Inguinal hernias happen because the natural openings in the abdominal wall through which your testicles descend during gestation don’t close down small enough.
They are very common in men, for some reason statistically more likely on the right side, and statistically more likely to happen to both sides If it has already happened on one side.
Things like lifting heavy weights and explosive sports movements which create a lot of internal pressure inside the abdomen will over time stretch the natural inguinal canal opening and eventually boom…. Hernia.
Now you can either “actively monitor” it, meaning you live with it and be careful not to let your intestine stick out to the point of losing circulation because that can mean death…. This is actually the option more doctors themselves choose because the surgical options are imperfect.
The two surgical options are
Old school “tissue repair”, where your inguinal canal is tightened by suturing your own tissues together in one way or another (there are multiple techniques and materials used for the sutures, some temporary that dissolve over time, and permanent stainless steel wire that stays in place for life.
The long term success of this option is highly dependent on the specific surgeon and their skill (and familiarity because it is rare these days)
The other option, which is what the vast majority of surgeons recommend, and what the vast majority of people end up choosing, is a “mesh” repair, where an artificial material mesh, made either of plastic, metal, or a combination of both l, is inserted into your abdomen, usually laparoscopically, and it “plugs” up the hernia hole.
This is easy for the surgeon because they literally just put the mesh in, (hopefully) unroll it and place it correctly. It’s also profitable because the companies that make the mesh give doctors financial incentives to sell mesh. And the mesh itself has ridonculous markup…
Problem is that this material ends up fusing to your tissues. Ideally just the abdominal wall and not to any of the nerves in your groin, your bladder, or your vas deferens because while it is not completely rigid, it is not as flexible and stretchy as your tissues. A significant percentage of people deal with life-long pain associated with meshes. Worst case scenario, you can lose your fertility, or even have sexual side effects if it impinges on the vas deferens or various nerves.
And once you get a mesh and it fuses with you, there is virtually no chance of ever removing it, or if you do, the tissue destruction in the process is extensive.
That’s why I personally decided to go with the “riskier” tissue repair that my eventually fail, but I can always get a mesh at that point I guess…
Funny thing about the tissue repair is that as much as most doctors poo-poo it, if you get an inguinal hernia as a child, it’s ALWAYS a tissue repair… mesh can’t grow with you.
One of my coworkers got mesh on both sides 15 years ago and he says he can feel them constantly to this day and deals with pulling, tugging sensations when he bends and twists at the waist.
I think getting back to being physically active quickly after getting mesh can help with that, although since the mesh isn’t actually fixed in place inside you, how they guarantee it doesn’t migrate and fold once inside of you before it fuses I have no idea…
