What is a hernia?
A hernia is an opening or weakness in the muscular structure of the wall of the abdomen. This defect causes a bulging of the abdominal wall and is usually more noticeable when the abdominal muscles are tightened. Lifting, coughing, or even straining to have a bowel movement are activities that can worsen a hernia.
Symptoms of a hernia include pain or discomfort and a localized swelling somewhere on the surface of the abdomen or in the groin area.
Signs & Symptoms
- A bulge in the groin, abdomen, thigh, genitals or site of a previous operation
- The bulge may get bigger when you stand and go away when you lie down
- Discomfort or pain during lifting, coughing, sneezing or physical activities
Who gets hernia?
Most hernias in adults result from strain on the abdominal muscles, which have been weakened by age or by congenital factors. The types of activity associated with hernia include:
- Lifting heavy objects
- Sudden twists, pulls, or muscle strains
- Marked gains in weight, causing an increase in pressure on the abdominal walls
- Chronic constipation, which places a strain on the abdomen while on the toilet
- Repeated attacks of coughing
How is a hernia repaired?
A hernia repair requires surgery. There are several different procedures that can be used for fixing any specific type of hernia.
- Traditional repair
An incision is made over the hernia. The protruding tissues are returned to the abdominal cavity. The sac is removed and strong surrounding tissues are sewn over the defect. This type of repair may however create tension on the sutured tissues and hence cause pain. The incidence of recurrence is also higher
- Tension-free repairs using mesh
Nowadays most hernias are treated with “tension-free” repairs. A special mesh is used to repair the weak area. This procedure repairs the defect area without creating tension in the tissues. Post-procedure discomfort is minimized and recurrence is lower with tension-free repair.
- Laparoscopic hernia repair (Key hole surgery)
In a laparoscopy, the surgeon makes a few small incisions in the abdomen. A laparoscope – a long metal tube with a tiny camera is attached and placed into the small incisions. Surgical tools are placed into the other incisions to hold or manipulate tissue in the abdomen. After the defect is identified, a mesh is placed to cover and reinforce the weak area in the abdominal wall.
Laparoscopic surgery avoids the need for a large incision, thereby lessening the pain and promoting faster recovery.
Should all hernias be repaired?
In general, hernias that are at risk for complications, cause pain, or limit activity, should be repaired. If they are not repaired, there is a risk that an emergency procedure may be required at a later date.
How can I tell if a lump or swelling is a hernia?
Not all lumps or swellings on the abdominal wall or in the groin are hernias. Your doctor should evaluate any such swelling.