As my physical anthropology instructor Turhon Murad used to say, there's a vas deferens between men and women. (Groan!) This undisputable fact is no more apparent than with inguinal hernias - a condition that is ten times more common among men than women. Inguinal hernias occur when soft tissue - usually part of the intestine - protrudes through a weak point or tear in the lower abdominal wall, leaving a rather unsightly (and often quite painful) bulge.

The most obvious symptom of an inguinal hernia is the visible (and palpable) bulge created by the protruding intestine. Other symptoms include:

  • Pain or discomfort in your groin, especially when bending over, coughing or lifting
  • A heavy or dragging sensation in your groin
  • Occasionally, in men, pain and swelling in the scrotum around the testicles when the protruding intestine descends into the scrotum

The reason why inguinal hernias are more common among men than women is because men have a built-in weak spot along the inguinal canal. This is the area where the spermatic cord, which contains the vas deferens (the tube that carries sperm), enters the scrotum. Women also have an inguinal canal, which contains a ligament that helps hold the uterus in place, but men are more likely to have an inherent weakness along the canal due to the way males develop in utero. In the male fetus, the testicles form within the abdomen, then move down the inguinal canal into the scrotum. (What we liked to call in anthropology class "The Descent Of The Testes".) Shortly after birth, the inguinal canal closes almost completely, leaving just enough room for the spermatic cord to pass through, but not large enough to allow the testicles to move back into the abdomen. Sometimes, however, the canal doesn't close properly, leaving a weakened area.

A newborn boy with an inguinal hernia. 5/100 children are born with inguinal hernias.
Female inguinal hernias are rare, but they do happen - as this photo attests!

Once a weakened area is present, such risk factors as heavy physical labor, chronic cough, chronic constipation, excess weight, and pregnancy can cause the hernia to form. Although usually not requiring urgent treatment, inguinal hernias can be quite painful and may result in a life-threatening condition if a loop of intestine should become trapped in the in the weak point of the abdominal wall. This can obstruct the bowel, leading to severe pain, nausea, vomiting, and the inability to have a bowel movement or pass gas. It can also diminish blood flow to the trapped portion of the intestine — a condition called strangulation — that may lead to the death of the affected bowel tissues. A strangulated hernia is life-threatening and requires immediate surgery.

Hernia repair operation.
A strangulated intestine - bad news!!

Luckily, surgical repair of inguinal hernias ain't what it used to be. Back in the day, they'd rip you open, but these days thanks to laparoscopies, your groin can soon be returned from freak show to normal (which may, in all honesty, still be a freak show) with minimum suffering. Ah, the wonders of modern medicine!

Thanks to Elizabeth for the suggestion.

The information and photographs above were mercilessly swiped from the following fine websites:
Mayo Clinic
Indian Pediatrics

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