What does a womans hernia look like
A hernia occurs when an organ pushes through an opening in the muscle or tissue that holds it in place. For example, the intestines may break through a weakened area in the abdominal wall. Many hernias occur in the abdomen between your chest and hips, but they can also appear in the upper thigh and groin areas. Sometimes they can require surgery to prevent dangerous complications.SEE VIDEO BY TOPIC: Women Hiding Hernias
SEE VIDEO BY TOPIC: Laparoscopic Ventral HerniaContent:
Common Types of Hernias
Chronic pelvic pain in women due to hernias may be misdiagnosed by practicing clinicians. These fascial defects, their symptoms, physical findings, and proper treatment must be known in order to help women experiencing this form of chronic pelvic pain.
All procedures were performed by the primary author using standard laparoscopic tension-free mesh techniques. The study included patients referred to a chronic pelvic pain clinic, who underwent laparoscopic surgical repairs of hernial defects. Ninety percent of the patients underwent concomitant procedures appropriate for their multiple pain generators.
Length of follow-up is 1. There have been no recurrences. One persistent ilioinguinal neuropathy from an inguinal hernia repair. All other patients received relief of their hernia pain Four complications from concomitant surgeries 1. Laparoscopic treatment of hernia pain in women is effective in relieving chronic pain and has a low recurrence and complication rate in the hands of experienced laparoscopists. Inguinal, abdominal, and pelvic floor fascial defects cause pain in many patients, male and female.
Pain patterns are very specific to the location and hernia type. However, women are subject to delayed diagnosis and treatment because they may present to their gynecologists with chronic pelvic pain due to a condition formerly relegated to the discipline of general surgery.
Physicians treating chronic pelvic pain patients should be knowledgeable in the diagnosis and surgical treatment of these women. A hernia is an abnormal opening or defect through which organs or tissue may protrude. The actual mechanism by which these defects produce pain is debatable. Incarceration and ischemia notwithstanding, the majority of painful hernias produce pain by mechanical distortion transduced into an electrochemical impulse transmitted by peripheral nerves to the central nervous system where it is perceived.
The location of the pain is specific for the location of the hernial defect and its neuralgia. Not all hernias are symptomatic. Hernias are classified by anatomical location: ventral, inguinal, and pelvic floor. Ventral hernias can be either spontaneous or incisional. Midline, epigastric, and umbilical hernias are usually easy to detect. A Spigelian hernia is congenital and occurs at the lateral border of the rectus abdominis muscle and just below the semilunar line of the posterior rectus fascia.
Pain and tenderness over the area may be accompanied by a palpable mass. Patients with symptomatic ventral hernias complain of sharp intermittent pain aggravated by activity and decreased by lying down. The tenderness on examination is exacerbated by having the patient raise her head.
An incisional hernia is usually due to midline incisions, but may be due to a Pfannenstiel. Diagnosis of these transverse incisional hernias may be more difficult.
Ilioinguinal neuralgia from entrapment will produce a similar history and physical findings. Inguinal hernias are much more difficult to diagnose in women than in men. It is typical for women to have nonpalpable or occult inguinal hernias. These can only be adequately evaluated laparoscopically. Symptoms include pain in the lower abdomen or groin when lifting, coughing, and sneezing with radiation into the labia majora and anterior thigh. The neurological nociceptors include the genital branch of the genitofemoral nerve, the ilioinguinal nerve, the femoral nerve, or all of these.
Patients may have indirect, direct, femoral, or a combination of any of these three. Indirect inguinal hernia is the most common hernia in women. It is congenital and due to nonclosure of the processus vaginalis. Tissue protrudes through the internal ring and passes down the inguinal canal a variable distance with the round ligament.
Direct inguinal hernia is acquired and is the second most common inguinal hernia in women. Femoral hernias occur more commonly in women than in men.
They are produced by a protrusion of preperitoneal fat or viscus through a weak transversalis fascia and into the femoral ring and the femoral canal. Pelvic floor hernias include sciatic, obturator, paravesical, and perineal.
All pelvic floor hernias are more common in women due to the broader pelvic inlet and the stresses of pregnancy, labor, and delivery. Sciatic hernias result from the protrusion of a peritoneal sac through the greater or lesser sciatic foramen. These patients will have typical sciatica with a negative MRI for disk herniation.
Findings at laparoscopy are a sac in the lateral pelvis that deviates the ureter medially toward or onto the uterosacral ligament. Ovarian incarceration can occur in these defects. Obturator hernia results from a protrusion of preperitoneal fat or an intestinal loop through the obturator foramen alongside the obturator vessels and nerve. It is considered rare 0. These patients present with pain in their lower pelvis and inner thigh, which radiates into the hip and behind their knee.
Pain increases when standing, lifting, and crossing the legs. Three types of obturator hernias are described based on the anatomical defect that is present. Type I occurs when preperitoneal fat and connective tissue pilot tag enter the pelvic orifice of the canal. Type II causes dimpling of the peritoneum over the canal leading to the formation of an empty peritoneal sac.
Type III occurs on the entrance of an organ bowel, ovary, or bladder that eventually fails to reduce spontaneously. The incidence of these hernias is significantly higher in females and may be due to their larger foraminal diameter.
Bowel obstructions from obturator hernias are usually in elderly average age 70 , thin patients. A small proportion of patients may present only with chronic pelvic pain and inner-thigh neuralgia. Diagnosis is made by vaginally palpating the obturator foramen reproducing the symptoms as a result of compression of the obturator nerve in its tunnel Howship-Romberg sign. A paravesical hernia may pass through the supravesical fossa of the anterior abdominal wall or into spaces around the urinary bladder.
Increased lower pelvic pressure may be the only symptom. These hernias are easily diagnosed laparoscopically. Perineal hernias are extremely rare and can be either anterior or posterior to the superficial transverse perineal muscle. They can be spontaneous or occur after abdominoperineal resection.
The treatment of chronic pelvic pain due to hernias is surgical. It can be performed by open or laparoscopic techniques. The laparoscopic approach is either transabdominal or extraperitoneal. We strongly favor the laparoscopic approach due to its minimally invasive nature and its diagnostic capabilities. For most patients with chronic pelvic pain, surgical trauma increases spinal cord upregulation and potentiates their associated neuropathies and reflex myalgias.
Many patients will have multiple pain generators and the transabdominal approach allows concomitant diagnosis and surgical management. However, the technical ease and improved visibility of the extraperitoneal access to the obturator space makes this technique preferable for obturator hernia repairs.
Recently, our preference for laparoscopic treatment of inguinal hernias in women has been challenged by a large randomized, controlled study in male patients. The study did emphasize that the results are experience dependent.
After a surgeon had performed a large number laparoscopically, there was no significant difference in recurrences or complications. An issue not addressed by this study was the difference in patients with acute pain versus chronic pain. Chronic pain causes complex neuroplasticity, centralization, and neuroupregulation that may not be seen in the usual hernia patient. Most of our patients have multiple visceral pain generators in addition to hernias.
These include endometriosis or ovarian and tubal pathologies, which require treatment along with their hernias. Therefore, this all-male study may have limited value for those who treat chronic pelvic pain in women. To test our hypothesis that hernia pain could be effectively treated by laparoscopic repair in women with chronic pelvic pain, we undertook this retrospective study.
An attempt was made to identify all pain generators preoperatively, visceral and somatic, and to specifically evaluate the surgical treatment outcomes based on that portion of the patient's symptoms produced by the hernial defect. Alleviation of site-specific groin, sciatic, abdominal, and obturator pain was the end point for successful surgical treatment. Relief of concurrent dysmenorrhea, dyspareunia, pelvic floor tension myalgia, irritable bowel syndrome, vulvar vestibulitis, painful bladder, iliopsoas and quadratus lumborum muscle spasm, trigger points and a host of other pathologies were evaluated and treated independently as indicated.
Our patient population comes from a referral-based practice dedicated to the diagnosis and treatment of chronic pelvic pain in women. All patients completed an extensive pelvic pain questionnaire designed to detect multiple pain generators both visceral and somatic. This instrument is available at the International Pelvic Pain Society website, www. All previous operative reports were obtained and reviewed. A detailed, pain-focused, physical examination was conducted including a careful search for hernial defects, which might be suspected from the patient's history.
Lower pelvic pain complaints were investigated by careful palpation of the internal rings for tenderness and impulse both lying and standing. Pain in the pelvis and medial thigh with referral to the hip and posterior knee had palpation of the obturator canals. Palpation of abdominal scars with and without head raising was routine.
Sciatic hernias were suspected by the patient's complaints of buttock pain referred down the posterior thigh in the absence of herniated disks. Laparoscopic repairs were performed by the transabdominal preperitoneal technique, except for obturator hernias, which were done entirely extraperitoneally. Standard tension-free mesh techniques were used in all cases. All repairs were performed by the primary author. All 16 obturator hernia patients underwent bilateral repair. This was due to the high incidence of contralateral recurrence and the fibrosis from the initial repair limiting future access to the retropubic space in these patients.
From January 13, , through December 17, , hernial defects were repaired by the primary author on patients referred to a chronic pelvic pain clinic.
Hernias as a Cause of Chronic Pelvic Pain in Women
Back to Health A to Z. In many cases, it causes no or very few symptoms, although you may notice a swelling or lump in your tummy abdomen or groin. The lump can often be pushed back in or disappears when you lie down. Coughing or straining may make the lump appear.
Back to Health A to Z. A hernia occurs when an internal part of the body pushes through a weakness in the muscle or surrounding tissue wall. Your muscles are usually strong and tight enough to keep your intestines and organs in place, but a hernia can develop if there are any weak spots. Femoral hernias sometimes appear as a painful lump in the inner upper part of the thigh or groin. The lump can often be pushed back in or disappears when you lie down.
Types and treatments for hernia
Find out about the most common hernias in men and women and treatment options that work best for each sex. But other types of hernias are actually more common in women, while still others occur at similar rates in men and women. Hernias occur when an organ or tissue bulges through a weak spot in the wall of muscle that's holding it in. Inguinal hernias aka, groin hernias occur when contents of the abdomen — usually fat or part of the small intestine — bulge through a weak area in the lower abdominal wall into the inguinal canal in the groin region. Ganshirt notes. By contrast, a femoral hernia occurs when a portion of the intestine pokes through a weakened area in the upper thigh muscle, just under the groin. Femoral hernias are more common in women than in men, Ganshirt says, adding that it probably has to do with the shape of the pelvis, which is shaped differently to accommodate childbearing. An umbilical hernia occurs when tissue lining the abdomen protrudes into the belly button area. As people get older, however, umbilical hernias tend to be equally common among women and men. The telltale sign for most inguinal hernias is an achiness or dull pain, especially while lifting something, gardening, or getting in and out of a car.
The Differences Between Hernias in Men Versus Women
Hernias are relatively common and can afflict anyone. But how do you know if you have one? Hernias can be caused by a variety of circumstances. You might get one because of muscle weakness, straining from heavy lifting or a previous injury.
Hernia is a common problem. It causes a localized bulge in the abdomen or groin. In this article, we investigate what a hernia is, the common causes of hernia, and how they are treated.
How Hernias Present in Women
A hernia occurs when an internal organ or other body part protrudes through the wall of muscle or tissue that normally contains it. Most hernias occur within the abdominal cavity, between the chest and the hips. Inguinal and femoral hernias are due to weakened muscles that may have been present since birth, or are associated with aging and repeated strains on the abdominal and groin areas.
A sports hernia in women can go undiagnosed for months, or even years. A hernia occurs when an area in the abdominal wall becomes thin, weak, or separated, allowing the internal organs, such as the small intestines, to push through. The hernia may cause bearable bouts of severe abdominal and pelvic pain. The symptoms of hernias in women are quite different from those experienced by men. One difference is the location.
Everything You Want to Know About a 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. An inguinal hernia occurs when tissue, such as part of the intestine, protrudes through a weak spot in the abdominal muscles. The resulting bulge can be painful, especially when you cough, bend over or lift a heavy object. An inguinal hernia isn't necessarily dangerous. It doesn't improve on its own, however, and can lead to life-threatening complications.
Chronic pelvic pain in women due to hernias may be misdiagnosed by practicing clinicians. These fascial defects, their symptoms, physical findings, and proper treatment must be known in order to help women experiencing this form of chronic pelvic pain. All procedures were performed by the primary author using standard laparoscopic tension-free mesh techniques.
What Is a Hernia?
When Fergie sang about "lovely lady lumps," she certainly wasn't talking about hernias. But that's exactly what they are def not lovely tho —little bulges that occur when an internal organ pushes through the wall of muscle or tissue surrounding it, says Mary Ann Hopkins, M. But left untreated, certain hernias can lead to discomfort, pain, and more dangerous conditions like intestinal blockages and even gangrene.