Pathophysiology[edit]

In men, indirect hernias follow the same route as the descending testes, which migrate from the abdomen into the scrotum during the development of the urinary and reproductive organs. The larger size of their inguinal canal, which transmitted the testicle and accommodates the structures of thespermatic cord, might be one reason why men are 2 times more li!ely to have an inguinal hernia than women. "lthough several mechanisms such as strength of the posterior wall of the inguinal canal and shutter mechanisms compensating for raised intra#abdominal pressure prevent hernia formation in normal individuals, the e$act importance of each factor is still under debate. The physiological school of thought thin!s that the ris! of hernia is due to aphysiological difference between patients who suffer hernia and those who do not, namely the presence of aponeurotic e$tensions from the transversus abdominis aponeurotic arch.[
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Management[edit]
Conservative[edit]
There is currently no medical recommendation about how to manage an inguinal hernia condition, due to the fact that until recently,[%][&] elective surgery used to be recommended. The hernia truss is intended to contain a reducible inguinal hernia within the abdomen. It is not considered to provide a cure, and if the pads are hard and intrude into the hernia aperture they may cause scarring and enlargement of the aperture. In addition, most trusses with older designs are not able effectively to contain the hernia at all times, because their pads do not remain permanently in contact with the hernia. The more modern variety of truss is made with non#intrusive flat pads and comes with a guarantee to hold the hernia securely during all activities. "lthough there is as yet no proof that such devices can prevent an inguinal hernia from progressing, they have been described by users as providing greater confidence and comfort when carrying out physically demanding tas!s[citation needed]. " truss also increases the probability of complications,which include strangulation of the hernia, atrophy of the spermatic cord, and atrophy of the fascial margins.This allows the defect to enlarge and ma!es subse'uent repair more difficult. [(] Their popularity is li!ely to increase, as many individuals with small, painless hernias are now delaying hernia surgery due to the ris! of post#herniorrhaphy pain syndrome.[)] The elasticised pants used by athletes also provide useful support for the smaller hernia.

*urgical correction of inguinal hernias is called a hernia repair. It is currently not recommended in minimally symptomatic hernias, for which watchful waiting is advised,

due to the ris! of post herniorraphy pain syndrome. *urgery is commonly performed as outpatient surgery. There are various surgical strategies which may be considered in the planning of inguinal hernia repair. These include the consideration of mesh use +e.g. synthetic or biologic,, open repair, use of laparoscopy, type of anesthesia +general or local,, appropriateness of bilateral repair, etc. -uring surgery conducted under local anaesthesia, the patient will be as!ed to cough and strain during the procedure to help in demonstrating that the repair is without tension and sound. [./] 0onstipation after hernia repair results in strain to evacuate the bowel causing pain, and fear that the sutures may rupture. 1pioid analgesia ma!es constipation worse. Promoting an easy bowel motion is important post#operatively.