If you have a scrotal hernia, one of the first things you may notice is a bulge in the abdomen or groin. This bulge could be the intestine or its contents pressing on the abdominal muscles. It is usually a fairly simple condition to diagnose and the first treatment that is considered is surgery. While scrotal hernia is generally not a fatal disease, complications can arise if it is not treated properly. The consequences could be intestinal torsion, which occurs when part of the intestine twists on itself and remains isolated from the rest due to extroflexion. As a result, an intestinal blockage can form, you can have abdominal pain, fever and, if the disorder is not treated promptly, it becomes a medical emergency. Read this tutorial to learn how to recognize the signs of scrotal hernia, how to treat it, heal it, and most importantly, prevent it.
Steps
Part 1 of 3: Check for Symptoms
Step 1. Look in the mirror to check for signs of a hernia
Take off all lower body clothing and observe yourself. Place two fingers over the area you think is affected by the hernia. Make an effort to cough and pay attention to the presence or sensation of a lump. You can also try to hold your breath and push (squeeze your abdomen as if to evacuate). Always use your fingers to check for a swelling in the area. The various types of hernias can be aggravated by abdominal pressure. Furthermore you should also check:
- A bulge in the groin area: in this case you can have a direct or indirect hernia.
- You will notice swelling in the lower abdomen extending towards or even into the scrotum.
- A lump on the thigh below the groin: This is most likely a femoral hernia.
- One testicle that is larger or swollen than the other: it can be caused by an indirect hernia.
- Burning, aching, or severe pain in the groin: This symptom may also indicate a hernia, as the intestine may be pinched or trapped in adjacent structures, thus causing pain.
- If the swelling is oval in shape but not localized in the scortal area, it is likely a direct hernia rather than an inguinal hernia.
Step 2. Check if you can push the hernia in
Consider if it can be reduced or if it can be returned to its correct position. Lie down so that gravity helps you reposition it. Slowly apply pressure to the bulge with your index finger and try to push it in. Don't push too hard though, as you could rupture the contents of the hernia or tear the protrusion. If you are unable to reduce it, see a doctor immediately.
- You should also tell your doctor if, in addition to not being able to reduce the hernia, you experience symptoms such as vomiting, which could be signs of a complication, such as intestinal torsion.
- You must see your doctor right away even if you have abdominal pain or fever.
- Torsion of the intestine and related blood vessels prevents the intestine from getting the nutrients it needs, causing tissue death and preventing it from functioning properly. In this case, surgery is necessary to eliminate dead tissue and allow the passage of digested products.
Step 3. See your doctor
You need to see a doctor regardless of the type of hernia you suffer from. In his office you will have to remove clothing from the waist down and the doctor (and possibly an assistant) will examine the abdomen and genitals for abnormalities and asymmetrical bulges. It will ask you to cough while pressing a few points or to contract the abdomen without breathing. If there is a bulge, there is a suspicion of a hernia. The doctor will probably want to find out if the hernia is reducible by feeling the area with the index finger.
The doctor may also place a stethoscope on the bulge to listen for bowel sounds. The absence of noises could indicate intestinal tissue death or twisting
Step 4. Learn about the types of inguinal hernia
There are various types of hernia, which differ according to the location and causes. The main inguinal hernias are:
- Indirect inguinal hernia: This is a congenital defect (from birth) whereby the intestine or its lining descends into the area that should be occupied by the testicles before the baby is born. In most cases, this area does not heal properly before birth and therefore weakens.
- Direct inguinal hernia: This is usually caused by direct trauma due to repeated stressful strain, such as lifting heavy objects, frequent coughing, straining to evacuate, or, in women, pregnancy. The intestine, its lining or intestinal fat crosses the barrier of weakened muscles located near the groin and genitals, but does not pass through the scrotum or testicles.
- Femoral hernia: the main cause is due to pregnancy or childbirth. The contents of the intestine pass through the weakened groin area, where the blood vessels that supply blood and oxygen to the thighs and legs in general are located.
Part 2 of 3: Treatments and Convalescence
Step 1. Discuss different treatment options with your doctor
The surgical solution is the most widespread and most accepted for hernias. However, if you don't show any symptoms and your hernia can be pushed back (i.e. it's reducible), you can also wait. Either way, you should seek professional advice from your doctor. If you wish to undergo surgery, even though your doctor is not of the same opinion because you do not have symptoms, you still have the right to opt for surgery for aesthetic reasons. So if you choose this solution, make an appointment with a surgeon.
If you plan to have surgery, you must have certain laboratory tests done: blood tests (PT, PTT, INR and CBC), tests for electrolytes, such as sodium, potassium and glucose level, and the electrocardiogram to check for any heart problems or abnormalities. All these tests will be performed during a pre-operative day hospital, so as to minimize the days of hospitalization
Step 2. Undergo laparoscopic surgery
With this type of surgery, local anesthesia is performed to reduce pain and discomfort. The surgeon dilates the abdominal tissues using air to facilitate maneuvers during the operation. He then inserts a probe with a camera to guide the other surgical probes that can cut, remove and suture. The probe is able to reposition the contents of the hernia and apply a support mesh to reinforce the weakened abdominal wall and thus prevent recurrence. At the end of the operation, the small incisions caused by the probes will be sutured.
- Laparoscopic surgery is minimally invasive, leaves a minimal scar, causes reduced bleeding and generates less post-operative pain.
- This procedure is preferable to the open one when the hernia is bilateral, recurrent or femoral.
Step 3. Undergo traditional surgery
In this case, the surgeon makes an incision along the groin to open the area; at this point he manually puts the tissue back in place by pressing it into the abdomen and verifies that flatulence can pass through the intestinal canal. Later he will likely apply a net around the weakened abdominal muscles or tie them together to prevent recurrence. At the end the incision will be sutured.
- If your hernia is quite extensive or if your doctor sees fit, you will need to undergo this type of open surgery.
- Traditional surgery is preferable to laparoscopy if the patient has already undergone previous operations in the same area, if it is the first scrotal hernia, if the hernia is extensive or if there is an infection in progress.
Step 4. Take care of yourself after the surgery
Since you will be in pain for a few weeks after the operation, you will need to take pain relieving medications that your doctor will prescribe for you and which you will need to take as directed. You will also need to eat a high-fiber diet or take 2 tablespoons of milk of magnesia (magnesium hydroxide) twice a day for the days following the surgery. After surgery, it will take 1 to 5 days to return to normal defecation, so a high-fiber diet can help restore normal bowel functions.
To relieve pain, you can also apply a cold pack wrapped in a towel to the area for about 20 minutes
Step 5. Clean the wound
Keep the dressing on the wound for a couple of days. You may see blood or fluid draining from the cut, but be aware that this is completely normal. 36 hours after surgery you can take a shower; However, be sure to remove the gauze before you get wet and apply gentle pressure to the area as you wash with soap. At the end, dry the skin by gently patting it and apply a new clean gauze.
Avoid soaking or soaking the wound in a pool or hot tub for at least 2 weeks
Step 6. Slowly resume your normal physical activities
After the surgery you will not have any medical or physical restrictions, but the area will still be sore; therefore you should avoid doing some activities that put pressure on the abdomen for at least a week, such as physical training, running and swimming.
- You should also avoid lifting any weight greater than 5 pounds for the next 6 weeks or as long as your doctor tells you, otherwise you could aggravate the situation and cause a new hernia in the same site.
- It is not recommended to drive during the first two weeks following the surgery.
- Sex is allowed after a hernia, but as long as it doesn't cause discomfort or pain.
- Within a month, you can generally recover and return to work.
Step 7. Pay attention to the presence of complications
See your doctor if you experience the following symptoms after surgery:
- Fever (38.3 ° C) and chills: You may have a bacterial infection on the incision.
- Foul-smelling or pus-like material (usually brown / greenish in color) leaking from the wound: The bacterial infection produces a foul-smelling, thick fluid.
- Constant bleeding from the surgery site: A blood vessel may have ruptured that was not sutured properly during the operation.
- Difficulty urinating: it is completely normal for fluid to form and for the surgery area to be inflamed; however, if the inflammation is excessive, it can compress the bladder or urethra and make it difficult to urinate.
- Swelling or pain in the testicles becomes worse.
Part 3 of 3: Preventing Scrotal Hernia
Step 1. Lose weight
If you are obese or overweight you should try to lose weight by eating low calorie foods and doing moderate exercise. Excessive body weight can weaken the abdominal area by putting too much pressure on it, more than it can handle. This increases the stress on the already weak area, raising the risk of a hernia.
Make sure you choose those physical exercises that don't aggravate abdominal pressure, such as walking, running, swimming, and cycling
Step 2. Get more fiber
The fibers help to regularize the intestine and empty it properly. In addition, a diet rich in these elements softens the stool thus reducing tension and effort during the evacuation. The foods richest in fiber are wholemeal bread, fruit and vegetables. You should also drink plenty of water throughout the day to help empty your bowels.
Fiber is especially important if you have had hernia surgery, because both the surgery itself and pain medications can slow bowel functions and cause constipation, which can worsen the situation
Step 3. Learn to lift objects correctly
If possible, you should avoid lifting weights or otherwise be very cautious. You can start lifting weights over 5 kilos no earlier than six weeks after surgery. To grab them properly, bend your knees and lower your body. Take the object by holding it close to your body and to lift it use the strength of the legs and not that of the back, so as to reduce the strain and tension in the abdominal area.
You should also wear a lumbar support band that wraps around your waist to support your abdominal muscles, especially when you need to lift weights
Step 4. Stop smoking
Smoking is directly related to chronic cough, which causes and worsens a hernia. If you already have a hernia, it is extremely important to avoid behaviors that could cause another one, such as smoking.
Advice
- Don't rule out scrotal hernia a priori just because you don't feel pain; sometimes it can be a completely painless ailment.
- The main risk factors for scrotal hernia in adults are previous hernias occurring at a young age, old age, being male or Caucasian, chronic cough, chronic constipation, abdominal wall injury, smoking or a family history of hernia.
- If you are undergoing surgery, do not eat anything from midnight before the operation to avoid the risk of stomach food being drawn into your lungs while under anesthesia.
- Try to quit smoking, as it can cause a cough, which in turn causes the abdominal muscles to contract.
Warnings
- If you have a previous history of hernias, it is essential to adhere to the prevention procedures described in this tutorial.
- If you experience severe pain in your testicles, you should go to the doctor immediately. It could be due to a twisting of the blood vessels leading to the testicles, reducing the blood supply to the area. If not addressed promptly, lack of blood to the testicles can cause permanent damage that requires their removal.
- If the scrotal hernia is not treated promptly, it can lead to bowel torsion and obstruction, a serious and life-threatening condition.
