Inguinal - scrotal hernia in men and boys - Causes, Symptoms and Treatment .MF .
inguinal-scrotal hernia - a loss of internal organs in the scrotum, due to the failure of the connective tissue of the internal or external inguinal rings, which are natural openings in the abdominal wall.
Causes inguinal-scrotal hernia
authentically be called the cause of the disease is impossible.There are many factors, which in one way or another contribute to the reduction of the inguinal ring tone and loss of internal organs in a bag formed by a fold of peritoneum.
Most often hernias occur in men older than 50 years, when the connective tissue loses its natural elasticity.It promotes the development of a hernia physical work, which leads to increased pressure inside the abdomen.In addition, the contributing factors can be considered excess body weight and illness of the internal organs.Among the latter is necessary to highlight the pathology of the liver, accompanied by ascites, ie the accumulation of fluid within the abdominal cavity.This is the same as the physical activity results in increas
also necessary to identify congenital inguinal-scrotal hernia in boys developing due to violations of embryogenesis, when the development of the egg is not completely omitted from the abdomen into the scrotum.
Symptoms of inguinal-scrotal hernia
men with inguinal-scrotal hernia usually complain of the presence of tumor formation in one of the groins.If the hernia is not infringed, the formation of painless.
In the case of infringement of the latter, there is a sharp pain and redness of the skin over the tumor.When lowering the hernia sac into the scrotum latest increases in size and becomes sharply painful.Limits to increase scrotal virtually none.There are clinical cases, when almost the entire intestine from hernia sac left in the scrotum, and it became the size of several soccer balls.
The symptoms also depend on the body, which falls into the hernia sac.Most often, it is the small intestine, or large omentum.When injected into the greater omentum hernia patients are concerned only pain in the hernia sac.In the case of infringement of the intestine are joined to pain and even symptoms of intestinal obstruction: no chairs, poor discharge of gas, bloating, and hernia sac, nausea, vomiting, intestinal contents.
infringement ulcer in hernial sac
If a man saw in his groin tumor formation, it is necessary to immediately consult a surgeon or urologist, so that they can evaluate its clinical condition and to offer the right method of treatment.
Diagnostics inguinal-scrotal hernia
Typically, clinical examination is enough to set the exact diagnosis of inguinal-scrotal hernia.To find out infringed hernial ring or not, check the symptom of "cough shock".On the hernia sac lay hands and ask the patient to cough.If the cough is transmitted to push the hernial sac, it says that there is not strangulated inguinal hernia.If the hernia is not bulge when cough movements, while exhibiting a diagnosis of strangulated inguinal hernia.This differential diagnosis is very important because it completely determines the tactics of surgical treatment.
In some cases, such as at small sizes hernia may be difficult to diagnose and it is necessary to use additional methods of research.For example, an ultrasound investigation can give more accurate information about the origin of tumor formation in the groin area.
also used contrast radiography of the abdominal cavity in order to determine the presence of a hernial bag loops small or large intestine.
In rare cases, can be used to diagnose hernia sac puncture.As a rule, it is carried out in cases of suspicion of a cyst of the spermatic cord, which can reach large sizes and simulate inguinal hernia.Histological examination of the puncture material gives an accurate conclusion about the origin of the formation.
Treatment of inguinal-scrotal hernia
Treatment of the disease can be carried out by conservative or operative methods.Conservative treatment is recommended in cases where surgery is contraindicated.This usually occurs in elderly patients or those with serious diseases of the internal organs in the stage of decompensation.
Conservative treatment of inguinal hernia involves the use of a special brace that prevents infringement of hernia sac.Typically, the elastic band has the form of melts, which fit snugly to the body and do not give internal organs fall into a hernial sac.
more common treatment for inguinal-scrotal hernia is surgery.In the case of infringement of the inguinal ring operation is performed for health reasons, and in the absence of infringement - in a planned manner.If it is a strangulated hernia, when the hernial sac in a loop of the small intestine hit, absolutely necessary to check the latest viability.In the normal pink color and active peristaltic movements of the body simply dipped into the abdominal cavity.If the intestine is black or purple color, and the poor is reduced, it is removed and the intestine is applied between the ends of the anastomosis.
After removing the hernia sac is made of plastic hernial ring.To date, developed a huge number of types of plastics hernial ring, but the most popular is gryzheplastika Liechtenstein.To do it on the spot stepping hernia of the abdominal cavity is set lavsanovaja special mesh, which is fixed to the surrounding tissues of the individual seams.Ends stratified operation suturing wounds with the installation of rubber drainage for the evacuation of effusion of blood and debris.In place of sutures applied aseptic bandage to prevent wound infection.
rehabilitation after illness
all patients recovering from surgery are advised to wear elastic trunks that support the scrotum in its physiological position.This promotes proper and fast healing of wounds, but also prevents relapse.
With regard to medicines, the postoperative period all patients received broad-spectrum antibiotics for the prevention of secondary wound infection.As a rule, it is enough to ceftriaxone two tablets a day.
Feeding habits and way of life
To date not yet developed a special diet, which could influence the healing of wounds or early recovery of the patient after inguinal hernia.All patients were recommended for general dietary table Pevzner №15, which included high-calorie foods with a high content of protein.
As for lifestyle, then during the first two months after surgery, the patient should refrain from strong physical work and to wear elastic melt.Lifting a heavy load during the first two weeks after surgery in most cases ends with a divergence of postoperative wounds and indispensable relapse.
Treatment folk remedies
Since all methods of treatment, even if traditional, are not based on surgical intervention, do not have a stable positive effect on an inguinal hernia, the effectiveness of folk methods of treatment can not speak.
Very often patients are turning to traditional healers in the case of infringement of a hernia, when they are worried about strong pain in the groin area.As a rule, the healers, if it turns out, reduce a inguinal hernias, which is not always a good predictor of the effect.If the gut is clamped in the hernial ring more than 12 hours, it certainly necrotic and if such a body is entitled to the abdominal cavity, then there is a very strong likelihood that the patient will develop peritonitis.Therefore, if pain in the groin area is better to ask for help than to traditional healers, and in specialized medical institutions.
Complications of inguinal-scrotal hernia
most common complication of hernia, regardless of its location, is an infringement of the latter.With regard inguinal-scrotal hernia infringement is dangerous because in the hernia sac can get colon and the patient will develop symptoms of acute intestinal obstruction, and after peritonitis.In such a situation, it will need surgery, which is done not through a small inguinal incision and median laparotomy, after which the scar is more than a polzhivota.
Another severe complication of scrotal hernia, which is more common in younger patients, is erectile dysfunction and infertility.The fact that the loss of the whole complex organs in the scrotum, they exert considerable pressure on the testes and vas deferens.Consequently, the latter will simply cease to function and do not produce sperm.If, after some time, to operate such a patient, the chance that he will restore the normal activity of the seminal glands remains minimal.
Prevention inguinal-scrotal hernia
Basically, inguinal-scrotal hernia is the result of an inguinal hernia, hernia since the first bag from the abdominal cavity gets into the inguinal canal, and only then falls directly into the scrotum.And if the first phase carry out an effective treatment, the second can be avoided.To do this, you need time to consult a surgeon and do a little surgery routinely.
As for the primary prevention of inguinal-scrotal hernias, it is more complicated.Patients who are engaged in physical work, it is difficult to explain what their profession is a direct path to the inguinal hernia.Probably, in such a situation would be the most optimal annual checkups at the surgeon to identify the disease at an early stage.
also to prevent the increase of intra-abdominal pressure, which can also be the cause of an inguinal hernia, you need time to diagnose and treat diseases of the liver, which is often accompanied by this symptom.
Ed.urologist, sexologist-andrologist Plotnikov AN