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An inguinal hernia or groin hernia is a hernia (protrusion) of abdominal cavity contents through the inguinal canal. Symptoms, which may include pain or discomfort especially with or following coughing, exercise, or bowel movements, are absent in about a third of patients. Symptoms often get worse throughout the day and improve when lying down.
Inguinal hernias are a common occurrence in young children. [29] Unlike hernias in adults, these hernias involve the failure of the peritoneum , the sac that encloses the intestines , to close properly, resulting in an opening between the abdomen and scrotum .
In many infants with inguinal testes, further descent of the testes into the scrotum occurs in the first six months of life. This is attributed to the postnatal surge of gonadotropins and testosterone that normally occurs between the first and fourth months of life. Spermatogenesis continues after birth.
A hernia usually can be reduced, transmits a cough impulse, and is not translucent. A hydrocele cannot be reduced into the inguinal canal and gives no impulse on coughing unless a hernia is also present. In young children a hydrocele is often associated with a complete congenital type of hernial sac. [citation needed]
An indirect hernia is situated laterally to these vessels, whereas a direct hernia is positioned medially to them. Inguinal hernias are the most common type of hernia in both men and women. In some selected cases, they may require surgery. There are special cases where a direct and indirect hernia appear together.
A hernia that exits the abdominal cavity directly through the deep layers of the abdominal wall, thereby bypassing the inguinal canal, is known as a direct inguinal hernia. In males with strong presentation of the cremasteric reflex , the testes can—during supine sexual activity or manual manipulation—partially or fully retract into the ...
The more patent the vaginal process, the more likely the patient is to develop a hernia. Congenital malformation of the vaginal process is also the leading cause of testicular torsion , since lack of attachment to the inner lining of the scrotum leaves the testicles free to twist.
As the scrotum and labia majora form in males and females respectively, the gubernaculum aids in the descent of the gonads (both testes and ovaries). [3] The testes descend to a greater degree than the ovaries and ultimately pass through the inguinal canal into the scrotum. [3] The mechanism of this movement is still debated. [3]
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