Inguinal hernia in men: causes and stages, treatment methods, nutrition, prevention

In the article, we consider the causes of inguinal hernia in men.

This is a partial or complete prolapse of the organs of the peritoneal cavity into the inguinal canal. It includes hernial glands, which are formed at the site of the most weakened muscles that surround and protect the groin area, and from the hernial sac (abdominal parietal tissue), and internal organs fall out directly into it.

The most common type of abdominal hernia is an inguinal hernia, it makes up more than 80% of cases. Most often, pathology occurs in men (both in young boys and adults). This fact is due to the anatomical features of the body structure and weakened abdominal muscles. The inguinal region and muscle corset in women is stronger, which allows you to bear children and give birth to them, but the disease can also occur in women.

Causes of inguinal hernia in men

Under inguinal hernia is understood as the swelling of the organs of the peritoneal cavity beyond its limits due to the increase in the size of the inguinal canal. In accordance with the structure of the man’s body, it passes through a gap located between the muscles and tissues. Because of this, it is becoming a particularly vulnerable area.

What are the main causes of inguinal hernia in men?

It often occurs due to prolapse of certain parts of the internal organs. Loss occurs due to the arising of the lumen of the groin channel into the peritoneal cavity. Sometimes this can happen in the scrotum, and in this case is diagnosed as an inguinal-scrotal hernia.

The causes of inguinal hernia in men should be determined by the doctor.

Inguinal hernia is a tumor, can be either congenital or acquired. In men, congenital formations appear due to genetic predisposition and heredity. In addition, underdevelopment of the connective and muscle tissue affects the appearance of education. Congenital pathology manifests itself very quickly in the form of various symptoms. There are such reasons for the appearance of inguinal hernia in men:

1. Overweight and obesity.
2. Frequent constipation and poor digestion.
3. Lack of necessary activity.
4. Long physical activity.
5. The processes of inflammation in the prostate gland, for example, prostatitis.
6. A strong and frequent cough against a background of chronic pathology of the respiratory system.
7. Changes in the tissues of the peritoneal cavity with age.

Provoking factors are enough, but the main reason for the occurrence of inguinal hernia in men is weak abs muscles (passive lifestyle or hereditary predisposition). In sports and active people, even under the influence of a factor, pathology is much less common.

Classification and stages

There are 2 types of inguinal hernias in men:

1. Congenital. Appear in cases where the abdominal process, located in the inguinal canal in early childhood, does not overgrow, its cavity communicates freely with the peritoneum.
2. Acquired. Mostly develop in adult men and are divided, in turn, into the following types:

• Internal, or direct hernias. The direct hernia has a short stroke, it is not connected with the human reproductive system and, in any case, acquired.
• Outside or oblique. With this type of hernial sac, it is very tightly connected to the membrane of the spermatic cord and testicle, which often leads to complications of the genital organs.

Inguinal oblique hernias, in turn, have several stages:

• The hernia begins. At this stage of inguinal hernia in men, a hernial sac is felt only at the entrance to the groin canal. The patient alone is almost impossible to identify. The hernial sac in this case is located in the inguinal canal, but does not affect the abdominal wall, and can only be diagnosed with strong tension of the anterior wall of the peritoneum.
• Cord shape. A bag of hernia descends towards the scrotum along the spermatic canal.
• Scrotum form. The most severe type of oblique hernia, found in our country quite often. A hernial sac in this form with all its contents (internal organs, peritoneum, intestinal loops) is lowered into the scrotum and thereby increases its size several times.

Main symptoms

Symptoms of inguinal hernia in men at the initial stage of the disease are subtle. Outwardly, it looks like a small swelling in the inguinal region. The magnitude of the swelling can be different and even be large, interfering with the person's movement. The size and shape of the protrusion can vary, a lot here depends on the position of the body and physical activity. Also, dimensions change with straining or severe coughing.

The swelling is most often rounded (inguinal type) and slightly oval (inguinal-scrotal hernia).

A man with an inguinal hernia feels aching, dull, pulling pain. It is localized in the lower abdomen and groin. Especially noticeable symptoms are manifested during physical exertion.

What are the symptoms and signs of inguinal hernia in men? Patients often complain of discomfort and burning in the groin. Frequent urination, vomiting, nausea, intestinal disturbances due to infringement of the organ are also observed. Similar manifestations are observed if the disease is in an advanced state.

Diagnosis and treatment methods

Many are interested in how to determine an inguinal hernia in men.

The doctor at the reception can visually diagnose this pathology in the patient. The patient is examined using two methods before preparing treatment:

• Ultrasound of the hernial sac and peritoneum allows you to establish what is inside, to determine the number of intestinal loops and their location.
• Irrigoscopy is carried out by introducing a special solution into the anus, which can be well seen in x-rays, and the contents and dimensions of the bag become clear.

In the absence of treatment and diagnosis of inguinal hernia in men, an organ is infringed over time, which is very dangerous. Because of this, the organ dies, peritonitis occurs, it carries a threat to life. In such cases, the patient needs to undergo an emergency operation. If an inguinal hernia has been impaired, the following complications may appear:

• a negative effect on potency, due to which infertility can subsequently occur;
• impaired intestinal functioning with bloating and constipation;
• dysuric phenomena, sometimes up to an absolute delay in urine.

All the unpleasant symptoms of inguinal hernia in men are visible in the photo.

Treatment methods

Treatment of inguinal hernias in all developed countries is only surgical, regardless of the age of the patient and the cause of the appearance. This is due to the fact that a hernia diagnosed and operated on at an early stage in a planned manner very rarely becomes a cause of relapse and complications. Large-sized hernias and especially strangulated ones appear repeatedly in almost 50% of situations. A strangulated hernia is operated on an emergency basis, which causes many complications from the gastrointestinal and genitourinary systems. Because of this, the patient for a long time becomes incapable of work, with prolonged infringement can lead to death. Conservative treatment is used in more rare cases, more will be discussed below. Only the surgeon decides in each individual case how to treat such a disease, evaluating the condition of the patient and the timing of the surgical intervention.

Surgery

Hernioplasty according to Liechtenstein has now become the "gold standard" in the surgical field regarding inguinal hernias. For all types of hernias, this operation is used. During its conduct, plastic groin canal is made, reinforcing it with a special mesh made of polymer materials, which prevents the likelihood of relapses. However, in some cases it is necessary to use other varieties of hernia repair: if the hernias are small, especially in young people, hernioplasty according to Girard-Spasokukotsky is used. Recurrent straight groove and large oblique hernias will be eliminated by the Kukujanov or Bassini method. The same types of operations are desirable in the treatment of elderly patients with strangulated hernias, and if the operation was done in a timely manner, the strangulated organ was not removed, it is not much different from simple hernioplasty.

Pain after intervention

Any surgical intervention is associated with a particular pain syndrome. After hernia repair, the patient will feel an unpleasant, but still tolerable pain. It disappears as it heals and then passes completely. Depending on the specific pain threshold, moderate-acting pain medications may be prescribed to the patient. After about a week, acute pain becomes periodic, aching, it can intensify during walking.

It is very important that pain sensations that are tolerable for the patient are considered normal after surgery, they can not be avoided. But the presence of strong and constant pain can indicate a divergence of sutures (including internal) or the process of inflammation. In this case, you must definitely consult a doctor and undergo an additional examination.

The consequences of the operation

All complications can be caused by a doctor’s mistake during surgery or appear in the healing process:

• bleeding (can appear after the operation or during it);
• damage to any organ of the genitourinary system;
• hematomas;
• nerve damage;
• suppuration due to infection of the suture;
• dropsy of the testicle;
• the appearance of blood clots;
• inflammation of the peritoneal cavity (peritonitis);
• difficulty urinating
• the possibility of relapse.
  

Conservative treatment

Under the supervision of a physician, treatment without surgery with both medicinal and folk remedies is permissible if there are currently contraindications for planned surgical intervention. Relative contraindications are:

• severe pathologies of the cardiovascular system: heart failure IV FC, acute stage of a heart attack or stroke, hypertension with a crisis;
• pathologies of the lung system: pulmonary emphysema, exacerbation of chronic glomerulonephritis or pyelonephritis, the severe nature of bronchial asthma;
• cirrhosis of the liver or acute hepatitis;
• leukemia, anemia and other disorders of the coagulating blood system;
• decompensated diabetes mellitus - in many surgical facilities, operations are permitted for patients with a sugar level of less than 9-10 mmol per liter.

If a hernia has been infringed, the intervention is urgent, according to the testimony of life, that is, to preserve it, and surgeons no longer pay attention to relative contraindications. In this case, conservative treatment is strictly prohibited. It can eliminate only the symptoms of dyspepsia that appears when loops of the small or large intestine remain in the hernial sac, and to reduce discomfort during physical exertion and walking. First of all, it is necessary to note the need to follow a diet with a groin hernia, especially if the intestinal loops are in the hernial sac. The main requirements for the diet are as follows: to limit or exclude (in the presence of recurrent, gigantic, scrotal hernia) foods that cause gas formation and fermentation in the intestines - cabbage, legumes, beer, kvass, fresh pastries with yeast, a lot of meat, eggs. You also need to cut back on foods that contain coarse fiber, are difficult to digest and can cause constipation. With such a disease, this condition is undesirable, since it causes an additional increase in pressure inside the peritoneum, increases the likelihood of infringement. Before use, it is recommended to grind or chew foods very carefully to avoid constipation. Another good way to prevent pain and growth of the neoplasm before the intervention, the development of relapses after it is to use a special bandage.

Medications

Medicines that can be used for hernias are as follows:

• Antacids: "Almagel", "Maalox", "Phosphalugel" are used to prevent violations of the mucous membrane of the digestive tract.
• Antispasmodics: "Papaverine", "No-Shpa" are used for discomfort and excessive peristalsis. It is not recommended for all types of hernias of the anterior wall of the peritoneum to use anti-inflammatory non-steroidal agents. This is due to the fact that these drugs not only eliminate the inflammatory process, but also pain (especially Ketorolac and Analgin). Using these pills, you may not notice when an infringement of the hernia of the groin occurs, which is mortally dangerous for the patient.

Folk recipes

Treatment of inguinal hernia in men with alternative methods is also aimed at eliminating some of the symptoms and improving the digestion process. The following proven recipes can be used for this purpose:

• Protection of the intestinal mucosa (similar to "Maalox" and others). You can use a decoction of burdock root in milk. You need to take one tablespoon, chopped through a meat grinder, pour this pulp with a glass of milk, boil for 20 minutes. Such a decoction should be taken in three tablespoons before a meal in 30-40 minutes.
• Infusion of caraway seeds and coriander also improves digestion, helps to avoid constipation. Such seeds are in most stores. To prepare the infusion, you need to take one teaspoon of seeds (it is recommended to crush them), pour boiling water and insist for ten minutes, take after each meal.

There are a lot of folk recipes for the treatment of hernias in the form of ointments, lotions and compresses. Such methods are ineffective, since the active component not only does not penetrate through the epidermis and subcutaneous fat into the muscles and hernial sac, but also can cause irritation and flicker. The same applies to various ointments based on bark, herbs and fat.

Recovery and rehabilitation

Rehabilitation after inguinal hernia in men is important. Immediately after surgery, a person usually feels minor pain for a couple of days and discomfort at the site of the intervention. Much here is determined by the size of the inguinal hernia. If the pain is more intense, pain medications may be prescribed to the patient. In some cases, the use of antibiotics is required. To eliminate puffiness in the seam area, special ointments and gels are required, which improve its resorption.

The entire rehabilitation period after inguinal hernia is prohibited for men from physical activity. The specialist will prescribe a special diet to the patient, which will be aimed at preventing intestinal gas formation and the appearance of constipation.

Two weeks after surgery, the patient can return home (when there are no complications). The rehabilitation period will depend on the type of operation performed, possible complications and the condition of the person. The patient is forbidden to work in hazardous working conditions for a month after the intervention. If the patient follows all the recommendations of the doctor, then relapses, as a rule, practically do not occur.

After an operation with inguinal hernia in a man, diet is of great importance.

Nutrition

With inguinal hernia, it is necessary to follow a special diet, which is aimed at eliminating the main problems:

• the main "evil" of an inguinal hernia is constipation;
• fermentation in the intestines and stomach (exclusively natural products are allowed);
• weight loss if necessary;
• gas formation.

The list of prohibited products is as follows:

• cabbage;
• smoked, fried and greasy;
• milk;
• mushrooms;
• legumes;
• sweets;
• corn;
• chewing gum;
• bow;
• fast food, convenience foods, shop sausages or sausages;
• pastry and white bread;
• carbonated drinks;
• figs, dried apricots, prunes;
• pickles;
• potatoes;
• pears, cherries, peaches, apples (fresh).

The basis of the patient’s diet:

• lean fish and meat;
• cottage cheese and other sour-milk natural products that do not contain additives;
• rosehip broth;
• whole wheat bread;
• natural fruit jelly;
• oatmeal and buckwheat;
• eggs
• bananas
• baked apples;
• bran;
• fiber-rich vegetables (carrots are especially recommended), leafy lettuce.

Preventative measures

Groin hernia is the most common male disease. There are many preventative measures that will help to avoid this pathology and prevent a recurrence of a hernia. After a period of rehabilitation, patients can do special exercises. With inguinal hernia for men, such a complex is quite effective if it is repeated every day. Each exercise should be done 50-60 times.

Prevention rules will also help avoid the appearance of a groin hernia. If a person is actively engaged in physical labor, then he must control the degree of load, not to lift too heavy weights. To avoid the disease, you need to strengthen the abdominal muscles.

An important thing is maintaining an active lifestyle, the absence of overeating and bad habits. It is necessary to monitor the condition of other organs, especially respiration and digestion. Persistent constipation and chronic cough often cause inguinal hernia.

As soon as the first symptoms of the disease appear, you need to see a doctor to determine the cause and purpose of treatment. In the absence of any measures, serious complications of inguinal hernia in men can occur. Next, we find out what is the prognosis for this pathology?

Forecast

Is inguinal hernia dangerous in men?

If you contact the surgeon in a timely manner and have an operation, the prognosis is favorable. The recurrence rate after hernioplasty according to Liechtenstein is very low, from 0.3 to 0.5%. If older techniques are used, relapses may occur more often. Injured hernias, which are performed with a resection, that is, removal of the contents due to the development of peritonitis or necrosis, can have very different consequences. Patients die from complications (from 8 to 15%) - most often weak elderly men due to infection of the peritoneal cavity, the intervention does not end with plastic hernia gate, and the number of relapses as a result ranges from 16 to 25%.