DEXTER G. TURNQUEST, MD PA

Inguinal Hernia

What is an Inguinal Hernia?
An inguinal hernia is a protrusion of soft tissue, such as a portion of the intestine, through a weak spot in a muscle, usually in the abdominal wall. Inguinal hernias occur where the abdomen meets the thigh, the area known as the groin. Anyone can have an inguinal hernia. Men, women and even children of all ages experience hernias. They typically occur two ways: first, by wear and tear over time (acquired hernias) and secondly from a weakness in the abdominal wall that is present at birth (congenital hernias). Although many people "live" with hernias for years before they even know it or it becomes a problem, over time they often get worse due to physical stress or aging.  Typically men are about 10 times more likely to get an inguinal hernia than women.

Signs and Symptoms
Lump in groin area when standing/straining & disappears when reclining. Pain at the site of the lump, especially when lifting a heavy object, Swelling of the scrotum, Excruciating abdominal pain (caused by the intestine twisting and getting caught in the muscle tear). Nausea, vomiting, loss of appetite & pain (if intestinal obstruction occurs) associated with constipation or a change in bowel habits. Hernias produce different symptoms or feelings. Sometimes you'll notice a protrusion or lump in your groin area between the pubis and the top of the leg, or feel pain when you strain during urination or a bowel movement or when you lift a heavy object. The pain can be sharp and immediate. Other times you'll just feel a dull aching sensation, a vague feeling of fullness, nausea or constipation; these feelings typically get worse toward the end of the day or after standing for long periods of time and may disappear when you lie down. And, while persons certainly can live for years with hernias, without treatment they will not disappear.

Diagnosis
Your evaluation will include completing a medical history form or questionnaire, and talking with our doctor about the problem. A physical exam is performed in which the actual defect and protrusion are felt by the physician. This is not painful, but you may feel uncomfortable from the pressure applied as the physician evaluates how large the opening (defect) actually is. It is important that the patient notify the doctor of changes in bowel or bladder functions during this exam. Other complications that are resulting from your condition will also be evaluated. Should surgery be recommended you would be asked to have a medical work up including blood tests, chest x-ray or EKG as needed. If you have had them recently, these will not be repeated.

How Is An Inguinal Hernia Treated?
Various lifestyle and medical treatments often can help. Since hernias are caused by obesity, a serious program of weight control is recommended, especially if your weight is centered in the abdomen. Eating more fiber often helps reduce straining of the bowels. Getting more exercise, avoid standing for long periods of time and learning proper lifting techniques can strengthen the back areas or eliminate strain on the hernia. Since smoking often causes straining when coughing, it is also recommended that you stop. Since these approaches do not completely get rid of the hernia, often most people elect to have surgery to cure a hernia defect. Surgery for repair of a hernia is usually done via a laparoscopic approach utilizing a mesh material to buttress the defect but in some incidences may best be accompished via a traditional open approach. The laparoscopic approach is perferred by Dr. Turnquest because of its smaller incisions, less dissection, smaller incisions and quicker return to normal activity. The surgery is accomplished via 3 small incisions just below the belly button. It takes about 45 minutes to complete and most patients are discharged home the same day of surgery. Risks are generally low and include but are not limited to infection, bleeding, wound infection, injury to the blood vessels supplying the testicles, nerve injury as well as persistent pain.