Hernias and hydrocoele explained

Hernias

Most hernias occur when the intestines protrude through a weakness in the abdominal muscles. This weakness can be present from birth or it can develop over time. Risk factors include obesity, pregnancy, constipation and heavy lifting.

Symptoms may include a lump or swelling in the affected area, pain that is exacerbated by lifting or straining (such as when going to the toilet) and digestive problems (such as nausea or constipation).

Most hernias are harmless, although there is the potential for the hernia to become ‘strangulated’. This means the portion of bowel pushed through the opening becomes cut off from its blood supply and dies.

The only way to permanently repair a hernia is through a surgical procedure – this is one of the most common operations performed in Australia.

Hernias are classified by their position in the body:

• Inguinal hernia – the most common type of hernia, it’s more common in men than women. The intestines push through a weak spot in the inguinal canal (a triangular opening between the layers of abdominal muscles near the groin)
• Femoral hernia – much like the inguinal hernia, the femoral hernia appears in the groin area, near the leg crease. It occurs in the triangular gap between the inguinal ligaments (the lower side of the pubic bone and the femoral vein). Because of the angle and shape of the pelvis, this type of hernia is more common in women. It's also most likely to become strangulated
• Incisional hernia – also known as a ventral hernia, this is when the bowel pushes through an incision made during previous abdominal surgery. The site of an operation is always structurally weaker than the surrounding area, leading to a susceptibility for hernia development
• Umbilical and paraumbilical hernia – this type of hernia is most common in newborn babies. It’s caused by a weakness of the abdominal wall in the area around the navel. In some cases they close naturally: if they don’t, they may require surgery.

Hydrocoele

In normal development the testicles move down a tube from the abdomen into the scrotum. A hydrocoele occurs when the tube doesn't close and fluid drains from the abdomen into the scrotum and becomes trapped. This causes an enlargement of the scrotum.

A hydrocoele can also be caused by trauma or inflammation to the testicle. This type of hydrocoele is more common in older men. In most cases hydrocoeles are painless and not dangerous, only requiring treatment should they become uncomfortable or embarrassing.

In rare cases, hydrocoele can become so large they may block the blood supply to the testicles.