Update: October 2018
The inguinal gap is not by chance the most common place.
bulging hernia. The reason lies in its complex structure and
natural “weakness”. It is especially weak in men, although
hernias also occur in women of different ages.
In the groin area there are several layers of fascia, between
which runs the inguinal canal. It is located in women
round ligament of the uterus, artery and nerve bundle. As in any channel,
It has an outer and an inner ring (exit and entrance).
Normally, all layers of the groin area successfully resist pressure.
organs from the inside. But with a combination of some factors, they
slip through the “weak” places, forming a hernia.
What is an inguinal hernia?
Inguinal hernia – penetration of internal organs into the inguinal canal
through its natural holes and crevices. Contents of the hernial bag
there can be anything in the abdominal cavity. More often
there are an epiploon and a small intestine, less often – a large intestine, ovaries,
uterus and fallopian tubes, spleen, even the gallbladder and
Hernia formation is a pathological process; it leads to it.
set of factors. Predisposing causes create a background for
hernial disease, and producing factors cause immediate
bulging of internal organs. It is a combination of the reasons of these
two groups lead to disease.
- Weak physique
- Lack of exercise
- Congenital features of the structure of muscles and ligaments
- Hereditary predisposition
Increased intra-abdominal pressure:
- frequent crying and screaming in children
- a long, painful cough (for various
- frequent chronic constipation or diarrhea
- difficulty urinating (with tumors and constrictions
- hard work
- playing wind instruments
- difficult childbirth (especially the second and subsequent)
The weakening of the muscles of the anterior abdominal wall:
- sedentary lifestyle, lack of exercise
- weight loss and muscle weakness
- repeated pregnancies and childbirth
- injuries, anterior abdominal wall surgery
Herniation peaks occur in children (1-2 years) and
maturity (40 years and older). It is believed that babies have hernia more often
�”Congenital” associated with anatomical defect of the ligaments, but in
Producing factors are important to older people. Women
face this disease much less often than men. The reason for this is
contents and features of the formation of the inguinal canal. In the process
intrauterine development, the testes in boys descend into the scrotum from
abdominal cavity, forming an easy path for a hernia. Ovaries
girls do not go anywhere, so penetrate the contents of the stomach
through the inguinal canal is difficult.
- Tumor bulging in the groin area
- Pain in the groin and pain in the lower abdomen, extending to the sacrum and lower back
- Possible increased pain when coughing, sneezing and physical
- Impaired digestion (diarrhea, constipation, bloating)
Symptoms of an inguinal hernia in women may be erased, since
protrusion sizes are often small. In addition, pain
increases in the days of menstruation, which indicates the presence of genital
organs in the hernia.
|The beginning of the formation of a hernia||Formed|
Types of inguinal hernia
All inguinal hernias can be divided into 3 groups in
depending on the place of their bulging.
- TOосые грыжи – содержимое мешка выходит через наружную паховую hole. TO
this type applies most cases.
- Direct hernia – exit through the internal inguinal
- Наружная надпузырная грыжа выходит через надпузырную hole.
Another criterion by which hernias are divided. Is an
the degree of its relevance.
- Replaceable hernias easily set themselves (in a prone position, for example)
or with a little hands
- Unreducible hernia can not be brought back in this state
they are all the time. More often грыжи перестают вправляться при
adhesions, they can cause indigestion, vomiting and
Complications of groin hernia
Aesthetic defect and discomfort – not the most
the sad consequences of a hernia. There are many complications
which sometimes arise suddenly and lead to severe
The inflammatory process in the hernial sac is rather rare, but
unpleasant complication. More often в пределах грыжи развивается
acute appendicitis, colitis and inflammatory diseases of the female genital
organs. Sometimes a woman’s condition does not suffer much,
temperature rises slightly. But even in mild cases
adhesions are formed that make reversible hernia irreducible.
If the condition worsens, pain occurs тошнота и vomiting
– it can be a sign of acute inflammation in the appendix,
eg. Such situations require immediate surgical intervention.
If the contents of the hernial bag is the area of the colon,
that is, the risk of fecal blockage. Intestinal tract gradually
becomes impassable with the accumulation of fecal masses in it. it
entails a violation of digestion, and in advanced cases and
dying of the intestine due to lack of blood supply. Usually such an outcome
случается у пожилых людей с obesityм, страдающих невправимой
hernia. Sometimes it is possible to alleviate the condition of such patients by
application of massage and laxatives. But often the operation –
the only way to free the intestines from stagnation.
Infringement паховой грыжи – очень грозное осложнение, которое
often develops suddenly and quickly. In this case, the bodies included in
hernia sac, compressed in its gate. There is a violation
blood supply and innervation. According to statistics, subject to infringement
about 15% of all inguinal hernias. The main signs of hernia injury are:
- sudden occurrence of hernia irreducibility, which previously was free
- severe pain in the groin, and sometimes all over the stomach
- with the infringement of the ovaries and uterus, the pain is unbearable, often
- hernial protrusion is very tight and tense to the touch
- тошнота, vomiting
- sometimes – temperature increase
Diagnosis of inguinal hernia
First, the doctor listens to complaints (signs of inguinal hernia in women
similar to the complaints of men), then makes an inspection.
Palpation (probing) hernial sac
- The symptom of “cough shock”: when coughing, vibration is transmitted to
- The symptom of a “stretched string”: a patient with an inguinal hernia,
formed during adhesions, feels tension in the abdomen
when straightening. Therefore, in a standing or sitting position such women
try to bend slightly to reduce unpleasant
- Determination of herniation.
Using ultrasound does not determine the fact
hernia, and its contents. it важно знать перед оперативным
Examination through the vagina and rectum. itт способ
used if the contents of the hernia are female genitals
(for example, ovary). Signs of an inguinal hernia.
|Onset of the disease||Sudden or gradual||Gradual||Gradual||The sudden||The sudden|
|Pain||Moderate||Moderate||Moderate||Moderate, в районе грыжи||Strong, all over the belly|
|Vomiting||Not||Seldom||there is||there is||Indomitable|
|Fever||Not||not||Sometimes||there is||there is|
|Hernia size||Within the hernial sac||Within the hernial sac||Increases||Increases||Increases|
|TOашлевой толчок||there is||Often there||there is||there is||Not|
|Hernia to the touch||Different||Softish||Tense||Tense||Hard|
|Shock||Not||Not||Not||Чаще not||there is|
The main rule of treatment: surgery – the only effective
method. Exercises, physiotherapy, compresses, bandages, as well as many
other anti-scientific methods are not able to heal from this
The time spent on questionable therapies may be
missed in vain, because a simple uncomplicated hernia at any moment
capable of becoming dangerous stinging with a multitude
complications. The same applies to little girls. Unlike
umbilical hernia, inguinal never pass by itself. Nearly
always have to perform an operation.
The main goal of treatment (removal of inguinal hernia and hernioplasty) –
eliminate hernial protrusion and prevent re-formation
hernia. The methods of surgical intervention have changed many times
over the centuries. Now there are several basic ways
the expediency of each of which is determined by the surgeon.
The method is based on the usual tightening of tissues followed by
stitching them around the hernia gate. itт способ один из самых
old, simple and inexpensive. But in the modern world it is used
seldom. This is due to frequent relapses of the disease, long recovery
and pronounced scar.
The method is based on strengthening the wall of the inguinal canal.
synthetic materials. One of the variations is surgery
Liechtenstein – has become the most common in most
Russian clinics. The mesh prosthesis is sutured to the aponeurosis. Muscle
they are not injured, and the lack of tension reduces the risk
relapse to a minimum. Modern polypropylene mesh is not
allergens do not dissolve and almost never cause
infection. At the same time, the search for “ideal” material continues.
Hemming of the wall is possible by open and laparoscopic
access. The latter has advantages in the form of low morbidity and
minimal cosmetic defect. But many experienced surgeons
prefer to work through open cuts, considering them more
effective and safe. TOроме того, лапароскопический доступ
necessarily requires general anesthesia.
Endovascular extraperitoneal hernioplasty
Although this type of operation is essentially non-tensioned
method, it makes sense to put it as a separate item. Main
feature of such an operation is extraperitoneal access. I.e
the prosthesis is placed over the peritoneum, almost immediately under the skin.
The main advantage of such access is the absence of adhesions in the abdominal cavity.
Among the minuses – the complexity of implementation.
Treatment паховой грыжи у женщин требует меньше времени и усилий в
connection with anatomical features. Therefore the number of unsuccessful
operations are also small.
Recovery after surgery
Продолжительность notрудоспособности после вмешательства зависит
on the type of operation. With open access it is somewhat more, then
laparoscopic manipulations are performed almost on an outpatient basis. But
in any case, modern interventions are fairly safe and
Occasionally, patients are prescribed pain medication with the aim of
relieve pain. Also the doctor gives customized
recommendations for a return to physical labor. Muscle strengthening
the abdominals are very important for preventing relapses, but
start training immediately after hernioplasty is unacceptable.
Butшение послеоперационного бандажа при паховой грыже не требуется,
although it is possible at the request of the patient.
Complications after surgery
TOак и любое хирургическое вмешательство, герниопластика может
вызвать ряд complications. More often – инфекцию в ране, отсутствие
intestinal motility, problems with the lungs and heart in patients
chronic illnesses. But эти случаи бывают гораздо реже, чем,
например, омертвение кишки после ущемления hernia. Therefore, the main
the principle of prevention of complications is the choice of a good surgeon and
timely appeal for medical care.
TO сожалению, грыжу паховой области не всегда удается излечить
Once and for all. Even in the case of planned operations
highly skilled surgeons may experience recurrences of the disease.
The main reasons for the recurrence of the disease consider:
- doctor’s mistakes
- anatomical failure of the connective tissue
- infectious complications after surgery
- are at risk of relapse and people involved in severe
by physical labor
- or suffering from chronic lung and intestinal diseases.
Elimination of recurring hernia is a responsible and complex
task. Usually surgeons use methods that are not used in this
Prevention of inguinal hernia
- Regular exercise to maintain overall
- Proper nutrition for the prevention of obesity
- Protection of the groin area from injury in contact types
- Limiting heavy physical labor, especially when
hernia susceptibility to hernia
- Timely access to a doctor for suspicious
- Treatment паховой грыжи после операции ограничивается здоровым
way of life. Pseudoscientific methods can lead to relapse.
Frequently Asked Questions by Your Doctor
- there is ли болезненность в районе грыжи? Her character,
intensity and spread?
- Features of hernia marked by a woman
- TOак давно появились первые симптомы?
- Was there a mention of hernia in childhood?
- If a hernia was previously affected, then how often and with what
- Were any operations performed on this hernia?
- TOакие условия работы и особенности профессии?
- TOак часто Вы занимаетесь спортом? TOакие виды физической
- TOакие заболевания и операции были в прошлом?
- TOак протекали беременности и роды, если они были?
- TOакие еще жалобы на здоровье Вы отмечаете в последнее