Hernias In Men The Hidden Risk Factors And Modern Repair Techniques

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A HERNIA occurs when an organ or other tissue pushes through a weakened muscle or connective tissue area.
While often underestimated, hernias are more common than many realise. In 2019 alone, 32.53 million cases of inguinal, femoral, and abdominal hernias were recorded globally, with 13.02 million new cases—primarily among men aged 50 to 69.
Approximately 25% of men in this age group experience an inguinal hernia during their lifetime.
Understanding the root cause: Anatomy and physiology
The increased susceptibility of men to hernias is fundamentally linked to their unique anatomical structure. During embryonic development, the testicles in men start inside the abdomen and descend into the scrotum via the abdominal wall.
This descent creates a natural opening, the inguinal canal, which remains a potential weak point in the abdominal wall, predisposing men to developing inguinal hernias. In most cases, this canal closes properly, preventing any complications.
Hernias develop when internal pressure exceeds the strength of the abdominal wall, exploiting natural or acquired weak points. Several factors increase the risk, such as:
Chronic cough or constipationA history of abdominal or pelvic surgeriesObesityStrenuous physical activity or improper lifting techniquesRecognising the Symptoms of a Hernia
According to Sunway Medical Centre General Surgery and Upper Gastrointestinal Surgery consultant Dr Soon Yuen, hernias can present in various forms, with the most common types being inguinal and umbilical hernias, alongside less frequent varieties such as Spigelian and Lumbar hernias.
“While some hernias may remain asymptomatic, others may cause noticeable swelling, discomfort, or pain,” he shared.
“Patients often present either with a visible lump or pain. The danger of delaying treatment carries a risk, as approximately 5% of patients experience incarceration or strangulation, where the intestine becomes trapped and cannot be repositioned.
“This can result in serious complications requiring more complex surgical interventions. Otherwise, the lumps may increase in size, making surgical intervention more challenging.”
Key warning signs include a bulge or lump in the affected area, particularly in the groin or abdomen, discomfort or pain that worsens with physical activity, coughing, or heavy lifting, severe pain, nausea, or vomiting in strangulation cases.
Advancements in hernia repair: The era of single port surgery
“Hernias do not resolve without intervention,” Dr Soon emphasised, highlighting the importance of timely medical attention. Modern surgical treatments now offer tailored solutions based on the severity and complexity of the hernia:
Watch and wait: Small, asymptomatic hernias may be monitored without immediate risk. However, hernias that are increasing in size or causing symptoms should be addressed with medical attention.Open surgery: This traditional method involves a larger incision to repair the hernia with stitches or mesh, often used for large or complicated cases.Laparoscopic surgery: This minimally invasive approach uses small incisions, reducing scarring and recovery time. It includes single-port surgery.Single-port surgery is at the forefront of minimally invasive techniques, requiring only one small incision to repair the hernia.
“This technique reduces scarring, postoperative pain, and recovery time compared to traditional and laparoscopic surgeries,” said Dr Soon.
“Most patients can go home the same day, resume daily activities within three to seven days, and many don’t require painkillers.”
Advanced surgical expertise remains crucial for complex cases, such as giant or recurrent hernias. Single-port surgery, however, represents a leap forward in ensuring most patients’ faster and smoother recovery.
Preventing hernias
While some hernia risk factors, such as anatomy and age, are unavoidable, lifestyle changes can reduce its risk:
Practice proper lifting techniquesMaintain a recommended healthy body weightIncrease core strengthAvoid chronic coughing or constipation by addressing underlying conditionsDr Soon emphasised early diagnosis and treatment to prevent complications. “Seeking medical attention early improves recovery outcomes and quality of life,” he stressed. ‒  Focus Malaysia

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