Nagging pain in the lower back and groin in men and women: causes, how to treat

Inguinal hernia: symptoms, causes and treatment options

An inguinal hernia in men is a disease in which the walls of the abdominal cavity weaken and cannot hold the internal organs in place. In this case, an inguinal-scrotal hernia appears due to weakening of the inguinal muscles. As a result, protrusion of the organ under the skin is visible. Hernia occurs quite often, especially in older men.

The main factor in its occurrence is serious and regular stress on the abdominal cavity. In order to recognize the disease in time and prevent the development of complications, you need to know its symptoms. And for clarity, you can see what an inguinal hernia in men is in the photo. They will help present the overall picture of the disease.

Causes

An inguinal hernia can occur for a variety of reasons. The following factors are identified that can contribute to the appearance of this disease in men:

1. Frequent (chronic) cough, which will put a lot of strain and pressure on weakened areas of the abdomen, which in turn can give rise to the formation of an inguinal hernia.
2. A person's hereditary predisposition to an inguinal hernia is revealed in the anatomical weakness of the abdominal muscle tissue.
3. Some diseases of the intestinal system can increase intra-abdominal pressure, especially when they cause constant constipation in the sick person.
4. Excessive physical activity, which puts strong pressure on the abdominal cavity (and increases intra-abdominal pressure itself). Lifting heavy objects, holding something suspended, and carrying heavy things in front of you is considered especially dangerous.
5. Previously suffered injuries to the groin area, which caused a sharp weakening of ligaments and muscles.
6. Sudden weight loss leads to the formation of empty volumes in the human peritoneum, which can push outward into the abdominal cavity.
7. Excess weight can put excessive stress on internal organs, which increases a person’s tendency to develop an inguinal hernia.

As can be understood from the above, several factors can contribute to the development of an inguinal hernia in men, but the most common cause of this disease is lifting heavy objects. It is most quickly capable of leading to an acute condition in a person, in which he will require immediate treatment.

Ovarian cyst

The ovaries contain follicles - sacs in which eggs mature. A mature follicle ruptures during ovulation and releases an egg. If this does not happen, it turns into a cyst. Such ovarian cysts are usually harmless and can go away on their own, but they can cause pain and an enlarged abdomen. When the cyst is torsioned, a threatening condition occurs - severe acute pain should force you to immediately consult a doctor. Ovarian cysts are detected during a gynecological examination and ultrasound.

Classification

Depending on the origin of the hernial sac, hernias are:

• Acquired - occur mainly in adults who experience severe physical exertion. They are both straight and oblique.
• Congenital - occur when the vaginal process of the peritoneum does not grow, when the testicles descend into the scrotum before birth. They are only oblique.

According to the anatomical classification, hernias are of the following types:

• Direct inguinal hernia is always acquired, never passes through the spermatic cord and does not descend into the scrotum; these are the signs that distinguish it from an indirect inguinal hernia. This hernia is very rarely strangulated. The sizes are usually not very large, on average 5-10 cm;
• Oblique PG - characterized by the passage of the hernial sac as part of the spermatic cord with the subsequent appearance of a protrusion under the skin of the groin area, and in advanced cases, in the scrotum. Has a tendency to infringe. Sizes vary from 4-5 cm to giant ones - 30-40 cm;
• Supravesical PG - occurs when there is weakness in the anatomical structures located immediately above the pubic bone. The protrusion is usually not very large;
• Sliding hernia – already from the name it can be assumed that this type of hernia is characterized by incomplete entry of the organ into the hernial sac, but only by one of its walls. Often, only part of the bladder and cecum ends up in the hernial sac. That is why, with this type of hernia, some difficulties arise when suturing the hernial sac during surgery;
• Combined inguinal hernia - with this type of hernia, the patient simultaneously experiences direct and oblique inguinal hernias, very rarely they are joined by a supravesical hernia.

Another important clinical classification on which the choice of treatment depends:

• Irreversible PG - occurs when there is a long-term presence of a hernia, when the hernial sac is connected by adhesions to the subcutaneous fatty tissue. In this case, it is not possible to reduce the hernia into the abdominal cavity, but its contents are not tense and may slightly decrease or increase;
• Reducible hernia - characterized by independent or manual reduction of the contents of the hernia into the abdominal cavity. Usually these are small hernias and at the initial stage of development, when adhesions between the tissues have not yet formed;
• Strangulated hernia - if it is strangulated, it is impossible, even with external help, to reduce the contents of the hernia into the abdominal cavity. In this case, the hernial sac is tense and painful.

You can determine whether an inguinal hernia is strangulated or not by performing a simple task - holding the hernia with your hand, you need to cough several times. If at the same time the hernial protrusion increases and decreases, then the hernia is reducible. Otherwise, if, when coughing, the protrusion does not change its size and continues to hurt, it is most likely that the hernia is strangulated!

How to relieve pain

It is not always possible to see a doctor right away if your lower back hurts and radiates to the groin. Sometimes you have to look for a temporary solution to relieve pain in the lower body before visiting the clinic. Taking antispasmodics, which include no-spa and papaverine, can help. If you need to bring down the temperature, you can take Ibuprofen or Nurofen, but if the temperature is below 38 degrees, it is not recommended to bring it down. Under no circumstances should you heat or cool a sore spot without a doctor’s instructions. It is also worth providing the patient with bed rest.

Symptoms

In men, the symptoms of an acquired inguinal hernia (see photo) are as follows:

1. The formation can be straightened with regular pressure, and a characteristic rumbling sound can be heard.
2. In a lying position, the protrusion usually either levels out or greatly decreases in size, and vice versa, in an upright position it increases and appears again.
3. In the reduced state of the hernia, you can easily feel the enlarged inguinal ring through the skin.
4. When the hernial sac descends into the scrotum, the corresponding half of the scrotum increases in size.
5. With strong coughing, straining, or sneezing, the hernia increases in size and becomes tense; if you put your hand on it, you can easily feel it.

With a small inguinal hernia, there are no longer any symptoms that bother the patient. But with a significant increase in protrusion, the following ailments may appear:

1. Pain in the lower back, lower abdomen - this occurs due to compression of other organs and intestines.
2. Aching, prolonged pain in the area of ​​the hernial formation.
3. Other signs of indigestion, such as bloating, loud rumbling.
4. Constipation, this is also caused by compression of the intestinal loops in the hernial sac.
5. In rare cases, if part of the bladder gets into a hernial formation, problems with urination may occur.

The symptoms of an inguinal hernia are quite obvious upon visual examination; the formation has a dense elastic consistency and is easily palpable on its own. It can be round, and if the hernial sac descends into the scrotum, then the protrusion has an elongated shape. As a rule, with a genetic predisposition, the body’s tendency to develop a hernia, a hernial protrusion may occur after lifting weights and intense physical activity.

Which doctor should I contact?

As has already become clear, there are many reasons why pain appears in the groin and left or right lower back. Determine independently whether in this case it is necessary to be treated by a urologist-andrologist

or
a gynecologist
, a
neurologist
or a surgeon, it is not possible. The best solution in such a situation is to make an appointment with a general practitioner. After the specialist performs an examination, he will draw preliminary conclusions about your state of health and prescribe the necessary types of diagnostics. Based on the results of a more detailed examination, it will become clear which specialist you need to be redirected to, and whether this will be necessary at all. Then you will be prescribed adequate treatment tactics that will allow you to improve your health.

Strangulated hernia

A strangulated inguinal hernia is accompanied by the following symptoms:

• weakness, tachycardia;
• nausea, vomiting;
• bloating, lack of stool;
• negative reaction to a cough impulse; when coughing, placing a finger on the inguinal ring, shocks are usually felt; if the hernia is strangulated, the impulse is not transmitted;
• the hernia stops being reduced;
• the hernial sac is very tense;
• sharp, acute pain in the hernia area and in the abdomen.

A strangulated inguinal hernia is a very dangerous complication, so medical care should be provided as soon as possible. The operation must be performed as quickly as possible, since serious complications may develop, such as:

1. Necrosis is the necrosis of parts of the intestinal loops or omentum that have fallen into the hernial sac.
2. Peritonitis - with prolonged strangulation of the groin hernia, inflammation of the abdominal cavity develops.

At the same time, irreducible and large hernias, even without complications, cause discomfort to patients: they limit their activity and are accompanied by unpleasant symptoms.

Diseases of the musculoskeletal system

ARS syndrome is inflammation and degeneration of tendons and ligaments attached to the pubic bone and symphysis. Athletes face this. Pain is observed in the lower abdomen and groin area, intensifying with hip abduction.

Hip sprain. May be caused by a fall or sudden abduction of the hip while performing any exercise.

Coxarthrosis, arthropathy, femoral neck fracture. These are diseases associated with damage or disease to the hip joint and the proximal part of the femur where it attaches to the joint.

Treatment of inguinal hernia in men

The only treatment for inguinal hernia in men is surgery. During the operation, the doctor excises the hernial sac and performs plastic surgery of the hernial orifice, which prevents further relapses of the disease. Plastic surgery of the hernial orifice can be performed either using an aponeurosis (tension technique) or using a special mesh prosthesis (non-tension technique).

In most cases, removal of an inguinal hernia in men is performed with the subsequent use of a polypropylene mesh. It is installed in the hernial orifice and fixed. Subsequently, connective tissue fibers grow through its cells and form a reliable barrier for the abdominal organs on the way to the inguinal canal. Using this technique significantly reduces the likelihood of recurrence of the disease.

Surgeries for inguinal hernia in men can be performed either in the traditional open way with a skin incision, or laparoscopically - through a small puncture.

Laparoscopic surgery for inguinal hernia

Laparoscopic technology allows special manipulators to enter the patient's abdominal cavity through small punctures on the anterior abdominal wall. The advantage of the operation is that there are no scars left after it, and minor damage to the tissues is caused during the procedure.

1. At the initial stage, the patient is given anesthesia. The intervention is performed under general anesthesia (anesthesia).
2. Carbon dioxide is pumped into the abdominal cavity, due to which the anterior abdominal wall is raised like a dome, and conditions are created for surgeons to work.
3. The hernial sac with its contents returns back to the abdominal cavity.
4. A mesh is sutured from the inside to the abdominal wall. As a result of this, it more effectively holds the abdominal organs and prevents them from extending beyond its limits. Gradually it grows and is securely fixed in its place.

Due to a number of advantages, laparoscopic hernia treatment methods are gradually gaining popularity. However, if the protrusion is large, then surgeons prefer to work using traditional methods, since it is technically easier to perform the intervention. Therefore, it is necessary to contact doctors for help as early as possible and receive treatment using the most modern methods.

How long do you need to stay in hospital? Usually, after laparoscopy, a man can go home within 1 day after the operation, if no complications arise.

Myofascial pain syndrome (MPS)

Quite often, the source of pelvic pain is the muscles and ligaments. This condition is called myofascial pain syndrome and has the following causes:

• muscle and ligament sprains;
• bruises;
• frequent minor muscle injuries, for example, during heavy physical work or sports;
• overstrain of the pelvic muscles, when you have to maintain an uncomfortable position for a long time;
• Sometimes the cause is hypothermia and frequent stress.

There can be many causes of pelvic pain. Sometimes it is difficult for a doctor to determine the cause of this condition without additional examinations. If you are worried about pelvic pain, make an appointment with a gynecologist at ProfMedLab, our phone number: +7 (495) 120-08-07.

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Complications after surgery

The most common consequences after surgery are:

1. Seams coming apart.
2. Hematomas. To prevent them, ice is applied immediately after surgery.
3. Infection and suppuration of the wound. To avoid this, a course of antibiotics is prescribed.
4. Dropsy of the testicles. Develops due to damage to the membranes of the testicle. A symptom of this complication is an enlargement of the scrotum on one or both sides. It can only be treated surgically.
5. Damage to the spermatic cord. It occurs due to the fault of the doctor and is associated with the structural features of the inguinal canal. The spermatic cord passes close to the hernial sac, so if the doctor is insufficiently qualified, it can be damaged. This complication can lead to infertility.
6. Damage to the hip joint. Occurs in case of rough sutures.
7. Relapse. Recurrence of a hernia most often occurs due to patient non-compliance with the regimen.
8. Damage to blood vessels. This is also a rather serious complication, as it leads to testicular atrophy.

Even an operation to remove an inguinal hernia in men that is considered easy and safe can be accompanied by complications. Most often, they arise through the fault of the patient himself, due to violation of restrictions during the rehabilitation period. Sometimes complications arise due to the fault of the surgeon, or arise as a result of the individual characteristics of the body.

Diet after hernia repair

A proper diet will speed up recovery. For the first few days, it is better to eat only liquid and pureed food in small portions. On day 4-5 you can go back to your normal diet.

You need to eat as many foods rich in protein and fiber as possible. The diet should include:

• lean boiled meat (chicken, beef);
• seasonal vegetables (raw or steamed);
• dairy products, especially cottage cheese;
• fruits and berries;
• various porridges (buckwheat, millet, oatmeal, pearl barley);
• Fish and seafood;
• nuts and dried fruits.

It is better to exclude alcohol and coffee from your diet, as well as smoking.

What are the options for treating an inguinal hernia without surgery?

Taking into account the pathogenesis of the disease, it is believed that treatment for inguinal hernias without surgery is impossible. It should be borne in mind that the bandage also does not cure, but only helps to keep a reducible inguinal hernia in men in the abdominal cavity.

According to some doctors, treating an inguinal hernia in men with physical exercise has no therapeutic effect. However, many experts advise using exercises to increase the strength of the abdominal muscles, but only while lying on your back or sitting.

For example, exercises such as:

• breathing with the stomach with a load (1-2 kg) on ​​the abdominal wall;
• raising straight legs 30° relative to the horizontal position of the body;
• raising the shoulder girdle and shoulder blades from a horizontal position (with hands placed on head);
• squeezing a ball placed between the knees (lying on your back, with your knees bent), etc.

The most suitable yoga asanas for inguinal hernias are: uddiyana, pavanmuktasana, sarvangasana, etc. Uddiyana asana should be performed while sitting: exhale the air forcefully, “squeezing” it out of the lungs, drawing in the stomach as much as possible, hold for three seconds, and then take a deep breath through the nose. Repeat 5-6 times.

Sexually transmitted infections

Characteristic signs of sexually transmitted infections (STIs): pain during urination, vaginal discharge, vaginal bleeding between periods. The most common types of STIs are gonorrhea and chlamydia. The final diagnosis can be made by a doctor after laboratory tests. If you are diagnosed with a sexually transmitted disease, your partner should also be tested.

Prevention

The disease can be prevented by avoiding excessive physical activity and lifting heavy weights. It is important to take care of the stable functioning of the gastrointestinal tract, because constipation provokes hernias. You need to lose excess weight and do physical therapy. You should strengthen your abdominal wall by performing abdominal exercises and “bicycle” exercises. Therapeutic gymnastics should be given at least 20-30 minutes a day.

It should be noted the importance of maintaining a competent diet. You need to eat often, but little by little, and no alcohol. Instead of fatty and spicy foods, flour and confectionery products, you need to eat vegetables, fish and meat, boiled or steamed.