Men have a 27% risk of developing an inguinal hernia in their lifetime, whereas women have a 3% risk.
There is no single insult that causes the injury (usually) rather, we must take into consideration abdominal straining, collagen diseases that are genetic, intra-abdominal pressure increases and more.
Specific to men; as the testes migrate through the inguinal canal they may experience processus vaginalis which leads to a higher incidence of inguinal hernias in the male species (Indirect Hernia).
Direct hernias, on the other hand, result from an attenuated transversalis fascia lateral to the rectus abdominis muscle above the inguinal ligament.
Femoral hernias, which – commonly – are mistaken for inguinal hernias are known to occur more commonly in females, occur medial to the femoral vein in the femoral canal and carry a higher rate of incarceration and strangulation.
General indications for laparoscopic inguinal hernia repair are the same as those for an open inguinal hernia repair.
Classically, the existence of an inguinal hernia has been considered sufficient reason for operative intervention. This has now changed due to studies showing that the presence of a reducible hernia is not, in itself, an indication for surgery and that the risk of incarceration is less than 1%.
Patients with pain or discomfort, should undergo repair.
However, even an asymptomatic patient, if “medically fit”, should be offered surgical repair.
Patients who are undergoing laparoscopic repairs should be educated on postoperative pain, possible temporary discoloration of the groin and scrotum, and seroma formation within the first few postoperative days.
It is also important to discuss with your general surgeon in Atlanta of the possibility of nerve injury and chronic postoperative pain (defined as pain lasting longer than 6 months).
Although this is an uncommon result, it can be highly frustrating to the patient and should therefore be addressed beforehand.
Patients undergoing a unilateral laparoscopic repair should be counseled on the possibility that bilateral hernia repair may be necessary if a contralateral hernia is encountered during surgery.
Consent for this procedure should be obtained!