Men may be more susceptible to hernias

Posted on 30 July 2018

A hernia is one of those uncomfortable realities of being human. We speak to a Mediclinic expert about why men are more susceptible to this ailment.

In Latin, the word, ‘hernia’, literally means, “to rupture”. In most cases, this occurs along your abdominal wall, when an abnormal exit of any tissue, including an organ, protrudes through the wall of the cavity it normally resides in.

There are various kinds of hernias, but inguinal hernias are the most common for men. These occur when tissue protrudes through the abdominal wall into the inguinal tract.

General Surgeon at Mediclinic Potchefstroom, Dr Chun-yen Wu, says inguinal hernias are eight times more likely to occur in males than females because of male embryological development. ‘In utero, the testes develop in the abdomen and only descend down into the scrotum closer to birth via the inguinal canal, or the processus vaginalis, which is unique to males,’ he explains.

According to Dr Wu, the main risk factors include:

Smoking, as cough-related pressure is placed on the abdomen.

Constipation, which leads to straining and increased pressure in the abdominal cavity.

Obesity, which results in added intra-abdominal pressure.

Hereditary reasons, some people are born with a weaker abdominal wall.

Inguinal hernias can either be “direct” or “indirect” in nature.

Direct inguinal hernia: This occurs when a part of the intestine protrudes through a weakness in the abdominal muscles along the wall of the inguinal canal. This usually occurs in adults.

Indirect inguinal hernia: This affects between 1 and 5% of normal newborns and up to 10% of premature infants. It occurs when the internal opening of the inguinal canal remains open instead of closing at the time of birth. It can also present in adults.

Inguinal hernias and erectile dysfunction

While studies have been conducted around the issue of inguinal hernia-related erectile dysfunction, there’s no conclusive evidence that an inguinal hernia can directly lead to erectile dysfunction, Dr Wu says. Although erectile dysfunction may result indirectly from the complications of a hernia, particularly due to severe pain, there is no direct link, he adds.

Symptoms

Dr Wu says signs and symptoms may include:

• An evident bulge in the groin area, especially when coughing or when pressure is applied to this region
• Pain in the groin area

Patients need to be especially aware of the following symptoms around the afflicted area, according to the British Hernia Centre:

• Sharp or severe pain
• Vomiting
• Blood in excrement
• Constipation
• Malaise with or without a fever
• A burning or hot sensation around the hernia

When pain is present, it’s likely due to the strangulation of the hernia, which occurs when the wall clamps down on the hernia and restricts blood-flow to this region. Emergency treatment and/or surgery may be indicated in this case. Dr Wu says patients should seek medical attention while the hernia is asymptomatic to avoid strangulation or the hernia becoming incarcerated (not being able to slide back through the abdominal wall).

Dr Wu explains that surgery is usually required to reinforce the inguinal floor by inserting a synthetic mesh.