Any surgical procedure on the abdominal wall weakens it and can lead to a possible hernia. The risk is greatly increased if a surgical site infection occurs as this inhibits normal healing of the fascia. What are the different types of hernias? Inguinal Groin Hernia : This is the most common type of hernia in both men and women. However, it is about ten times more likely to occur in men. In males, it happens when an opening in the abdominal wall from the passage of the testicle into the scrotum does not close normally before birth, or reopens later in life.
In women, this canal contains the round ligament the area that surrounds and supports the uterus and is much smaller but still exists and can reopen later in life. Femoral Hernia : Appears as a bulge near the groin or thigh. This type of hernia is not common and usually occurs in elderly, thin females. It is due to an enlargement of the small hole in the abdominal fascia needed for the major blood vessels of your leg. Umbilical Hernia : As an unborn baby develops during pregnancy, there is a small opening in the abdominal wall, where the umbilical cord passes from the unborn baby to the mother and provides all of the nutrients for life.
After birth, this opening closes but is an area of weakness in the abdominal wall. Over time, and with strain, this area of weakness can reopen. A loop of intestine can then move into the opening, causing an umbilical hernia. Incisional Hernia: Usually occurs months, or years, after surgery in the area overlying the scar. The size of this type of hernia depends on the initial surgery. Epigastric Hernia: Normally present in the middle of the belly between the breastbone and the belly button.
In the mid-line, the fascia is not covered with muscle and is a natural area of weakness. Fat or intestine can push through a weak spot in the abdominal wall. You can't prevent the congenital defect that makes you susceptible to an inguinal hernia.
You can, however, reduce strain on your abdominal muscles and tissues. For example:. Mayo Clinic does not endorse companies or products. Advertising revenue supports our not-for-profit mission. This content does not have an English version. This content does not have an Arabic version. Overview Inguinal hernia Open pop-up dialog box Close. Inguinal hernia Inguinal hernias occur when part of the membrane lining the abdominal cavity omentum or intestine protrudes through a weak spot in the abdomen — often along the inguinal canal, which carries the spermatic cord in men.
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Share on: Facebook Twitter. Show references Brooks DC, et al. Classification, clinical features and diagnosis of inguinal and femoral hernias in adults.
Accessed Feb. Ramsook C. Overview of inguinal hernia in children. However, the outcomes of these technical innovations are not very satisfactory, and the risk factors and patterns of concomitant hernia between men and women are unclear based on the current literature. The incidence of RAD is increasing alongside the aging population and the growing obesity epidemic worldwide, providing a greater insight into the characteristics of this special population.
Therefore, we conducted this retrospective study to explore the characteristics of hernia in patients with RAD. We hypothesized that the prevalence, patterns, and risk factors of hernia in women with RAD differ from that in men with RAD.
The institutional review board of the research of Partners approved the study protocol. Individual-level data including diagnosis, primary source ultrasound when available , demographic information, health history, open surgery history open abdominal operations were included, but laparoscopic operations were excluded , operative notes, imaging reports, and procedures were extracted from RPDR.
The demographic and health history variables included in this study were age, race or ethnicity, body mass index BMI , abdominal surgery history, smoking status, and alcohol use.
Except for hernia, other coexisting conditions of the patients were identified and they included low back pain; pelvic and perineal pain; incontinence; strain of muscle, fascial, and tendon SMFT ; and depressive disorder.
We reviewed the trend of hernia. The cumulative composition ratio of hernia was defined as the percentage of patients who were diagnosed with the disease in the past or current year to account for all patients. Age at the onset of the disease was defined as the age for the first time when the patients were diagnosed with this disease.
Abdominal wall hernia, in this study, mainly included incisional hernias which occur along incisions from a prior surgery , diaphragmatic hernias, ventral hernias, inguinal hernias femoral hernias , and umbilical hernias, unilaterally or bilaterally, referring to the definition of abdominal wall hernia Data are summarized as mean and standard deviation or frequencies and percentages where applicable.
Pearson's and continuity correction chi-square test was used to test the differences between groups for counting data and Wilcoxon's W non-parametric test was used for continuous variables with non-normal distribution. Univariate and multivariable binary logistic regression analyses were used to identify the independent risk factors of hernia. Risk ratio formulation was used to calculate the relative risk. Missing data was treated as system-missing values automatically. Clinical characteristics, including demographics, social history, abdominal surgery history, and coexisting conditions at presentation, are outlined for all patients Table 1.
Of the 1, cases, were women Female subjects demonstrated a 1. It is worth noting that women account for The mean age at the onset of RAD in the male group was significantly higher than the female group 41 vs. The mean BMI in the female group was significantly lower than that of the male group Of the 1, cases, 37 patients were younger than 10 years and 24 of them were men The top three concomitant disorders with RAD we identified were hernia Of the 1, cases, of them The most common types of hernia unilateral or bilateral in patients with RAD were ventral hernia There were subjects There was no difference in the prevalence of hernias in the male group when compared with the two groups based on BMI category.
Significantly differences in terms of smoking statuses were noted in both the male Based on gender classification, we further categorized these data into two subgroups depending on the presence of the concomitant hernia.
The mean age in the hernia subgroup was significantly higher than that in the non-hernia subgroup, both in the male group 6. Women with concomitant hernia had significantly higher mean BMI compared to those without hernia Univariate and multivariate binary logistic regression analysis predicted coexisting hernia occurrence in patients with RAD. In this large multicenter retrospective study, significant gender differences with regards to RAD were demonstrated.
Firstly, women had an approximately two-fold greater risk of developing RAD compared with men, and the age at onset in women was found to be two decades earlier than that in men.
Thirdly, women with RAD underwent more than double the number of abdominal surgeries compared with men. In a previous study, we noted that the risk of RAD in women who underwent cesarean delivery CD was 4.
This finding was consistent with the studies by Reinpold et al. It was also reported that pregnancy related to the number of pregnancies and multiple births increase the risk of developing RAD during the course of pregnancy 3.
Given the characteristics mentioned above and the data presented in previous findings, it is reasonable to infer that pregnancy, delivery, and CD might be important factors leading to the development of RAD in female population, but the precise mechanism has not been well-recognized yet. It was more common in men than in women.
Approximately five million Americans have abdominal wall hernias, the majority of which are inguinal hernias 16 , This implies that RAD cases have over 20 times more abdominal hernia compared with the general population. The most common type of hernia in men was ventral hernia Therefore, in both men and women in the RAD population, the rate of abdominal wall hernia was significantly higher than that in the general population in USA, and the distribution of hernia type in RAD individuals differed from the general population as well.
Interestingly, the cumulative composition ratio of hernia before 50 years of age was higher in women than in men, but, eventually, the men had a higher incidence of hernia. This might relate to that women had a pregnancy history and underwent more than double the number of abdominal surgeries than men before the age at onset of RAD. Additionally, we demonstrated that smoking and age might be risk factors contributing to coexisting hernias in women with RAD.
Smoking is a modifiable risk factor impacting outcomes in patients undergoing hernia repair and is the risk factor for the development of inguinal hernia in the general population 23 , Furthermore, for women with RAD, the risk of coexisting hernia increases 1. This is consistent with a study that found the prevalence of femoral hernias increases steadily throughout life Alcohol use and depressive disorder contribute to the development of coexisting hernias in men with RAD.
We also confirmed this positive association between alcohol use and the occurrence of hernia in men with RAD; men with RAD who used alcohol have 1. However, this is in contrast to some other studies 28 , Therefore, further prospective study with large samples on hernias is worth carrying out to identify whether alcohol use is associated with hernias.
To our knowledge, it has never been reported about the relationship between depressive disorder and hernia. We found that over one-quarter subjects in our study had depressive disorder, and men with the depressive disorder had 1.
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