Precautions can delay hernial surgery
Dear Dr. Gott: A year ago, I was diagnosed with an inguinal hernia that I ultimately had repaired. Last week, my family doctor said I have another weakness in the wall and I will develop a hernia within a year or two. Other than avoiding heavy lifting, he gave no direction. Are there exercises I can do to strengthen the muscles, or is it too late and is surgery again unavoidable?
Dear Reader: In the male embryo, the testicles develop in the abdominal cavity and descend through channels called the “inguinal canals” into the scrotum at the time of birth. Ordinarily, the inguinal canals close and fuse shut after the testicles descend.
However, as men age and their tissues sag, one or the other inguinal canal may open and stretch, allowing a portion of the intestine (or intestinal covering) to herniate (protrude) into the canal, perhaps even into the scrotum itself.
Such inguinal hernias are common.
They cause a soft lump, which may occasionally be painful, to appear in the groin. Small hernias do not need treatment. However, they tend to enlarge. Then a “knuckle” of intestine can become strangulated (wedged) in the canal.
Because of swelling and pressure, this “knuckle” may be deprived of its blood supply; emergency surgery becomes a necessity to prevent gangrene of the bowel and other serious complications.
This constant and unpredictable threat of strangulation makes many men with inguinal hernias opt to have the weakness repaired before an emergency operation is required.
The surgery is relatively easy but has one drawback: The hernia may recur. Evidently, this is what happened to you. If your doctor is correct, your inguinal canal is once again weakening; with time; you may develop another hernia.
Repeat surgery is not a necessary option at this time. You can safely wait until a hernia appears. If you avoid heavy lifting and straining, you may not need surgery for years, because these activities accelerate the development of a hernia.
Unfortunately, there are no exercises or treatments that will strengthen the inguinal canal. You and your doctor should periodically monitor the situation and make a decision about surgery if and when the time is appropriate.
To give you related information, I am sending you a copy of my Health Report “An Informed Approach to Surgery.” Other readers who would like a copy should send a long, self-addressed, stamped envelope and $2 to Newsletter, P.O. Box 167, Wickliffe, OH 44092. Be sure to mention the title.