Inguinal Hernia (cont.)
IN THIS ARTICLE
Surgery has generally been recommended for all inguinal hernias to avoid complications such as strangulation, in which a loop of intestine becomes tightly trapped in a hernia, cutting off the blood supply to that part of the intestine. But surgery may not be needed if the hernia is small and you do not have symptoms. Consult with your doctor to decide if you need hernia repair surgery.
If a hernia in an adult can be pushed back (reduced), surgery can be done at the person's convenience. If it cannot be pushed back, surgery must be done sooner.
Laparoscopic hernia surgery may have some advantages over open surgery in certain situations, such as fixing a hernia that has returned. Studies show that people have less pain after this type of surgery and return to work and other activities more quickly than after open repair. But laparoscopic surgery is more expensive than open repair. And laparoscopic surgery has a higher risk for serious complications.3
The risk of a hernia coming back after surgery varies depending on a surgeon's experience, the type of hernia, if mesh is used, and the person's age and overall health.
Surgery in children
In most cases, a child with an inguinal hernia will need surgery to correct it.
Infants 6 months of age and younger who have inguinal hernias have a much higher risk of strangulation than older children and adults. So surgery for inguinal hernias in infants is not delayed like it can be for adults.
One of the major decisions concerning infants and children is whether to explore the opposite groin area for a hernia during a hernia repair. A hernia develops in the other side of the groin in about 30% of children who have had hernia surgery.
Things to think about in deciding whether the other side should be explored include the overall health of the child, the risk of incarceration of a hernia, and the experience level of the surgeon (how many of these surgeries the doctor has done and his or her recurrence rates).
Two types of surgery are done to repair inguinal hernias:
What to think about
The laparoscopic procedure causes less pain and numbness after surgery and usually allows you to return to work and activities sooner. But serious complications such as bladder injury are more likely to occur with a laparoscopic procedure. Also, the success of a laparoscopic surgery depends more on the surgeon's experience, and laparoscopic surgery is more expensive than open surgery.3
Laparoscopic surgery may not be possible for a person who has tissues that have grown together (adhesions) from previous abdominal operations.
Most hernias that will recur do so within 5 years after surgery.
There are some considerations before having inguinal hernia repair surgery, such as what kind of hernia repair is performed most at the hospital or clinic. Talk with your doctor so that you make the best decision for your condition.
Recurrent inguinal hernias are harder to repair and pose more risks than initial hernia repairs. The risks linked with recurrent hernia surgery are more scar tissue, numbness and pain after surgery, and a greater chance of injury to a testicle or the spermatic cord.
Conditions that might increase the risk of recurrence include abdominal muscles that are not strong or healthy enough to "hold" the stitching (suture) material and bleeding or infection that weaken the repair.
Fertility is usually not affected by an inguinal hernia or hernia surgery. But in males there is a chance that surgery or an incarcerated hernia can cause injury to the vas deferens, the tube that carries sperm from the testicles to the urethra. It is not yet known how often or to what degree this affects a man's ability to father a child. In rare cases, surgery or an incarcerated hernia may injure the blood vessels that supply one or both testicles with blood, which may cause the affected testicle to shrink.
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