A hernia is a condition in which part of tissue of an organ gets displaced and extends beyond the wall of the cavity that contains it. Hernia can develop at any point of the abdomen but if often occurs at a weak point of the intestine or the abdominal wall called as Inguinal Hernia. It appears as small swelling or bumps on the groin or sometimes as swelling of scrotum bag (that contains the testicles). The lump can be seen when the person tries to lift something from the ground surface. The bump will disappear once he lies down. It is the responsibility of the muscles to bind the tissues and organs of intestine in its place. But hernia can develop at some weak point of the muscle in the abdomen.
Symptoms :
The signs of hernia vary according to the type of hernia and the location it occurs. Some of the common symptoms of hernia are swelling below the skin in the region of groin or abdomen that can be seen clearly when the person bends to lift something. It would cause heavy feeling or fullness in the abdomen and also Constipation problem or bloody discharge in the stool. In addition there would be sharp pain and discomfort on the groin or abdomen when the person bends over.
Types :
Inguinal Hernia :
It occurs when part of the body tissue protrudes through the lower abdomen or groin.
Femoral Hernia :
It occurs when part of fatty tissue pokes through the groin into the top of inner thigh region.
Incisional Hernia :
Any part of the tissue protruding though the surgical wound on the abdomen is incisional hernia.
Umbilical Hernia :
This type of hernia occurs when part of the body tissue protrudes out of the abdomen through the tiny opening of belly button.
Hiatus Hernia :
It is the hernia that occurs when part of the stomach tissue gets pushed upwards and opens through the diaphragm region. Although different types of hernia are given, still it rarely occurs. Most of the hernias are of inguinal hernia.
Who are at risk?
Men are more prone to develop hernia than women, at some point of their life. Other factors that increase the risk of hernia are old age, obesity, chronic cough, and chronic constipation and employed in manual weight lifting industry. Hernia repair is known as hernioplasty or herniorrhaphy in medical terms.
Causes :
Inguinal hernia develops when part of the tissue from the intestine protrudes through the groin located at the top portion of the inner thigh. Inguinal canal is that part of the body where the blood vessels of the testicles pass in men, and through which the important ligament that surrounds the womb passes in women.
In contrary to the popular myth that hernia occurs only in men, it can occur in women also. It would cause intense pelvic pain in women. Femoral hernia is common among women. Ageing is another main cause of hernia since old age makes the muscles of the abdomen weaker and vulnerable giving rise to hernia. In some cases, hernia can develop suddenly due to sudden straining while passing stool or lifting heavy objects.
Complications :
Hernia, as such, is not a serious medical condition that needs emergency medical care. But sometimes a part of the tissue gets stuck in the inguinal canal permanently. It would cause severe abdominal pain, nausea, vomiting and lump on the groin. This condition is called obstruction. In extreme cases section of the tissue gets trapped in the groin from other organs and the blood supply is cut off for the tissue. This condition is called as strangulation which needs emergency surgery.
Hernia Repair Surgery: Why it is done?
Hernia repair is done mainly to push the bulging tissue back into its place and also to strengthen the walls of the abdomen to reduce its weak spots. Not all the detected hernia cases need surgery. Surgery is to be done only if there is severe abdominal pain or any other complications like obstruction or strangulation.
Surgery is done either by open method (conventional) or through keyhole method. In the open surgery, the surgeon will make a long incision on the abdomen to push back the protruding tissue into its place. In the keyhole or laparoscopic surgery the surgeon makes multiple small cuts to repair the hernia. Both methods have pros and cons respectively. And it is your health condition, age and other factors that determine the type of surgery.
There is every chance that you may again get hernia even after surgery. Like other surgeries hernia repair also carries some risk. But you can get back home on the same day after surgery. Often you can get back to work after 2 weeks of complete rest. You should avoid doing any painful tasks and abstain from sex for at least 3 weeks after surgery. Do not involve in any activity that causes pain in the abdomen. Follow the instructions of your doctor for starting up your exercise program.
Surgery :
Open hernia repair can be done on outpatient basis using epidural (spinal) anesthesia or local anesthesia. But laparoscopic surgery can be made only by general anesthesia. A long incision will be made in the groin to push back the bulging tissue into its place. This is the routine for open hernia repair. For inguinal canal hernia the sac will be tied off or pushed back into the canal which is indirect hernia repair.
After the completion of surgery, the weak spot in the abdominal muscle will be repaired by binding the healthy part of the muscles together so that it does not recur. At present hernioplasty is done by including variety of synthetic material patches while repairing hernia. Such patches of material are sewn on the area of weak muscles of the abdomen wall after pushing the tissue on its place. This kind of approach will reduce the risk of hernia to occur again.
Infection :
Hernia repair surgery can cause swelling on the incision area. This can easily be managed by applying ice pack on the inflamed area of the belly. But for some people infection can occur when the testicles become hard and swollen. You need to consult your doctor immediately if you develop fever or if the incision area becomes red and warm, or if there is any bleeding from the incision area.
Risk on Hernia Repair :
Generally hernia repair does not carry any risk. But if the patient is very old or if he has many complications the surgeon has to be careful while handling the case. In rare cases infection can occur after surgery, damage of nerve cell can occur causing numbness, or sometimes the cord (vas deferens) can get damaged affecting the fertility of the male or it can damage the femoral artery in women.
Who have increased risk after surgery?
People who are long-term smokers, people who are using aspirin for long, people who are taking anticoagulant medicines for long, and those having problems with blood clotting have increased risk.
