Urology :: Inguinal Hernia
What is an inguinal hernia?
As a male baby grows during pregnancy, the testicles move from the abdomen into the scrotum through a canal called the inguinal canal. The canal will normally close after this to keep the testicles in the scrotum, but if the canal does not close completely, intestine and fluid from the abdomen can continue to move through this canal into the scrotal area. This creates a bulge noticeable in the groin region. This bulge is called a hernia. Hernias are most common in boys, but can also occur in girls.
What causes an inguinal hernia?
A hernia can develop in the first few months after the baby is born because of a weakness in the muscles of the abdomen. They will often occur in children whose inguinal canals do not close after testicles have come into the scrotum or in males whose testicles are undescended. Although girls do not have testicles, they do have an inguinal canal, so they can develop hernias in this area as well.
Who is at risk for developing a hernia?
Hernias occur more often in children who have one or more of the following risk factors:
- A parent or sibling who had a hernia as an infant.
- Cystic fibrosis.
- Developmental dysplasia of the hip.
- Undescended testes.
- Abnormalities of the urethra.
Who is affected by inguinal hernias?
Inguinal hernias occur:
- In 1 to 3 percent of full term infants.
- Three times more often in premature infants.
- In children who have a family history of inguinal hernias.
- More often in infants and children with other urogenital anomalies.
What are the symptoms of an inguinal hernia?
Hernias usually occur in newborns, but may not be noticeable for several weeks or months after birth. Straining and crying do not cause hernias; however, the increased pressure in the abdomen can make a hernia more noticeable.
Inguinal hernias appear as a bulge or swelling in the groin or scrotum. The swelling may be more noticeable when the baby cries, and may get smaller or go away when the baby relaxes. If the bulge is pushed on gently when the child is calm it should get smaller or go back into the abdomen, known as reducing the hernia.
Emergency Situations: Occasionally, the loop of intestine that protrudes through a hernia may become stuck, and is no longer “reducible.” This means that the intestinal loop cannot be gently pushed back into the abdominal cavity as it can be at all other times. When this happens, that section of intestine may lose its blood supply. A good blood supply is necessary for the intestine to be healthy and function properly. This is called an incarcerated hernia and requires immediate medical attention. If a hernia is no longer reducible, is hard, very painful, red or swollen seek medical attention immediately.
How is an inguinal hernia diagnosed?
Hernias can be diagnosed by a physical examination by the child's health provider.
What is the treatment for inguinal hernias?
Specific treatment for an inguinal hernia will be determined based on:
- The child's age, overall health, and medical history.
- The type of hernia.
- Whether the hernia is reducible (can be pushed back into the abdominal cavity) or not.
- The child's tolerance for specific medications, procedures, or therapies.
- The family’s opinion or preference.
An operation is often necessary to treat an inguinal hernia. A hernia operation is usually done as an out-patient surgery, and the child goes home a few hours after the surgery is completed. During a hernia operation, the child is placed under general anesthesia. A small incision is made in the area of the hernia, and the loop of intestine is placed back into the abdominal cavity. The muscles are then stitched together. Learn more about postoperative care for hernia out-patient surgery.
What is the long-term outlook for an inguinal hernia?
Once the hernia is closed, either spontaneously or by surgery, it is unlikely that it will reoccur. There is a 3 to 5 percent chance that after a surgery for a inguinal hernia on one side of the body a hernia on the other side may occur.