Herniated hernias

Hernias of the inguinal divide into oblique (hernial sac is located in the inguinal canal among the elements of the spermatic cord) and the straight (the hernial sac is located inside of the spermatic cord). Differentiate the slanting and straight hernia according to the following features: oblique are more common in young, usually unilateral, with prolonged existence can descend into the scrotum. Direct hernias often occur in the elderly, they are bilateral, do not fall into the scrotum. Slanting hernias can be congenital. In this hernial sac is an uninfected vaginal process of the peritoneum. It can appear at any age, but immediately after the appearance it becomes inguinal and scrotal. Differentiate inguinal hernia from the dropsy of the testis and the spermatic cord, inguinal ectopia of the testicle (see Cryptorchidism), femoral hernia.

Treatment operative. With any kind of inguinal hernia, the back wall of the inguinal canal, whose plastic is the main element of surgical treatment, suffers first of all. More often used method Bassini - hemming the lower edge of the internal oblique II transverse muscle to the papart ligament under the spermatic cord, followed by knocking over it aponeurosis of the external oblique muscle.

With a high inguinal space, when there is a significant tension of the muscles used to strengthen the back wall of the inguinal canal, weaken the tension by a lax incision of the anterior wall of the vagina of the rectus muscle (MacVay's method).

Relapses are 4-20%, depending on the type of hernia and the nature of the plasty of the inguinal canal.