What is the inguinal hernia?
The term hernia indicates the outflow of a viscus (that is, of an internal organ in a body cavity), or part of it, from the natural cavity that normally contains it.
Specifically, the term inguinal hernia indicates the exit of the bowel from the hernial gate located in the inguinal region.
This spill may be more or less consistent and in more severe cases it is clearly visible as a large swelling located at the level of the groin (see figure). Initially the swelling may not be visible even if pain is present.
The inguinal hernia is one of the most frequent pathologies in the world and mainly affects men who suffer from 7 to 10 times more than women.
This diversity is linked to anatomical differences relating to the inguinal canal, an anatomical structure similar to a duct that connects the abdomen with the outside, crossing the abdominal wall to its full thickness.
In humans, the canal is traversed by vessels and nerves directed to the ipsilateral testicle and is therefore much more vulnerable than the female one, which consists only of the round ligament and an exfoliation of the peritoneum called the Nuck canal.
Inguinal hernia occurs mainly in middle-aged adults but can also affect children and the elderly.
Among the various types of hernia (disc, hiatal, crural, umbilical, diaphragmatic, etc.) the inguinal type is the most common type (about 80% of cases).
Again according to statistics, the inguinal hernia occurs in most cases on the right side of the body, although it is often bilateral.
A little anatomy
The abdominal wall is formed by a solid muscular scaffold that with its action holds and protects the organs contained in the homonymous cavity. If this function fails, for example due to a small failure, the intra-abdominal pressure tends to let the viscera out through the point of least resistance.
In this way a small hole is formed through which a more or less large tract of bowel emerges (inguinal hernia).
Symptoms
To learn more: Symptoms Inguinal hernia
If in some cases the inguinal hernia does not give particular signs of suffering, in other situations the pain can be unbearable or at least very annoying (associated with a sensation of weight or burning). The extent of pain increases if the herniation compresses an area rich in nerve endings.
Rest and in particular lying down after searching for the most comfortable position makes the symptoms pass almost immediately. The pain reappears in getting up or as soon as you turn around taking particular positions.
The most serious complication is linked to the possible compression of the part of the intestine that has escaped from the inguinal breccia that can be trapped and choked by the same hole.
The resulting strangulation of blood vessels is a rather rare complication (appears in about 4% of cases) but in addition to causing very severe pain and vomiting it can lead to necrosis and perforation with inflammation of the entire abdominal cavity (peritonitis). For this reason it requires immediate surgery.
In addition, any subsequent effort can widen the orifice that has been created by favoring the exit of the intestine in an increasingly conspicuous manner. In this way, if in the initial phases the hernia only partially involves the inguinal canal, as the pathology worsens, the hernia widens and descends downwards until, in humans, it reaches the exit in the scrotal sac.
Treatment
The formation of a hernia can no longer regress spontaneously and no drug can resolve the disease.
Conservative treatment, useful when surgery is contraindicated, involves the use of the hernia girdle, a device now fallen into disuse. Eventually it can be used pending the operation but it is often recommended to use special elastic panties, certainly more comfortable.
If the problem is at risk of worsening or particularly annoying the only solution is surgery.
The operation generally takes place in a day hospital with local anesthesia and after just a few days the subject can resume normal daily activities.
Inguinal hernia surgery has become a routine operation since it is the most performed surgery in the world. In most cases a small retina of biocompatible material is applied subcutaneously, which has the task of containing the hernia and strengthening the abdominal wall.
To learn more: Inguinal hernia surgery - Inguinal hernia operation
Inguinal hernia and prevention
The weakness of the abdominal wall is in many cases a congenital fact that can be influenced by the lack of exercise.
Although the causes of onset are still under study, particular conformations of the inguinal canal or umbilical region can predispose the subject regardless of age or type of work activity. In these conditions the innate weakness favors the herniation that can occur, for example, following constipation, intense physical exertion, pregnancy, coughing, or a simple sneeze.
Even the overweight or a marked weight loss can favor the onset of the disease.
The prevention of inguinal hernia involves the maintenance of a good muscle tone, in particular of the abdominal, oblique, lumbar and paravertebral muscles.
See also: Importance of the abdominal muscles in the prevention of low back pain
FUNCTIONAL EXERCISES
Inguinal hernia and sport
As we have said in the introductory part, the lifting of an excessive weight can cause the appearance of the inguinal hernia.
In the gym, when very heavy loads are raised in exercises that particularly stress the lumbar vertebrae, a containment belt is used .
In addition, a belt that is too narrow decreases the risk of herniated discs but considerably increases that of inguinal hernia due to the strong intra-abdominal pressures that are created.
After the operation the patient can resume training already 10-15 days after surgery. However, before starting again to use heavy loads in exercises that considerably increase the intra-abdominal pressure, it is advisable to wait about 6-10 weeks depending on the type of intervention immediately.
Inguinal hernia surgery - Inguinal hernia operation
