Inguinal

Definition

An Inguinal hernia is a protrusion in the lower abdomen or groin area. It often presents predominantly with a bulge in the groin area but can also present with pain and sometimes a burning sensation.

Who commonly presents with it?

Anyone can present with an inguinal hernia, but they are more common in men and are associated with:

1) Heavy lifting
2) Persistent coughing or straining (constipation, difficulty in passing urine)
3) Increasing weight (mild to moderate obesity)
4) Pregnancy
5) Keen sportsman, weight-lifting & cycling

How does it present?

An inguinal hernia usually presents with a lump or pain in the groin area.  The lump can be aggravated by exercise, coughing or sneezing and some inguinal herniae can also protrude down into the scrotum (men). Small inguinal herniae usually disappear on lying flat. Inguinal herniae are usually reducible by simple pressure but can on rare occasions become very painful and irreducible (incarcerated or strangulated). Usually the hernia will contain a sac, which may have small or large bowel contents.

What can be done?

An inguinal hernia is often painful and due to the risk of possible incarceration and/ or strangulation surgical repair is recommended. Surgery is performed as a day case for the large majority of patients requiring no overnight stay and can be performed by the following techniques:

1) Open surgery under Local or General anaesthetic (it can also be performed with epidural anaesthesia, where you are awake but numb below your waist due to a simple anaesthetic given by a needle in your back)

2) Keyhole 'laparoscopic' surgery - This involves a General anaesthetic a totally extra-pre-peritoneal reapir (TEP) offered by MGS.

3) TEP (totally extra-peritoneal repair) - This type of repair involves the creation of a space within the layers of your abdominal wall muscles and allows fixation of the hernia with placement of a mesh.

 
Your Surgeon will discuss all the options with you and together a decision will be made on which type of hernia repair will suit you best.

Mr Sheen utilises a specialised technique of fixation by the use of tissue glue to try and reduce the potential risk of long term groin pain and numbness (2% for all groin hernia repair), for more information on this technique click here.

How long will your recovery take?

Recovery is very quick, with most patients being discharged home the same day. Patients that undergo inguinal hernia repair on both sides (bilateral) may require hospital stay overnight. Patients are encouraged to start mobilising immediately after surgery and refrain from lifting heavy objects for at least one month as well as heavy duty activity for a possible further month. A return to full regular activities is expected within 2 weeks for keyhole surgery and up to one month for open groin hernia surgery.

What are the main risks of surgery?

Your surgeon will advise on any specific complications and risks. For all types of surgery there is always a risk of wound infection and a 1-2% risk of recurrence of the hernia. Specifically for inguinal hernia surgery the risk of groin pain and numbness is quoted as a long term risk seen in 2% of patients.

Undergoing Groin hernia surgery click here for your patient information

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