delayed healing of the wound after hernia surgery. However, the risk of complications such as infection and bleeding is low after operations performed by a specialized general surgery team in A-plus hospitals.

Frequently Asked Questions About Inguinal Hernia

Hernias that occur in the groin are one of the most commonly encountered types of hernias in society. Some frequently asked questions about inguinal hernia are addressed below.

If you notice a bulge, pain, or burning sensation radiating down the leg in yourself or your child, do not hesitate to consult a specialist doctor without wasting time.