If a woman feels pain in the groin while coughing or when lifting weights, the problem may be that doctors are called inguinal hernias. It occurs when part of the small intestine or fat bulges through a weak area of the lower abdominal wall.
Inguinal (inguinale) hernia can occur in person of any gender and age. While inguinal hernia in women is much rarer than men, it is often overlooked by doctors and not promptly diagnosed in the beautiful half of humanity. Protrusion of internal organs through the abdominal wall promises dangerous health problems, so symptoms should not be ignored. If you find that the hernia is large enough need surgery to fix it.
The name of this type of hernia comes from the term “inguinal canal”. It is a steam slit in the peritoneum at the sides of the groin. It contains blood vessels and nerves, and also ligaments that support the uterus in women. Broad ligament located right behind the abdominal wall supports it and protects the inguinal canal, reducing the probability of protrusion in the groin in women.
However, various factors, congenital and acquired, can weaken the muscular wall of the abdomen, and the extra pressure can trigger the development of a hernia.
The risk factors that may increase the chances of the development of a hernial diverticulum in women include:
- genetic predisposition;
- surgery on the abdominal cavity;
- excess weight or obesity;
- cystic fibrosis;
- chronic constipation;
- the presence of a hernia previously.
A hernia occurs as a result of a sharp increase in intra-abdominal pressure, e.g. straining during childbirth or periodic increase in hysterical coughs, physical work. Weakening with age the abdominal muscles, of abdominal trauma, childbirth, surgery, severe weight loss, and intestinal atony — all contributing to the gradual development of hernial diverticulum in women.
Inguinale hernias can be painful or sensitive to touch, they are most definable by their appearance. Appear as bulges along the pubic or groin area, the size of which increases during cough, or in an upright position.
Other symptoms include:
- pain when you cough, exercise or bending;
- sharp pain in the groin;
- a feeling of heaviness or fullness in the abdomen.
Sometimes a woman can own gently straighten the protrusion, temporarily freeing yourself from the discomfort.
When it detects suspicious symptoms, it is important to contact the surgeon. The doctor will listen to complaints and investigates palpable inguinal channels, assessing their size. Then conducted a little test. The patient is asked to stand and cough, while the doctor holds the fingers in the region of the intended protrusion. Tangible tremors witness in favor of developing a hernia.
In case of doubt regarding diagnosis can be assigned to instrumental studies, for example:
- abdominal ultrasound;
- computed tomography (CT);
- magnetic resonance imaging (MRI).
Differential diagnosis is carried out with lymphadenopathy and femoral hernia. Enlarged lymph node not associated with a cough, and femoral hernia more common in older women asthenic type, located below the inguinal ligament and at the side of the tubercle of the pubic bone.
In most cases, for diagnostic physical examination by a specialist.
The location is isolated protrusions:
In addition, hernia klassificeret for the mechanism of formation and degree of development.
The mechanism of formation
The mechanism of formation distinguish 2 types of hernias in the groin:
- 1Oblique — the hernial SAC is lateral in relation to epigastric arteries. Is the most common type (especially in premature babies), but women develop less common.
- 2Direct — the hernia is located medial relative to the vessels. These hernias often develop in the weakening with age the muscles of the peritoneum.
The degree of development
The initial signs of occurrence of a hernia I think of chronic groin pain on the background of the increased size of the inguinal canal, even in the absence of large or small protrusions. Appearing later in the cavity of the inguinal canal the hernia SAC klassificeret according to the degree of mobility:
- 1Pravima hernia. Infringement, in which there is a possibility of mechanical reposition of the protruding part of the body in its place.
- 2Irreducible hernia. Develops with the formation of adhesions of the hernia SAC, which excludes the possibility to return to the anatomical position of the organs without surgery.
Threatening complication, requiring emergency care, is a strangulated hernia.
The sudden or chronic compression of the body in gruzevich gate ends with a sharp violation of blood supply and subsequent tissue death. The infringement occurs in every tenth patient, accompanied by severe pain and is a life-threatening condition.
If the hernia is small and does not bother the patient, the proposed dynamic observation and conservative therapy in the form of wearing a supportive bandage or medical gymnastics. This tactic is temporary and does not cure the defect, but only allows you to reduce the symptoms and delay surgery.
The drugs administered by a physician or surgeon, in some cases, help to reduce discomfort and prevent the negative impact of the delay of a chair. With this aim can be spelled out:
- antispasmodic drugs (no-Spa, Spazmalgon) — abdominal pain;
- laxatives medicines mild (Duphalac, DataNorm, Normase) — for the prevention of constipation.
Do not take painkillers, they can mask the picture of dangerous complications, such as infringement.
Reduce the load on the groin muscles and minimize discomfort possible, applying a bandage to a belt, clip-on thighs. The bandage is made from semi-rigid materials, it reduces pain and prevents complications. In addition, provides additional microcompression of the inguinal canal.
Wearing the inguinal bandage is recommended at an early stage of the pathology only when ■ hernia. It is important to note that this measure, which relieves symptoms and allows patience to maintain the quality of life at the same level, in some cases it may cause undesirable effects:
- the growth of protrusions at the expense of scarring;
- excessive compression of the contents of the hernia SAC;
- the weakening of the abdominal wall.
Prolonged wearing of a bandage and the delay in surgical intervention leads to a loss of muscle tone in the groin and in the future may result in further complications.
Long-term use of the fixing belt is justified when the intervention should be postponed or there are significant contraindications to surgery:
- old age;
- poor overall health;
- acute infectious process;
- the recovery period after other surgical procedures.
Conservative treatment involves a diet high in fiber: a large number of fresh vegetables, fruits and whole grains, which is the prevention of constipation, which can lead to painful symptoms. It is important to avoid activities that increase intra-abdominal pressure (lifting, coughing, or voltage) that can result in a hernia.
Some women may prefer the use of home remedies as a complementary treatment. A few simple recipes below:
- 1Packs of sauerkraut brine. Several layers of gauze or bandage dipped in cool brine and lightly wrung out, is applied to the site of the hernia for 2-3 hours. Over the gauze you can place a bag of ice for 20 minutes. The tool is well relieves stress and swelling of the tissues.
- 2Tea of ginger from pain and inflammation. To prepare the drink, take 1-2 teaspoons chopped fresh ginger root in 250 ml of boiling water, insist 15 minutes. Take throughout the day as needed.
- 3Juice of aloe Vera. Has a soothing and cooling effect on the gastrointestinal mucosa, which helps to reduce the pain, burning and other symptoms of infringement of the intestine. To make 1 glass of juice at home you need to take half of the leaf, peel and extract the gel-like substance. Mix in blender the resulting gel with a glass of water. The number of the gel will depend on the density of the drink. To drink treatment juice is recommended 1 times a day after meals.
Most folk remedies, even harmless, can be used only after consultation with a specialist.
To prevent progression of the hernia is necessary to help the stomach to catch up and reduce the pressure of sagging internal organs. Shoulders and chest play the role of a “clothes hanger” that does not allow the abdomen to SAG and loading the groin and pelvic floor muscles. Strengthening these ties will help to keep the internal pressure of organs in the groin area.
Important 3 kinds of exercises:
- strengthen the muscles of the pelvic floor;
- strengthen the lower abdomen (transverse abdominal and oblique muscles);
- developing the connection between the stomach, shoulders and chest.
But exercises are not in all cases, but only in the early development of the disease. In the later stages of hernial protrusion of the physical load is dangerous.
Painful or enlarged hernia requires surgery. There are 2 basic types of operations to remove a hernia:
- 1Via open access.
- 2Laparoscopic surgery.
Preoperative preparation includes blood tests, medical examination, chest x-ray and an EKG depending on age and health status of the patient.
After midnight before surgery not eat or drink anything (even water).
Otherwise, the operation can be canceled. If you have difficulty with bowel movements after consultation with the surgeon, you can use a cleansing enema.
If necessary, continuous use of any medication, the tablets should be taken several small SIPS of water. Receiving blood thinners (Aspirin), anti-inflammatory drugs (arthritis) and vitamin E should be temporarily suspended for a few days or a week before surgery.
The suturing of the hernia by open method (herniography, hernia repair) performed under local or General anesthesia.
The surgeon makes an incision in the groin and sets in place protruding organs. Then, the weakened area is stitched using a synthetic mesh (hernioplasty). Double mesh reinforces the location of the defect: one layer is placed under the muscle and the other over the damaged muscle. This type of plastics weakened muscles are treated both inside and outside. It is impossible to do surgery where it can be used only for the inner grid. Then the hole closed with stitches, staples or surgical glue.
Operated the woman returns home the same day or the next. In complicated cases may require one or more nights in the hospital where stronger pain medication before the woman is able to care for themselves.
After surgery, patients are advised to start moving as early as possible, but may take several weeks before a final healing.
Laparoscopic surgery — a minimally invasive procedure that requires General anesthesia, is performed through a few small punctures in the abdomen. In the abdominal cavity launch a special gas to improve visibility, then introduced the tools needed: a long, thin tube with a tiny camera on the end (laparoscope) and other surgical instruments.
The advantages of this type of operation is the lack of scarring and a shortened recovery period in comparison with the procedure via open access. Laparoscopy may be a good choice for people whose hernias recur after traditional gerniografii, and for patients with bilateral protrusions. The disadvantages include increased risk of disease recurrence compared to the open griseisticta.
The postoperative period
For the early postoperative phase is characterized by pain and swelling around the wound. To reduce swelling, you can apply an ice pack on the incision area 3-5 times a day for 15-20 minutes. In severe pain the doctor may write a prescription for pain drugs.If discomfort is slight, it is enough to receive over-the-counter analgesics (Ibuprofen, Paracetamol) as needed.
24 hours after surgery can remove the bandage and take a shower. To swim in a bathtub and swimming are prohibited for 2 weeks.
In the postoperative period is recommended to prefer loose underwear that does not compress the tissue. If necessary, you can wear a jockstrap.
During the first 24 hours after surgery your appetite may be absent or, on the contrary, wakes up craving for heavy food. Dietary restrictions after surgery is not prescribed. The patient is allowed to eat her usual diet. It is recommended to drink plenty of fluids. A few days later, appetite is normalized.
The first bowel movement may occur approximately 1-10 days after surgery. If nausea or stomach pain absent, this situation is acceptable.
Constipation after this surgery is not uncommon, and to prevent the problem by using magnesium Hydroxide, taking a laxative in the specified doctor the dosage.
There are no restrictions on everyday activities, including lifting and descending the stairs. If the health of the patient allows, it is recommended to walk for long distances.
Lifting more than 2.5 kilograms in the next 2 weeks. Within 6 weeks after the operation prohibited heavy physical exertion. Behind the wheel you can sit down two days later after taking narcotic painkillers.
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Although it is impossible to prevent genetic predisposition factors, a woman can reduce the risk of occurrence or the severity of abdominal hernia. It is recommended to follow the simple rules:
- to maintain a healthy weight;
- adhere to a diet high in fiber;
- to stop Smoking;
- to avoid heavy lifting.
It is beneficial to strengthen the muscles of the lower abdomen, and torso through exercise.