What Are the Different Types of Groin Pull Treatment?

Sliding inguinal hernia refers to the posterior organs of the abdominal cavity and part of the peritoneum prolapsed from the inguinal canal, forming a hernia of part of the hernia sac wall. The most common organs in sliding inguinal hernias are sigmoid colon, cecum, bladder, uterus, and accessories. This type of hernia often has no characteristic clinical manifestations, it is difficult to confirm the diagnosis before surgery, and it is often diagnosed during surgery.

Basic Information

English name

sliding inguinal hernia

Visiting department

General Surgery

Common causes

Congenital developmental abnormalities or acquired factors make the organ move more, plus the relaxation of old ligaments, weight loss, visceral droop, etc.

Common symptoms

Defecation after reduction of hernia, "diuresis" phenomenon, pulling testis

Causes of sliding inguinal hernia

Under normal circumstances, one part of the ascending colon, descending colon, bladder and fallopian tubes is covered by the peritoneum, while the other part is not covered by the peritoneum. The organ is caused by congenital abnormal development or acquired factors, which increases the mobility of the organ, plus the relaxation of old ligaments, weight loss, and visceral drooping.

Clinical manifestations of sliding inguinal hernia

Sliding inguinal hernias are almost always oblique hernias. Occasionally, straight hernias prolapse from the Hesselbach triangle. The symptoms are similar to general oblique hernias. Some special clinical manifestations are helpful for the diagnosis of synovial hernia.

Defecation after hernia reduction

When the hernia content is descending colon or sigmoid colon, the patient has no defecation, and can defecate after reduction.

2. Phenomenon of "urinary urination"

That is, the hernia is painful during urination, and the hernia shrinks after the first urination, and soon there is a urination, and the phenomenon of one urination and two urination is formed. This phenomenon is more common in bladder hernias and larger.

3. Testicular pulling phenomenon

Elderly sliding hernias appear when pulling testicles.

Sliding inguinal hernia

The above symptoms or signs are clinical. In order to prevent damage to the organs during surgical exploration, colonography, cystoscopy or cystography can be performed before surgery.

1. Digestive tract radiography or barium enema

Bowel shadows can be found in the groin area.

2. Intravenous nephrography or cystography

Observe whether the hernia affects the genitourinary system and determine the relationship between the hernia and the bladder.

Diagnosis of sliding inguinal hernia

Medical history

For middle-aged and elderly patients with a long course of disease, especially fat and huge complete hernias, which are difficult to restore, and those without incarceration should consider the possibility of sliding hernias.

2. Clinical manifestations

It looks like an oblique hernia, and it can appear quickly when it is still upright; there is a phenomenon of "diuresis", and the hernia of pulling testis appears, etc. The possibility of sliding hernia should be considered.

3. Auxiliary inspection.

4. Intraoperative exploration

It is not easy to find the hernia sac during surgery, or there is more adipose tissue surrounding it, which should be suspected as a sliding hernia; the hernia sac also retracts when the prolapsed mass is found during surgery, which is also a characteristic of sliding hernia.

Sliding inguinal hernia treatment

Should be treated surgically. The key to the operation is to free up and receive the slipped organs, reconstruct a complete hernia sac, and then perform high ligation and hernia repair.

1. Hernia sac forming and high ligation

(1) Bevan method Commonly used surgery method is suitable for smaller sliding hernias, such as the cecum slide out.

(2) La Roque method is suitable for larger sliding hernias, such as the sigmoid colon.

(3) Ponka method is suitable for larger sliding hernias.

Hernia repair

Sliding hernias are characterized by the hernia ring being enlarged, and the strength of each layer of the abdominal wall and the transverse fascia of the abdomen is severely damaged. Therefore, the Bassini method or the mesh repair is more commonly used to repair the inner ring.