Gut Check: Inguinal Hernias in Men
If you’re male, keep an eye on your lower abdomen. Why? Men are more prone to developing hernias – inguinal hernias, specifically – than women.
“This is because of the male anatomy of what runs through and what goes through the inguinal canal,” explains Stuart Donovan MD, of the TriHealth Surgical Institute. “In men, all the structures that go down and supply blood to the testicles, run through the muscles in the inguinal area.”
The inguinal canal is a passage in the abdominal wall. Men and women both have two inguinal canals: one on each side of the abdomen.
What is an Inguinal Hernia?
An inguinal hernia is a bulge in the abdominal wall of your groin, likely caused by your intestine pushing through this weakened area of the abdominal wall.
Wear and tear on that area, which stems from normal activities, like exercise or lifting, eventually breaks the muscle of this area down, and may lead to the formation of a hole. “That’s when things protrude through the muscle and cause a hernia,” Dr. Donovan says.
On the other hand, sometimes infants develop pediatric inguinal hernias, which occur when the small sac that comes through the inguinal ring does not close properly.
Symptoms of an Inguinal Hernia
Like other types of hernias, inguinal hernias often do not present any symptoms. "However, the hallmark of a hernia is a bulge,” Dr. Donovan explains.
Some people will experience pain in the abdominal or groin area, especially when they stand, strain or lift heavy objects. Eventually, as the hernia grows, people will notice a sore, growing bump.
Repairing an Inguinal Hernia
Inguinal hernias are repaired in one of two ways, either with open repair or a laparoscopic repair. An open repair involves making a larger external incision (three or four inches long) near the hernia to remove it. The surgeon then pushes the bulging intestine or hernia sac back inside, and closes the weakened abdominal muscle with stitches. A piece of mesh is usually placed on top of the reconnected muscle, as well.
In a laparoscopic repair, the surgeon makes three or four smaller incisions, usually a quarter-inch wide, away from the hernia. From there, the surgeon uses a tiny tube (a laparoscope) with a camera on the end to see inside the area, and places a piece of mesh behind the muscle to repair from the inside."
While a laparoscopic repair has a faster healing time, less pain and less scarring, "recurrence rates, which is one of the ways we measure success, is similar," Dr. Donovan points out. "It's really gotten to be equal."
Is it Possible to Prevent a Hernia?
While there’s no guaranteed way to prevent an inguinal hernia from forming, especially if you are born with weakened abdominal wall tissue, there are a few ways to avoid aggravating this delicate area. Dr. Donovan suggests:
- Keeping your weight under control
- Eating a nutritious diet, high in fiber, to avoid constipation
- Smoking cessation
- Using proper lifting techniques (bend from your knees, not your waist)
On the other hand, Dr. Donovan warns that while avoiding physical activity may help prevent an inguinal hernia, he does not recommend this for his patients. “I’d rather have them have a hernia and repair it, than lead a more sedate lifestyle,” he explains.