Inguinal scrotal hernia. How does a scrotal hernia manifest in men and what to do? Congenital inguinal hernia

An inguinal scrotal hernia is a surgical pathology, which is defined as the protrusion of part of the internal organs of the abdominal cavity into the scrotal area as a result of a number of provoking factors. There is no specific cause; the disease always develops under the influence of several factors at once.

It is believed that an inguinal hernia is the last stage in the development of an indirect inguinal hernia.

An inguinal scrotal hernia in men usually develops upon reaching 50 years of age, but this does not exclude the possibility of the disease developing in young people. Based on anatomical features, girls are not susceptible to this pathology.

The main factor in the development of this type of hernia is a strong increase in intra-abdominal pressure, as a result of which organs, under the influence of pressure, migrate to an area of ​​less resistance, which is the groin and scrotum. As a rule, elements of the gastrointestinal tract fall into the hernial sac: parts of the small and large intestines, the greater or lesser omentum.

There are two main types: congenital and acquired scrotal hernia. The specificity of the first option is determined by the anatomical and physiological characteristics of the baby’s development during the period of intrauterine development.

The boy's testicles do not immediately appear in the scrotal cavity. The baby's testicles begin to form and descend only from the third month of life in the mother's womb. So, as the testicles grow monthly, they gradually descend into the scrotum, and only by the end of 7-8 months do they reach their final destination. By the time the baby is born, the testicles are already located in the scrotum.

Normally, after the testicles descend, the canal through which the testicles passed closes. However, as a result of failures in embryogenesis or various genetic defects, such fusion may not occur. If the organs “follow” the boy’s reproductive organs, a hernia is formed in newborn boys.

Causes of acquired hernia

There are many factors that, to one degree or another, influence the development of hernia pathology.

These include:

1. Genetic predisposition to weakness of the ligaments and muscles of the hip joint.
2. Uncontrollable and intense physical exertion, such as carrying heavy weights. Most often, people whose lives involve constant physical activity suffer: athletes, builders, loaders.
3. The presence of excess weight, in which the greater and lesser omentum grows with adipose tissue. They push the organs out, forcing them into the groin area.
4. Sedentary lifestyle. Without minimal physical activity, muscles weaken and no longer serve as a muscular corset that maintains the tone of internal organs.
5. Diseases that are associated with constant coughing, regular constipation, sneezing. All of these are strong factors that increase pressure inside the abdominal cavity.

Clinical picture

Symptoms of inguinoscrotal hernia are varied. In many ways, the specificity of the signs is determined by the organs that are located in the hernial sac. However, bulging is always accompanied by pain. The pain is caused by constant irritation of the nerve endings, where there are already a lot of them in the pelvic area.

Painful sensations have the following character:

• increases with physical activity, but at rest there may be no pain;
• the intensity of the discomfort increases when you press on the hernia itself;
• The pain at first is easily relieved with painkillers.

Another noticeable symptom is the formation of the bulge itself. An external defect on the skin is easily noticed by the patient. There is asymmetry of the skin. The scrotum itself also greatly increases in size. Its volume sometimes reaches the size of a ripe watermelon.

In severe cases, the hernial sac may contain the entire intestinal tract.

Also, the following symptoms are typical for a groin hernia:

• frequent bloating, flatulence;
• nausea, loss of appetite;
• weakness, frequent malaise;
• during inflammatory processes, local lymph nodes enlarge;
• increased body temperature;
• discomfort.

The scrotum is part of the genitourinary system, so the following symptoms are recorded:

• erectile dysfunction;
• decreased libido;
• difficulty urinating.

With various complications, the following symptoms are layered:

• bowel dysfunction: feces do not pass through the strangulated intestine;
• no emission of gases;
• vomiting with intestinal contents.

Strangulated inguinal scrotal hernia

This condition is considered a serious complication of a stable course of the disease. Infringement occurs in both adults and children. Pinching usually means sudden compression of organs trapped in the hernial sac with subsequent cessation of their functional activity. As complications develop, local blood flow is disrupted.

The hernial ring is compressed, the vessels do not supply blood to the organs, necrosis and peritonitis often develop. The main syndrome that appears when pinched is considered to be acute intestinal obstruction syndrome. This condition must be treated exclusively with surgery.

Signs of a strangulated hernia in children:

1. Children, as a rule, become restless, irritable, take unnatural positions, may cry and almost always refuse to eat. Older children usually indicate the location of pain themselves.
2. At first, the body temperature is within normal limits, but as complications develop, the temperature rises sharply.
3. When examined, the hernia in boys becomes elastic, with severe pain.

Diagnostics

Diagnostic measures consist of three stages of examining the patient:

1. General inspection. Here the doctor assesses the general condition of the patient, examines his heredity, consciousness, and collects a life history.
2. Objective examination. In this case, the specialist studies everything that directly concerns the hernia: its size, degree of pain, stage of the disease, the likelihood of complications. In diagnosis, the cough impulse symptom is of great importance, when the doctor puts his hand on the hernia and asks the patient to cough. This is how differential diagnosis occurs between a strangulated and non-strangulated hernia.
3. Instrumental research methods:

• Ultrasound of the abdominal cavity, scrotum;
• herniography - a special x-ray examination of a protrusion;
• irrigography - the study consists of an x-ray examination of the colon, namely: its patency is studied;

Laboratory indicators such as a general blood test, biochemical analysis of blood and urine occupy a special place in the diagnosis of various complications. With a stable course of the disease, the laboratory is not very informative.

Treatment

Treatment of the disease is carried out both by conservative methods and by surgery. The first option is indicated in cases where surgery is contraindicated: the patient is elderly, has serious pathologies of internal organs.

A conservative treatment option involves wearing a special bandage, which allows you to keep local muscles toned and prevents the development of complications. A medical bandage for an inguinal scrotal hernia is most often represented by elastic swimming trunks that are in close contact with the body. They prevent internal organs from moving.

This type of treatment also involves taking a number of medications: anti-inflammatory drugs, muscle relaxants, painkillers.

However, the most effective method of treating a hernia is surgery. It should be remembered that treatment without surgery will not be as effective as with it. A direct indication for the operation is any complication. Operating procedures are performed under local anesthesia. The intervention itself does not take much time.

During the operation, an incision is made, as a result of which the surgeon gains access to the hernial sac. The specialist assesses the condition of the internal organs, which are then adjusted. After this, an inguinal canal plastic surgery procedure is performed in order to prevent complications after an inguinal scrotal hernia operation.

Consequences

The following consequences are considered common:

• tissue necrosis;
• inflammation of the abdominal cavity - peritonitis;
• appendicitis.

An inguinoscrotal hernia occurs when the internal organs of the abdominal cavity protrude through the inguinal canal into the scrotum. The cause of this deviation is weakness of the groin muscles and connective tissue disorders.

During the normal course of intrauterine development, the testicle develops in the abdominal cavity and then descends into the scrotum. If this does not happen, men in adulthood develop defects such as dropsy or inguinal-scrotal hernia. They are quite similar in manifestations and symptoms, but require different treatment; only a doctor can establish an accurate diagnosis. Based on this, it is necessary to conclude that one of the reasons for the formation of an inguinal-scrotal hernia is pathology of the prenatal period.

The problem often occurs due to excessive pressure inside the abdominal cavity. It can be provoked by a prolonged cough, difficulty in bowel movements, or heavy lifting. Depending on the characteristics, the hernia is identified as cord or testicular. In addition to the omentum, the hernial sac may contain intestines. Often the disease has the ability to progress. Diagnostics will help to begin timely treatment to avoid relapses. You need to remember about the possibility of complications.

Classification of inguinal-scrotal hernias

Depending on the location and size of the hernial sac:

• cordial;
• testicular.

By nature of education:

• straight;
• oblique.

Regarding provoking reasons:

• congenital;
• acquired.

According to the presence of infringements:

• elastic;
• fecal

Inguinal hernia occurs quite often. Conservative treatment is rarely effective in such cases; an effective method of eliminating pathology is surgery.

An indirect hernia can be either congenital or acquired. In such a case, prolapse of the internal organ occurs through the spermatic cord, and often remains inside it. A direct inguinal hernia is exclusively acquired; organ prolapse occurs due to weakness of the ligaments and muscles, which in this case are located outside the spermatic cord.

In the case of a combined hernia, several bags are formed; they are not interconnected and can be different depending on the nature of the formation.

Causes

Factors that determine a person’s predisposition to the formation of an inguinal-scrotal hernia include:

• genetics;
• mature age (often occurs in patients over 50 years of age);
• pathologies associated with the nervous innervation of the walls of the abdominal cavity;
• sedentary lifestyle;
• excess weight.

The manifestations of this deviation can be provoked by:

• significant physical activity aimed at the abdominal area;
• difficulty defecating, chronic constipation;
• problems with intestines, bloating;
• problems urinating (prostate adenoma);
• chronic cough.

Read also: Signs of an inguinal hernia in men

Often the disease is diagnosed in children; this is associated with pathology of intrauterine development, when the fusion of the vaginal peritoneal process has not occurred. The trigger for the formation of a hernia in a child can be frequent crying or coughing.

Symptoms that determine the presence of pathology

Patients diagnosed with an inguinal-scrotal hernia often come to the surgeon complaining of lumps in the groin area. In the absence of pinching, the pain symptom may be absent or less pronounced. If pinched, sharp pain occurs. The skin above the tumor acquires a bright color; when the hernial sac is lowered into the scrotum, it increases in size, and the pain syndrome increases.

It is difficult to name the maximum dimensions of an enlarged scrotum. In advanced cases, not only the hernial sac, but also the intestines go into it. There is no point in allowing pathology to reach such a state. If a tumor formation is detected in the groin area, you should contact a urologist or surgeon.

Symptoms include:

1. The occurrence of pain, which intensifies with movement and when urinating.
2. The tumor increases when coughing.
3. The scrotum does not increase proportionally on one side.

Manifestations of pathology may differ depending on the location of the hernia and the individual characteristics of the body. If the intestine is pinched, the patient may experience nausea and vomiting.

Diagnostic features

To make a diagnosis, as a rule, it is enough to undergo an examination by a surgeon. Incarceration of the hernial ring is checked using the “cough push” method. The surgeon places his hand on the bag and asks the patient to cough. If, when coughing, shocks are projected onto the hernia area, strangulation is not diagnosed. If the doctor does not feel any shocks, the hernia is pinched. Despite the fact that the diagnostic method seems primitive, it really helps the doctor make a diagnosis and, depending on this, select the necessary treatment.

If the formation is small, palpation may be difficult. In such a case, an ultrasound is prescribed. It allows you to detect the presence of a hernia at the stage of its formation. It is worth noting that this type of diagnosis is more accurate and completely safe.

To accurately determine the presence of loops of the large and small intestines in the area of ​​the hernial sac, radiography is used. If a spermatic cord cyst is suspected, it is advisable to perform a puncture and examine the hernial contents. The cyst often reaches a significant size and imitates an inguinal hernia. Such a study will help determine the nature of the tumor and understand the characteristics of therapy.

Such a defect can be either congenital or acquired. The first option accounts for the majority of cases of detection of inguinal-scrotal hernia in children under 2 years of age.

The problem lies in the disruption of embryo development. In male embryos, during the first 3 months of intrauterine development, the testicles are located in the posterior part of the peritoneum.

By about 5 months, the testicles begin to descend and enter the inguinal canal, which has developed by this time, through which they slowly move.

This process lasts until the 7th month of pregnancy. Only at the 9th month do the testicles completely occupy their correct anatomical place in the scrotum, and the pocket formed by the protrusion of the peritoneum closes.

After the birth of the child, it should be completely overgrown. If embryonic development is disrupted, the communication between the scrotum and the abdominal remains open and does not close. This leads to the fact that in the future, part of the intestine pushed out by pressure, and sometimes other internal organs, gets into the formed hernial sac.

In children, an inguinal-scrotal hernia is formed due to orthopedic pathologies, improper development of the nervous system, or constant physical activity. This diagnosis mostly occurs in children born prematurely.

As for men, the most common cases of inguinal-scrotal hernia formation are observed after 50 years, since during this period the muscle tissue weakens and becomes most vulnerable.

Provoking factors can be constant physical activity, excess weight, liver disease with the presence of ascites. Any of these factors can lead to increased intra-abdominal pressure. As a result, the organs come out through the connective tissues of the internal or external inguinal ring.

1 Congenital

In most cases, the cause of a congenital hernia is that the processus vaginalis of the peritoneum does not heal. A hernia occurs when the testicles pass from the peritoneum into the scrotum. During this, the organs extend beyond the boundaries of the abdominal cavity and a hernia occurs. The appearance may also be caused by underdevelopment of the abdominal cavity.

2 Purchased

An inguinal hernia is a more male disease than a female one. This is due to the anatomical features of a man. The phenomenon itself is a protrusion of the peritoneum into the area of ​​the inguinal canal.

In general, an inguinal hernia in men causes unpleasant and pronounced symptoms: there is a protrusion in the groin area, it increases in size when standing and decreases when lying down. The signs become more pronounced and the hernia becomes denser when straining, coughing, or sneezing.

Classification

Depending on the location of the hernia sac, there are 3 types of such formations: straight, oblique and combined. Each option has its own characteristics. When the contents of the sac extend through the entire inguinal canal next to the spermatic cord and the critical blood vessels supplying the area, an indirect inguinocanal hernia can be diagnosed.

• straight (closer to the middle of the body) and oblique, in the inguinal canal;
• actually inguinal, inguinal-scrotal cord and testicular according to the degree of descent of the contents of the hernia into the scrotum;
• disadvantaged and non-disadvantaged.

What's in the hernial sac?

By origin they are distinguished:

• congenital - formed in the prenatal state and is present in the boy at the time of birth;
• acquired - appears in a man during his life.

Depending on the origin, these pathologies are divided into congenital (they account for a small number of hernias) and acquired.

types of inguinal hernias

Scrotal hernia in children

Inguinoscrotal hernias in boys are most often congenital.

Prolonged crying and intestinal colic contribute to the growth of the tumor. Uncomplicated hernias in children have the ability to spontaneously reduce, so surgical intervention is recommended after 5 years. If there are complications, the operation is performed at any age.

Folk remedies provide temporary relief; it is impossible to get rid of a hernia with their help.

Since plant extracts can cause allergic reactions, they are used with extreme caution.

For oral administration use:

• Infusion of meadowsweet. 1 tsp. raw materials, pour 200 ml of boiling water, leave for 2 hours, take 4 times a day for a month.
• Tincture of cornflowers. 20 g of herb are brewed in 400 ml of hot water and left for 3 hours. The finished drug is drunk 50 ml 3 times a day.
• Clover decoction. Pour 1 glass of flowers with the same amount of water and boil for 10-15 minutes. Drink 0.5 cups before each meal.

For local treatment of hernia use:

• Sauerkraut brine. Gauze is soaked in the liquid and applied to the affected area overnight.
• Egg mixture. 100 ml of vinegar is mixed with 1 raw chicken egg and 100 g of lard. The drug is infused for a week in a cool, dark place. A compress with this ointment is left for 3-4 hours.
• Horsetail infusion. 3 tbsp. l. herbs are poured into 250 ml of boiling water, left for 40 minutes, the cooled liquid is used for compresses. The procedure is carried out before bedtime, the compress is removed in the morning.

A hernia in children can be a congenital defect of intrauterine development and appear immediately after birth. With this disease, the contents of the abdominal cavity descend into the scrotum.

The cause is non-fusion of the peritoneal process. At the initial stage of the formation of the genital organs in boys, the testicles are located in the peritoneum at the same level as the kidneys; later they, together with the peritoneum, descend into the scrotum.

The inguinal canal is lined from the abdominal walls. By the time of puberty, this process is overgrown.

Violation of this process leads to the formation of a scrotal or inguinal hernia.

Traditional treatment of inguinal hernia in men

An inguinoscrotal hernia is a prolapse of internal organs into the scrotum due to failure of the connective tissue of the internal or external inguinal ring, which are natural openings in the abdominal wall.

A hernia is a protrusion of an internal organ or part of it through a natural or artificial opening in a body cavity, called the hernial orifice. In this case, the integrity of the lining membranes and skin is not observed. Inguinal hernia is most often diagnosed in representatives of the stronger sex.

photo of inguinal hernia in men

Unfortunately, the first signs of this pathology are almost invisible. At the initial stage of hernia development, there is a slight swelling in the groin area.

It can have different sizes. In some cases, it is so large that human movement becomes difficult.

Over time, the bulge changes in size, especially with intense physical activity or changes in body position.

In the vast majority of cases, the hernial bulge has a round shape. This means that she is in the groin position.

When a hernia forms in the inguinal-scrotal area, the hernia in men has an elongated shape. The hernial bulge tends to fluctuate when straining or coughing. A clear sign of this pathology is that the prolapsed organ does not take its usual place in a supine position.

Many patients wonder: why is an inguinal hernia dangerous? If you do not start therapeutic actions in time, you can get one of the most dangerous complications - strangulation of internal organs, which can result in necrosis of the strangulated organ or the development of peritonitis.

Necrosis is the death of tissue, which is accompanied by an irreversible cessation of their functions. This condition is extremely dangerous not only for the patient’s health, but also for his life.

In case of necrosis of tissues and organs, immediate surgical intervention is required.

All patients with this pathology are concerned about the question of how to treat an inguinal hernia in men? In most cases, surgery is required. This is due to the fact that this pathology is practically intractable without surgical therapy.

Removal of an inguinal hernia in men is carried out by removing the formed hernial sac and repositioning the displaced internal organ in its place.

It is practically not accompanied by serious complications. This type of operation does not in all cases involve extraction and removal of the hernia.

At the initial stages of development of this pathology, obturation plastic surgery is used. During this operation, the tumor is inserted into the peritoneum through a small incision and then strengthened with a special mesh.

All manipulations to eliminate this pathology must be carried out at the first signs of the disease, then the likelihood of complications is reduced to zero.

Symptoms

With inguinal-scrotal hernia in men, symptoms can vary depending on the degree of protrusion and the duration of the disease. However, the most common is pain, which has characteristic features:

1. Present at rest or only during physical activity;
2. Intensifies with touching;
3. Goes away on its own with rest.

In the early stages, scrotal hernia in children is asymptomatic, which makes it difficult to identify.

Men with an inguinal-scrotal hernia usually complain of the presence of a tumor-like formation in one of the groin areas. If the hernia is not strangulated, then the formation is painless.

• A round, dense elastic formation in the scrotum or groin.
• The hernia is reduced in a lying position, appears when a person sits or stands, or strains.
• The hernia rumbles upon palpation.
• Constipation, difficulty urinating, flatulence, pain in the hernia area and abdomen.
• The inguinal ring is widened to the touch.

A scrotal hernia should be distinguished from hydrocele, varicocele and inguinal lymphadenitis. This is done using ultrasound and transillumination (diaphanoscopy). Our specialists will quickly make a diagnosis and prescribe the necessary treatment, which most often will be surgical. It is necessary to remember: the hernia does not go away without surgery, since there is a pathological canal in the anterior abdominal wall!

The following symptoms of a hernia are distinguished:

• The position of the scrotum changes. The patient can independently feel the tumor in the groin area.
• The patient experiences pain. The pain intensifies when performing physical exercises, or when accidentally pressing on the scrotum.
• The lymph nodes in the groin area are enlarged.
• A person may also experience other unfavorable symptoms: weakness, nausea, fatigue.
• When a hernia is strangulated, the skin underneath turns red and the size of the scrotum increases.

Diagnostics

The examination plan for inguinal-scrotal hernia in men includes:

1. Consultation with a therapist. At this stage, the general condition of the body is assessed and genetic pathologies are identified.
2. Examination by a surgeon. The doctor determines the location and size of the hernia, the presence of signs of inflammation and pain. An important role in diagnosing the disease is played by the assessment of the cough impulse symptom. The specialist places his hand on the protrusion and asks the patient to cough. Reducible hernias increase in size, while irreducible hernias do not change their size.
3. Ultrasound of the scrotum and abdominal area. Helps assess the volume of prolapsed organs and detect signs of inflammation and necrosis.
4. Herniography. It is an X-ray examination of the hernial cavity with the introduction of a contrast agent.
5. Irrigography. Examination of the colon helps to assess the patency of the organ and identify stagnation of feces.
6. General and biochemical blood tests. Used to identify complications associated with infection and inflammation of hernial contents. In this case, an increase in ESR and leukocyte count is detected.

If there are signs of an inguinal-scrotal hernia in a man, he should be examined by a surgeon. After clarifying the nature of the existing symptoms and an external examination, the doctor prescribes the following studies:

• Ultrasound of the scrotum, abdominal cavity and pelvic organs;
• irrigoscopy;
• herniography;
• cystography.

Considering that in most cases patients require surgical treatment, tests are immediately carried out to determine blood type, sugar level and Rh factor.

The first step in diagnosis is clarification of complaints and questioning regarding the development of the disease. This information helps in making a preliminary diagnosis and determining whether a strangulated or non-strung hernia. The duration of the disease also helps to assess the presence of complications, the degree of intestinal obstruction and the severity of the process.

To make an accurate diagnosis, a clinical examination is required. Checking for infringements is carried out using the “cough push” technique.

The doctor puts his hand on the resulting bulge and invites the patient to cough. When shocks caused by coughing are reflected into the hernia, there is no strangulation; if the shocks are not felt, strangulation has occurred.

Thanks to this technique, you can immediately determine the extent of the required surgical intervention. However, if the hernia is small, it is very difficult to use this method.

Instead of a “cough shock,” ultrasound examination is used, which gives the most accurate results in such cases. Examination of formations in the groin area in children is carried out using ultrasound, which is considered safe for children's health.

Another method of examination is radiography, which allows you to determine the presence of loops of the large and small intestine caught in the hernial formation.

As a rule, a clinical examination is quite sufficient to accurately diagnose an inguinoscrotal hernia. In order to find out whether the hernial ring is strangulated or not, the symptom of a “cough impulse” is checked.

They place a hand on the hernial sac and ask the patient to cough. If the cough impulse is transmitted to the hernial sac, then this indicates that there is a non-strangulated inguinal hernia.

If the hernia does not protrude with coughing movements, then a diagnosis of an incarcerated inguinal hernia is made. Such differential diagnosis is very important, as it completely determines the tactics of surgical treatment.

In some cases, for example, with a small hernia, it can be quite difficult to make a diagnosis and it is necessary to use additional research methods. Thus, ultrasound examination can provide more accurate information about the origin of a tumor-like formation in the groin area.

Contrast radiography of the abdominal organs is also used to determine the presence of loops of the small or large intestine in the hernial sac.

In rare cases, puncture of the hernial sac can be used for diagnosis. As a rule, it is performed in cases of suspected spermatic cord cyst. which can reach large sizes and imitate an inguinal hernia. Histological examination of the puncture material gives an accurate conclusion about the origin of the formation.

The diagnosis of inguinal-scrotal hernia is made after undergoing an appropriate examination. The specialist carefully examines the patient and listens to his complaints.

For a correct diagnosis, if signs are detected, you should consult a surgeon, since the pathology is surgical, and a urologist to exclude urological diseases with similar symptoms (varicocele, hydrocele).

An inguinal hernia (abbreviated as inguinal hernia) is diagnosed in a short time. Its definition does not cause any particular difficulties. When you consult a doctor while the disease is in a calm stage, the accuracy of diagnosis increases.

• examination by a doctor;
• undergoing irrigoscopy;
• herniography;
• examination by a surgeon.

There are several stages of examining a patient by a surgeon to clarify the diagnosis. Often, the surgeon additionally prescribes an ultrasound to confirm the diagnosis.

First, the doctor examines the groin area. And he conducts a survey of the patient to clarify such points as: whether there is pain in the groin, the period of hernia manifestation, what stress the patient experiences in everyday life and in professional activities.

In some cases, manifestations of PGR are unnoticed by the patient. In other cases, a person feels aching pain in the lower abdomen. They may intensify during physical activity. It happens that slight overexertion already provokes a hernia to appear.

Treatment methods

Conservative treatment methods cannot completely get rid of a scrotal hernia, but they can alleviate the patient’s condition if it is impossible to perform the operation or during the period of preparation for it. For this use:

• medicines;
• physiotherapeutic procedures;
• orthopedic devices;
• physical therapy;
• folk remedies.

Conservative therapy

If the patient has no complications, the contents of the hernial sac can be reduced without surgery. If there are contraindications for surgical intervention, therapy is carried out using conservative methods.

In this case, treatment of a scrotal hernia is carried out with the help of a support bandage, a course of massage and special exercises that help strengthen the muscle corset and stabilize the condition. In the conservative treatment of an existing inguinoscrotal hernia, some medications can be used to a limited extent.

Regardless of the stage of the disease, the presence or absence of complications and the degree of infringement, surgical treatment is recommended for patients. The operation is performed under local anesthesia, since its duration is short and the scope of intervention is limited. Preparation for surgery:

1. Performing a cleansing enema in the morning before surgery;
2. Refusal to eat the evening before the intervention;
3. Prescribing antibiotics for prophylactic purposes;
4. Hair removal from the groin area and the front wall of the abdomen;
5. For patients with diseases of the cardiovascular system - tight bandaging of the lower extremities;
6. Placement of a urinary catheter and complete emptying of the bladder.

The patient is placed on the operating table, positioned on his back, straight. An incision is made and layer-by-layer access to the hernial sac is made.

An audit is performed and the condition of the organs that have been protruded is assessed. The hernial sac is removed and the contents are reduced.

Then plastic surgery of the inguinal canal is performed to prevent relapses. To perform plastic surgery, lavsan mesh or your own fabrics are used.

The final stage of the operation is layer-by-layer suturing of the wound and installation of drainage. The peculiarity of the operation is that there is a risk of injury to the spermatic cord, which is located near the hernia.

Therefore, before starting to reduce the hernial contents, it is necessary to find the spermatic cord and separate it. The operation should be performed by an experienced surgeon, which will significantly reduce the risk of possible complications.

Since there are contraindications to surgery, and certain groups of people are not recommended to undergo surgery, conservative treatment has been developed. However, this therapy is ineffective. Conservative treatment is also prescribed for men with a small non-strangulated inguinal-scrotal hernia and a low risk of strangulation.

Contraindications for surgery:

• Severe general condition of the patient;
• Anemia of unknown origin;
• Acute infectious and inflammatory diseases in the body;
• Patient's refusal to undergo surgery.

Conservative treatment is based on methods of reducing hernial contents and wearing a special bandage for inguinal scrotal hernia. The support bandage is an elastic pant that fits tightly to the body, due to which the organs do not have the opportunity to fall out into the hernial orifice and scrotum.

It is also necessary to strengthen the abdominal muscles by playing sports or using exercise equipment that is attached to the required area of ​​the body and vibrating movements strengthen the required area.

In addition to treatment aimed at eliminating the hernia, symptomatic therapy is prescribed. It includes anti-inflammatory drugs, which also relieve pain, and detoxification therapy.

Treatment of inguinal-scrotal hernia with folk remedies cannot be an independent type of treatment. Such methods should be prescribed by a doctor based on the patient’s condition and in combination with surgical treatment.

Treatment of scrotal hernia with folk remedies occurs externally by rubbing ointments onto the affected area of ​​the scrotum, and internally.

Surgical intervention for scrotal hernia in boys is aimed at giving the prolapsed organs the correct position and eliminating the hernial canal.

This is done in 2 ways:

• by stretching and suturing the tissues of the inguinal canal;
• by installing an artificial mesh, which is highly flexible and durable and does not cause rejection.

Open way

In children, the most effective treatment is surgery. Thanks to recent developments in medicine, surgery is possible even in infants.

Modern techniques allow the operation to be performed without opening the inguinal canal, which reduces the risk of infertility in the future. There are several options for inguinal-scrotal hernia operations; the attending physician chooses it based on the examination results.

Children recover quite quickly. 3 hours after the operation, in the absence of complications, the child is discharged.

Cases with a strangulated hernia are the most dangerous, as they can lead to death. Immediate medical attention is required; minutes may count.

There are conservative and surgical methods for treating inguinal-scrotal hernia in men.

However, in most cases, doctors recommend an operative method of treatment, through surgery. If the inguinal-scrotal hernia is strangulated, a test is carried out for organ viability due to the entry of a loop of colon into the hernial sac. After checking, the hernial sac is removed, and the hernial orifice is subjected to plastic surgery.

The Lichtenstein method is considered the most popular method of inguinoscrotal hernia repair in the world. The operation using this method combines several recognized advantages: local anesthesia, conventional surgical access, ease of execution, low cost of the operation, stable results, rapid postoperative recovery of the patient.

Read how an inguinal hernia is removed in men and boys here.

The operation takes place in several stages under local anesthesia or general anesthesia. The surgeon dissects the damaged cavity and gains access to the hernial sac. Next, it is separated from the spermatic cord and dissected. The doctor determines the viability of the strangulated organs; in case of necrosis, resection of the affected parts occurs.

After suturing, plastic surgery of the inguinal ring is performed. After the operation, the patient is recommended to remain in the hospital for a week under the supervision of doctors.

The use of conservative methods of treating a hernia is used when surgery is contraindicated for medical reasons. It is impossible to get rid of a scrotal hernia at home; you can only relieve pain and slightly reduce the protrusion.

To maintain their health, patients are prescribed to wear a bandage or special elastic underwear. It will help to avoid injury and physical impact on the protrusion, and will fix the scrotum in its natural position.

There are several ways to treat hernia using traditional methods.

Clover decoction

You need to collect one glass of plant flowers and pour a glass of boiling water. You need to insist for an hour. Drink one tablespoon before each meal.

Cornflower tincture

Pour three teaspoons of flowers into two glasses of boiling water. You need to insist for at least two hours. Drink the resulting tincture in one day in four doses.

Meadowsweet decoction

Meadowsweet is widely used in the treatment of hernia. To prepare the tincture, you need to take a teaspoon of the plant and pour a glass of hot boiled water. The broth should infuse for two hours. Divide the resulting tincture into four parts and drink it the day before.

The duration of the treatment course using traditional methods should vary from two weeks to a month. If side effects occur or treatment fails, you should stop taking herbs.

Disease prevention

A scrotal hernia is the result of an inguinal protrusion. At the very beginning of the development of the disease, the hernial sac from the abdominal cavity enters the inguinal canal, and then descends into the scrotum. By contacting a doctor in time and correctly establishing a diagnosis, you can stop the development of the disease in the initial stages.

People whose professional activities involve heavy lifting and heavy physical activity should undergo a routine medical examination annually.

A responsible approach to regular diagnostics of the body, implementation of preventive measures and a healthy lifestyle will help avoid the occurrence of a scrotal hernia. Timely detection of the disease and surgical treatment will help get rid of the problem and prevent the occurrence of concomitant diseases.

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Treatment of this disease can be carried out using conservative or surgical methods. Conservative treatment is recommended in cases where surgery is contraindicated. As a rule, this occurs in elderly patients or with serious diseases of internal organs in the stage of decompensation.

Conservative treatment of an inguinal hernia involves the use of a special bandage that prevents strangulation of the hernial sac. As a rule, the bandage has the form of elastic swimming trunks that fit tightly to the body and prevent the internal organs from falling into the hernial sac.

The more common method of treating inguinoscrotal hernias is surgery. In case of inguinal ring infringement, the operation is performed according to vital indications, and in the absence of infringement - as planned.

If we are talking about a strangulated hernia, when a loop of the small intestine has entered the hernial sac, it is imperative to check the latter for viability. With a normal pink color and active peristaltic movements of the organ, it is simply immersed in the abdominal cavity.

If the intestine is black or purple in color and does not contract well, it is removed and an anastomosis is performed between the ends of the intestine.

Since any treatment methods, even traditional ones, that are not based on surgical intervention, do not have a lasting positive effect on inguinal hernia, there is no need to talk about the effectiveness of traditional methods of treatment.

Before using traditional methods of treatment, you should consult your doctor. You can drink a decoction of clover flowers: to prepare it you need to take 20 grams of plant material per 200 ml of boiling water. The product should be infused for at least an hour. The decoction should be drunk 50 ml three times a day.

Some people make lotions. For example, add a few drops of 4% vinegar to 20 ml of water. The part of the body in which the hernia is located must be thoroughly wiped, after which you need to moisten a clean napkin in the medicinal solution. The lotion should be applied to the tumor in the groin area.

Cornflower tincture is also used to treat the disease. 20 grams of medicinal raw materials are poured into 200 ml of boiling water, the mixture is infused for two hours, after which it must be filtered. You need to drink 100 ml of herbal remedy twice a day. In the absence of an allergic reaction, this tincture can be given to a child to drink.

Treatment without surgery

The following intervention methods exist:

1. Tension. The hernial opening is eliminated by tensioning and fixing its own tissues.
2. Non-tensioned. To eliminate an inguinal-canal hernia, a surgical mesh is used to create a durable frame.

Contraindications to surgical treatment are:

• old age of the patient;
• decompensated diabetes mellitus;
• acute cardiac and respiratory failure;
• acute infections.

The operation to eliminate a hernia in the groin area includes the following steps:

• administration of anesthesia;
• gaining access to hernial contents;
• separation of the abdominal organs from the testicle and spermatic cord;
• inspection of pinched tissues for necrosis and inflammation;
• giving organs the correct position;
• cutting off the hernial sac;
• closing the defect with an implant or your own tissues;
• suturing the surgical wound.

Rehabilitation period

During the recovery period it is necessary:

1. Provide quality wound care. The bandage is changed daily, the seams are treated with antiseptic solutions.
2. Avoid increased physical activity.
3. Perform exercises aimed at strengthening the muscles of the pelvic and abdominal area.
4. Eat properly. Yeast dough, legumes, fatty and fried foods are excluded from the diet. Fermented milk products, fresh vegetables and fruits are healthy.
5. Wear a bandage. The device prevents the recurrence of a hernia.

Surgical elimination of inguinal-scrotal hernia is the only effective method of treating such defects. If there is no infringement, the operation is performed as planned. In cases where there are signs of this complication, urgent surgical intervention is required. In the morning of the day of surgery, you must stop drinking water and food. In addition, the patient requires consultation with an anesthesiologist.

In the treatment of inguinal-scrotal hernia, various intervention methods are used depending on the characteristics of the existing defect. Often, the contents of the sac are reduced and the hernial orifice is sutured by laparoscopic intervention.

If the gate is large, a special mesh is installed, which in the future prevents the recurrence of this pathology. If there is a strangulated hernia, open surgery may be required.

The next day after surgery, the patient is allowed to stand up and move around the room. If there are no complications, the man can be discharged after 3 days. After approximately 7 days, the sutures are removed. During the postoperative period, patients are often prescribed painkillers and antibiotics.

The doctor carefully examines the patient's medical history. If he has chronic renal failure or a low-quality tumor, it is necessary to treat the disease with conservative methods.

In addition, there are the following contraindications to the operation:

• Senile age of the patient.
• Severe heart and respiratory diseases diagnosed in a man.
• Severe exhaustion.
• Serious chronic diseases of the genital organs.

If the patient is diagnosed with an “inguinal hernia” and has no contraindications to its implementation, then he is offered an operation, which consists of eliminating the resulting hernial sac. During this procedure, the displaced organ is moved back to its normal location. After this, the walls of the inguinal canal are strengthened. This can be done in two ways:

• By creating a duplication (doubling the fold of the aponeurosis by stretching and suturing to the muscle fibers).

• By sewing a special synthetic mesh made of special materials (polypropylene) to the canal. In this case, various weaving options are used, which affect the cost of this mesh. This procedure is called hernioplasty without stretching the internal tissues. Most often it is carried out using the endoscopic method.

Modern techniques make it possible to make surgery to remove an inguinal hernia the least traumatic. At the same time, the risk of relapse is minimized, and the recovery process is short-term.

One of the most popular methods of surgical intervention is laparoscopy, in which there is no suture in the usual sense. After it, there is no usual scar left, since the operation is carried out using modern video means, by making three small punctures in the anterior abdominal wall.

All manipulations are performed under anesthesia.

There are limitations to surgical intervention. These include:

• patient's age;
• health status;
• intolerance to medications used for anesthesia.

If there are one or more contraindications to surgery, the patient is prescribed conservative treatment. Special bandages are used for it.

A bandage for inguinal hernia in men is most often used as a measure to stop the development of pathology. It is also used to prevent strangulation of hernial contents.

It is also used to prevent relapses after surgery.

Possible complications

Does a scrotoinguinal hernia affect male infertility?

The most common complication of a hernia, regardless of its location, is strangulation. In relation to an inguinal-scrotal hernia, strangulation is dangerous because the intestine can get into the hernial sac and the patient will develop signs of acute intestinal obstruction.

And then peritonitis. In such a situation, an operation will be needed, which is performed not through a small inguinal incision, but a midline laparotomy, after which a scar will remain on more than half of the abdomen.

Another serious complication of a scrotal hernia, which is more common in young patients, is erectile dysfunction and infertility. The fact is that when a whole complex of organs prolapses into the scrotum, they put significant pressure on the testicles and vas deferens.

As a result, the latter simply stop functioning and do not produce sperm. If, after some time, such a patient is operated on, then the chance that he will restore normal activity of the testicular glands remains minimal.

Prevention

Primary prevention means:

• avoiding excessive physical activity;
• timely treatment of diseases accompanied by cough;
• introduction of moderate physical activity into the daily routine;
• body weight control.

Patients at risk should undergo regular examinations by a surgeon.

To reduce the risk of developing an inguinoscrotal hernia, you need to regularly exercise in the morning and maintain the desired level of physical activity. Long walks can be of great benefit.

It is imperative to follow the rules of a healthy diet, including in your diet a large amount of vegetables and fruits containing plant fiber, which has a positive effect on the functioning of the digestive system.

As part of the prevention of the development of inguinal-scrotal hernia, it is necessary to normalize the work and rest regime.

Basically, an inguinoscrotal hernia is the result of an inguinal hernia. because first the hernial sac from the abdominal cavity enters the inguinal canal, and only then descends directly into the scrotum.

And if effective treatment is carried out at the first stage, then the second can be avoided. To do this, you need to contact a surgeon in time and carry out a minor surgical intervention as planned.

As for the primary prevention of inguinal-scrotal hernias, it is more complex. It is difficult to explain to patients who engage in physical work that their profession is a direct path to an inguinal hernia. Probably, in such a situation, the most optimal would be annual preventive examinations with a surgeon to identify the disease in the early stages.

Also, to prevent an increase in intra-abdominal pressure, which can also be the cause of an inguinal hernia, it is necessary to promptly diagnose and treat liver diseases, which are often accompanied by this particular symptom.

An inguinal hernia is a fairly common occurrence, but if certain rules of prevention are followed, its occurrence can be prevented. People actively involved in physical education should monitor the stress on the body and not get carried away with lifting heavy weights.

The best way to prevent such a hernia is to regularly perform abdominal strengthening exercises. Also, an important role in the prevention of hernia is played by giving up bad habits, overeating, and timely elimination of diseases of the internal organs that lead to constipation and chronic cough.

An inguinal hernia in men is a rather serious disease, which, if not treated in a timely manner, can lead to dangerous complications, so it is extremely important to promptly identify the symptoms of this pathology and prescribe the correct treatment.

Forecast

The prognosis for timely diagnosis and surgical treatment is favorable for life and health, however, for professional activity it is conditionally favorable. Men are advised to refrain from work involving heavy physical exertion.

If the disease is diagnosed late, there is a risk of complications that can lead to general intoxication syndrome and death. In this case, the prognosis for health and life is unfavorable.

Also, a strangulated hernia, compared to a non-strangulated hernia, has a less favorable prognosis. This is due to the likelihood of developing complications.

megan92 2 weeks ago

Tell me, how does anyone deal with joint pain? My knees hurt terribly ((I take painkillers, but I understand that I’m fighting the effect, not the cause... They don’t help at all!

Daria 2 weeks ago

I struggled with my painful joints for several years until I read this article by some Chinese doctor. And I forgot about “incurable” joints a long time ago. That's how things are

megan92 13 days ago

Daria 12 days ago

megan92, that’s what I wrote in my first comment) Well, I’ll duplicate it, it’s not difficult for me, catch it - link to professor's article.

Sonya 10 days ago

Isn't this a scam? Why do they sell on the Internet?

Yulek26 10 days ago

Sonya, what country do you live in?.. They sell it on the Internet because stores and pharmacies charge a brutal markup. In addition, payment is only after receipt, that is, they first looked, checked and only then paid. And now everything is sold on the Internet - from clothes to TVs, furniture and cars

Editor's response 10 days ago

Sonya, hello. This drug for the treatment of joints is indeed not sold through the pharmacy chain in order to avoid inflated prices. Currently you can only order from Official website. Be healthy!

Sonya 10 days ago

I apologize, I didn’t notice the information about cash on delivery at first. Then, it's OK! Everything is fine - for sure, if payment is made upon receipt. Thanks a lot!!))

Margo 8 days ago

Has anyone tried traditional methods of treating joints? Grandma doesn’t trust pills, the poor thing has been suffering from pain for many years...

Andrey A week ago

No matter what folk remedies I tried, nothing helped, it only got worse...

Protrusion of elements of the abdominal organs through the inguinal canal is characterized as an inguinoscrotal hernia. This condition can be congenital or appear simultaneously with age-related changes, and is observed much more often in the male part of the population than in women.

The pathology responds well to treatment, especially timely treatment. Advanced cases can threaten strangulation of the hernial sac and necrosis of the strangulated organs.

ICD 10 code:

• K 40 – inguinal hernia.
• K 40.0 – bilateral inguinal hernias with symptoms of obstruction.
• K 40.1 – bilateral inguinal hernias with gangrenous complications.
• K 40.2 – uncomplicated bilateral inguinal hernias.
• K 40.3 – unilateral or unspecified, with symptoms of obstruction.
• K 40.4 – unilateral or unspecified with gangrenous complications.
• K 40.9 – unilateral or without specification, uncomplicated.

Causes of inguinoscrotal hernia

The factors that determine a person’s predisposition to the occurrence of an inguinal-scrotal hernia are:

• heredity;
• age after 50 years;
• neurological pathologies affecting the nerve innervation of the abdominal wall;
• obesity, extra pounds.

Functional factors that can lead to the appearance of pathology include the following:

• excessive physical activity on the abdominal area;
• chronic difficulty defecating, constipation;
• prostate adenoma, accompanied by urination problems;
• chronic coughing attacks.

Pathogenesis of the disease

The main causes of this disease are closely related to the structural features of the muscular-ligamentous apparatus of the abdominal and inguinal zone of a particular patient. The most important point is the condition of the inguinal canal itself and the inguinal ring. Weakness of these organs predisposes to the appearance of a hernia.

Inguinoscrotal hernias are divided into the following types:

• By location:
  • On the one side;
  • on both sides.
• Typical:
  • direct hernia;
  • oblique hernia.
• According to the variant of occurrence:
  • congenital type;
  • acquired type.
• By degree of development:
  • initial form;
  • inguinocanal form;
  • complete indirect inguinal hernia;
  • inguinoscrotal hernia;
  • giant shape.
• According to the nature of the flow:
  • without complications (with and without reduction);
  • with complications (with strangulation, with coprostasis, with inflammation, etc.).
• By severity:
  • simple hernia;
  • transitional form;
  • complex hernia.

Symptoms of inguinoscrotal hernia

An oblique inguinal-scrotal hernia is more common than a direct one. Direct hernia occurs only in 5-10% of cases, and even then mainly in older people. In most cases, such protrusion is bilateral. An indirect hernia usually appears in patients from adolescence to middle age, usually on one side.

One of the most characteristic symptoms of hernial pathology is a tubercle in the form of swelling in the groin area. An oblique inguinal-scrotal hernia has an oblong shape, it is located along the inguinal canal and is often lowered into the scrotum. If the protrusion is large, then part of the scrotum can be significantly enlarged, the skin on it becomes tense, and there is a visible deviation of the penis to the opposite side. With a giant hernia form, the penis may be buried in the folds of skin.

A direct inguinal-scrotal hernia has a relatively round shape and is located in the middle section of the inguinal ligament.

In situations where the hernia defect is located above the intended exit of the inguinal canal opening, it is necessary to exclude peri-inguinal or interstitial pathology.

Inguinoscrotal hernia in men manifests itself as severe pain. Pain may appear when palpating the area of ​​the protrusion, after physical activity, but the pain subsides with rest. Individually, signs such as general weakness and discomfort, dyspeptic symptoms (attacks of nausea, vomiting) may appear.

Inguinoscrotal hernia in children can form at any age, most often on the right side. The first signs can be seen with the naked eye:

• when the abdomen tenses, during laughter, sneezing, coughing, a tubercle with soft contents appears in the groin area;
• the tubercle disappears at rest or hides when pressed.

Sometimes discomfort and mild pain may appear, mainly after physical activity.

Inguinoscrotal hernia in newborns It is innate in nature and is formed inside the mother’s womb. The pathology can be determined already in the first months of the baby’s life: a lump in the groin appears and becomes larger during the child’s screaming and anxiety and disappears when the baby calms down. The tubercle is painless to the touch, has a round or oval shape, and is easily reducible.

A strangulated inguinal-scrotal hernia is a dangerous condition and requires urgent medical attention. How to recognize such a complication?

• The skin at the site of the protrusion becomes purple or bluish.
• Severe pain, nausea, or vomiting occurs.
• Disorder of stool, flatulence appears, and appetite disappears.

When pinched, the tubercle becomes very painful when touched. It is no longer possible to set it back, whereas an unstrangulated inguinal-scrotal hernia easily hides when pressed with a finger.

Constipation with an inguinal-scrotal hernia occurs when a loop of intestine is strangulated - a condition occurs that fully corresponds to the characteristics of intestinal obstruction. Constipation may be accompanied by a significant deterioration in health, bloating, belching, heartburn, and vomiting. It is pointless to wait for relief in such a state - it is necessary to urgently call “emergency help”.

Consequences

Complications of inguinal-scrotal hernia develop in the absence of timely treatment:

• strangulation of the hernial tubercle is the most common consequence, which can only be eliminated by surgical methods;
• necrosis of organs caught in the pinched hernial sac - intestinal loops, areas of the omentum, bladder;
• peritonitis - a dangerous inflammatory reaction that spreads to the entire abdominal cavity (can also occur as a result of strangulation);
• acute attack of appendicitis - inflammation of tissue in the appendix, which occurs as a result of compression of the vessels of the appendix by the inguinal ring;
• The clinical consequences of an inguinal hernia can include digestive disorders, intestinal dysfunction, bloating, etc.

The most serious complication is considered to be a strangulated hernia - this situation requires urgent medical attention, with hospitalization in a hospital and emergency surgery.

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Diagnosis of inguinoscrotal hernia

The doctor makes a diagnosis based on the patient’s complaints, as well as the results of an external examination. Palpation is carried out using the index finger: with an inguinal-scrotal hernia, the tubercle is easily palpated, but with a femoral hernia, it is quite difficult to palpate.

In children, the doctor simultaneously determines the descent of the testicles into the scrotum, their size and shape, and the absence of varicocele. The condition of the lymph nodes in the groin area is mandatory.

The condition of the hernia defect is checked in the horizontal and vertical position of the patient.

• Ultrasound scanning of the scrotum, which helps determine the contents of the hernial sac (for example, part of the bladder or part of the intestine). Additionally, using ultrasound, you can distinguish a hernia from testicular hydrocele;
• The diaphanoscopy method is a light transillumination of the scrotum - a simple and inexpensive diagnostic method. If the contents of the bag are liquid, then the rays are illuminated through the tubercle without problems. A denser structure will not allow the rays to pass through, and the light will appear dim or uneven.

Treatment of inguinoscrotal hernia

Drug therapy for inguinal-scrotal hernia disease is ineffective, and therefore this pathology can only be cured surgically. The operation can be performed from the age of 6 months (it is not advisable for newborns to undergo the intervention due to the use of general anesthesia).

Anesthesia is usually combined with tranquilizers and drugs for local anesthesia - this helps prevent the occurrence of severe pain in the postoperative period.

Surgery for inguinal-scrotal hernia is called herniotomy:

• the doctor makes an incision in the inguinal canal area;
• cuts off and sutures the hernial formation;
• elements of organs that are pinched are restored to their physiological place - the normal anatomical structure of the inguinal and abdominal region is restored.

During the operation, the surgeon ensures that the spermatic cord and efferent duct are not damaged.

As a rule, herniotomy surgery is not complicated - the procedure itself lasts no more than half an hour. Most often, the patient is discharged the next day, but bed rest is recommended for another three days. If the doctor applied regular stitches, they are removed after 7-8 days.

Traditional treatment for a hernia - applying tight bandages, applying coins, lotions, magnets, compresses - is a useless exercise. By engaging in such treatment, the patient only wastes time, which can lead to complications in the form of a strangulated hernia, which will require urgent surgical intervention. If the patient was operated on within 2 or 3 hours after the hernia was strangulated, then such an operation is successful in most cases. Delay in intervention can lead to serious complications, and in some situations, even fatal consequences.

Bandage for scrotoinguinal hernia

There is only one conservative technique that is used in the treatment of inguinal-scrotal hernia pathologies - this is a bandage.

In what cases may a doctor prescribe wearing a bandage:

• large hernial formations, if it is impossible to perform surgery for one reason or another;
• reappearance of pathology after surgical treatment;
• the presence of contraindications to surgical intervention (age restrictions, cardiovascular pathologies, problems with blood clotting, etc.);
• childhood diseases in which surgery is postponed indefinitely.

At the same time, the bandage does not radically cure the disease. Its purpose is to alleviate the patient’s condition, stop the increase in hernial protrusion and prevent strangulation. However, if the patient stops using the bandage, then all signs of pathology return.

So, what does wearing a bandage give:

• the degree of discomfort decreases;
• the patient's ability to work returns;
• the hernia loses its tendency to worsen and strangulate.

The bandage is put on every morning, on the naked body, in a horizontal position. At first, wearing it may be a little uncomfortable, but after a few days the patient gets used to it and does not notice any discomfort. Of course, choosing the right bandage is important: a medical specialist at a clinic or pharmacy can help with this.

The bandage can be removed before going to bed, but if the patient has coughing attacks at night, it is not necessary to remove the support device.

As practice shows, wearing a bandage is a temporary phenomenon, and sooner or later the patient still has to decide on surgery.

A scrotal hernia is said to occur when some internal organs move out of their normal anatomical position and protrude into the scrotal cavity. This disease occurs only in men. The most common patient age is 50-55 years. However, a scrotal hernia can also be found in children. Among the organs that go beyond their limits, parts of the intestinal tract, omentum or bladder are most often encountered.

The process of hernia development and causes

During normal development in male fetuses, the testicles mature in the abdominal area. When the fetus reaches five months of age, the testicles increase in size and gradually descend towards the entrance to the inguinal canal. Having reached seven months of life in intrauterine development, the boy’s testicles begin to move along the canal, and the vaginal process is formed along its course. Just before birth, the testicles enter the scrotal cavity completely. Thus, a certain communication with the abdominal cavity is maintained.

At birth, this canal normally closes and heals. But with defective maturation, the entrance to the abdominal cavity may remain open. This phenomenon may subsequently lead to the development of a hernia in the scrotum. This is a boy’s genetic predisposition to the development of pathology . There is another class of causes - acquired scrotal hernias.

The following factors influence the occurrence:

• weakness of the abdominal muscles;
• overweight, increasing the load on the abdominal organs;
• acquired injuries in the groin or abdomen area;
• sudden weight loss. The fat layer is one of the factors that acts as a corset for internal organs. When fat support disappears in the abdominal cavity, excess space is created where organs can collapse;
• long-term sedentary lifestyle, in which muscles lose their tone and weaken without prolonged stress. As a result, the abdominal muscles are unable to resist pressure;
• strong physical activity leading to increased pressure inside the abdomen;
• chronic cough, loading weakened areas on the abdominal wall.
• digestive disorders(constipation), leading to increased intra-abdominal pressure.

The inguinal canal normally contains some vessels and the spermatic cord. However, when a number of muscles are weakened and connective tissue is damaged, as a result of influencing factors, internal organs can go beyond their boundaries and descend along the inguinal canal into the scrotum.

Types of scrotal hernias

The following subtypes of hernias on the scrotum are distinguished:

1. Kanatikovaya- this is a variety that is characterized by the lowering of the hernial sac to the spermatic cord.
2. Inguinal-scrotal– the hernia descends to the line of the testicles.

Clinical stages of scrotal hernia formation

It should be emphasized that the hernia does not immediately appear in the scrotum, but goes through a series of transformations and stages before reaching its final destination.

Clinical stages of scrotal hernia formation:

1. Minor changes in the position of the scrotum. Externally, there is a slight protrusion in the groin area.
2. The appearance of pain in the scrotum. At this stage, pain does not spread beyond the groin area.
3. Clinical stage. This stage is characterized by severe symptoms.
4. Enlarged lymph nodes in the groin area.

Hernia symptoms

Signs of the disease vary depending on the stage of formation and duration of the disease.

However, a hernia in the scrotum has a number of “recognizable” symptoms:

1. Painful sensations appear as under load scrotum, and when it is calm.
2. The pain intensifies when touched to the damaged area.
3. The pain may suddenly go away on its own.
4. External deformation. There is asymmetry and elongation of the scrotum. Sizes can vary: from the volume of an acorn to the size of a melon. Medicine knows cases when patients came with a scrotum the size of several footballs.
5. General symptoms: increased body temperature, fatigue, irritability, decreased performance.

A complication of a hernia can be its pinching.

In this case, several more symptoms are added:

1. Deterioration of stool passage through the intestinal tract against the background of pinching of several parts of the colon. To this is also added difficulty in the emission of gases or their complete absence, which results in flatulence - a pathological accumulation of gases and bloating.
2. Stool may accumulate in the hernial sac, which is located in the scrotum. Then it becomes even larger in size.
3. Nausea and vomiting of intestinal contents.

How is the disease diagnosed?

A hernia on the scrotum has a number of similarities with other diseases. In order to make an accurate diagnosis, the doctor must assess the patient’s general condition, examine the scrotum and prescribe additional tests.

An objective examination that will be carried out by a specialist:

• examination and study of the scrotum, namely: its size, the presence of asymmetry, changes in skin color and the height of the prolapse;
• by palpation, the doctor assesses the contents of the hernial sac, his condition, the likelihood of reduction;
• Using auscultation, the doctor obtains additional information, such as: the presence of sounds of peristalsis (wave-like movements of the intestine), rumbling and movement of gases.
• may indicate a pinched or not pinched hernia symptom of cough impulse. If it is positive, the hernia is not pinched, and vice versa: if it is pinched, the symptom will be negative.

It is appropriate to conduct additional instrumental research methods:

• Ultrasound of the scrotum.
• contrast radiography abdominal organs. The method provides information about the presence of intestinal loops of the large or small intestine in the hernial sac.
• For differential diagnosis, doctors can sometimes use the method puncture of the bag. This is done in order to remove or confirm suspicions of a spermatic cord cyst.

Scrotal hernia in children

This pathology in most cases occurs in premature babies (up to 30% of all cases) together with other congenital ailments of the musculoskeletal system, including congenital hip dislocation or spinal cord herniation. The reason for such a high percentage is the fact that intrauterine development ends before the boy’s testicles have time to descend into their natural position.

The clinical picture of scrotal hernia in children does not differ from that in adults. Most symptoms also accompany young patients.

In the future, diagnosing such an ailment as a hernia in newborns does not cause difficulties for the doctor, since the pathological protrusion becomes noticeable immediately after the birth of the baby. In addition, the child constantly screams and coughs, which further contributes to the protrusion of internal organs into the scrotal cavity.

Treatment

Despite the stage of hernia formation, the presence of complications or a strangulation factor, the patient will be recommended for surgical intervention. Treatment without surgery has a high risk of relapse in the future. Before surgeons begin surgery, the patient must undergo preparation measures.

It consists of the following activities:

1. Using a cleansing enema before surgery in the morning.
2. Do not eat food the day before.
3. Administration of antibiotics. This measure involves the prevention of further bacterial complications.
4. Tight bandaging of the legs if the patient has pathologies of the cardiovascular system.
5. Emptying the bladder by inserting a catheter.

The course of the operation is classic and most common for a hernia of this localization:

1. Incision and dissection of the tissues surrounding the hernial sac.
2. External assessment of the contents in the bag. The doctor conducts an audit.
3. Removing bag tissue. The internal organs that were previously there are set back.
4. Carrying out plastic surgery of the dissected tissues and the inguinal canal itself, preventing re-protrusion.

Postoperative period

In the first 10 days, the patient should be under the attention of doctors. The patient is advised to wear a bandage and avoid any weight bearing. Experts also recommend wearing elastic underwear that supports the scrotum in the correct position. Drug treatment is indicated if there is pain or infection of the wound after surgery. Then doctors prescribe broad-spectrum antibiotics and painkillers.

Consequences

An advanced scrotal hernia in men can lead to a number of complications.

Among the main ones are:

1. Acute intestinal obstruction. This condition develops due to pinching of the intestinal sections in the hernial sac. The pathology is manifested by pain and bloating in the abdomen, vomiting.
2. Peritonitis.
3. Erectile dysfunction, possible infertility, decreased libido.

Forecast

With timely diagnosis and proper treatment, the prognosis is favorable for both life and productive professional activity. However, in the future, a man needs to limit strong physical exertion on the abdominal muscles.

If left untreated, there is a high likelihood of complications developing. In this case, the prognosis for life is conditionally favorable, for professional activity it is unfavorable.

Disease Prevention

To prevent the development of a scrotal hernia, a man should follow a number of measures, including:

• weight control: sudden jumps in body weight adversely affect the condition of internal organs and muscles;
• dosed physical activity;
• regular scheduled check-ups with doctors.