Hernias in Men: Different Types, Causes and Treatments

Hernias occur because of muscle weakness, often in the abdominal region, and where the cavity wall is weak. These points of weakness are usually where there is a natural gap such as the passing area of a digestive tube or blood vessel, or as a result of scar tissue. Men commonly describe the sensation of a hernia as feeling like something has popped or given way. Below are a few of the types of hernias that are common in men.

Men can be prone to numerous types of hernias and the causes of them are varied, a hernia is just as likely to occur during exercise, straining on the toilet, coughing or even during sex. It’s important to understand what type of hernia you have so you can find the best treatment options available.

Inguinal Hernias

Inguinal hernias are the most common type of hernia. In men, the inguinal canal is the area where the spermatic cord, which holds up the testicles, passes from the abdomen to the scrotum. These hernias occur when the intestines push through a weak spot or tear in the lower abdominal wall, often the inguinal canal, and protrude down the canal and into the scrotum. The reason this type of hernia is so common in men is because a man’s testicles descend through the inguinal canal shortly after birth, and sometimes the canal doesn’t close up completely and leaves a weak spot prone to hernias. Inguinal hernias can be painful, especially when you cough, bend over, or lift heavy objects.

Epigastric Hernias

Epigastric hernias are protrusions of fat or intestine through the upper part of the abdominal wall called the epigastrium, which is located between the navel and the breastbone. Typically, an epigastric hernia is small, with only the lining of the abdomen breaking through the surrounding tissue. However, larger hernias may cause part of the stomach or fatty tissue to push through. Many people are unaware that they even have an epigastric hernia, as smaller hernias often don’t cause many complications.

Hiatal hernias

A hiatal hernia, which is most common in people over the age of 50, occurs when part of your stomach protrudes up through the diaphragm and into your chest cavity. The diaphragm, which separates the organs in your abdomen from the ones in your chest, is a sheet of muscle that helps you breathe by drawing air into the lungs. Hiatal hernias almost always cause acid reflux, which is a burning sensation in the throat from stomach contents leaking back into the oesophagus.

Causes of hernias in men

Hernias are usually caused by a combination of muscle weakness and strain. Causes of muscle weakness include age, chronic coughing, damage from injury or surgery, or congenital birth defects. Factors that can strain your body and cause hernias, particularly if your muscles are weak, include constipation, lifting heavy weights, excess abdominal fluid, sudden weight gain, surgery, straining during bowel movements or urination, and persistent coughing or sneezing. Depending on its cause, a hernia can develop quickly or over a long period of time.

Treatment options for hernias

Whether or not you require treatment depends on the size of your hernia and the severity of your symptoms, your doctor may just want to monitor your hernia in case of any complications. Treatment options include lifestyle changes, medication, or surgery.

Lifestyle changes

Certain changes to eating habits can help to treat the symptoms of a hiatal hernia, but won’t get rid of the hernia. Avoiding large or heavy meals, keeping body weight in a healthy range, and not lying down or bending after eating can help ease the symptoms of a hernia. The acid reflux caused by hiatal hernias can also be lessened by avoiding spicy or acidic foods, losing weight, and quitting smoking.

Certain exercises can also help to strengthen the muscles in the area of the hernia, but, if done incorrectly, exercises can put excess strain on the area and actually make the hernia worse. It’s best to consult your doctor or physical therapist about whether or not exercise can be beneficial for you.

Medication

Over-the-counter and prescription medicines such as antacids, H-2 receptor blockers, and proton pump inhibitors can help relieve the discomfort caused by hiatal hernias.

Surgery

Many hernias, inguinal hernias in particular, won’t improve on their own and will need surgery to be repaired. If a hernia is growing larger or causing pain, doctors may decide it’s best to operate. The most common surgical procedure will involve patching the hole with surgical mesh.

Most hernias will be repaired with laparoscopic surgery, also known as keyhole surgery, which involves using a small camera and miniature surgical equipment to repair the hernia only using a few small incisions. However, some hernias, such as ones where a portion of your intestines has moved down into the scrotum, are not suitable for keyhole surgery and will require open surgery. The recovery process after open surgery is much longer, and it can also be more damaging to surrounding tissue.

Given there are many possible causes and types of hernias, the treatments are highly varied. However, if you suspect that you have symptoms of inguinal hernias, please do not hesitate to contact your urological specialist.

Dr Arianayagam is a highly skilled urological surgeon who treats many urological illnesses, including cancers and other disorders of the urinary system and is widely considered one of the top urological oncologists in Australia.

If you have any questions, or would like to book an appointment, please feel free to contact or call Dr Arianayagam’s office on 1300 307 990 and his staff will be able to assist.