From the Research
The most common type of inguinal hernia in females is the indirect inguinal hernia, accounting for approximately 72.5% of all inguinal hernias in females. This type of hernia occurs when abdominal contents protrude through the deep inguinal ring and travel along the inguinal canal, potentially extending into the labia majora. In females, indirect inguinal hernias are more common than direct hernias, with a study published in 2021 1 finding that indirect inguinal hernias accounted for 72.5% of all inguinal hernias in females, followed by femoral hernias (17.4%) and direct hernias (10.1%). The pathophysiology involves a patent processus vaginalis, which is an embryological outpouching of peritoneum that normally obliterates after descent of the ovaries. When this closure fails to occur, it creates a potential space for hernia formation. Risk factors include increased intra-abdominal pressure from pregnancy, chronic cough, constipation, or heavy lifting. Females typically present with a groin bulge that worsens with straining and may have associated discomfort. Treatment generally involves surgical repair, either through open techniques or laparoscopic approaches, with mesh reinforcement commonly used to prevent recurrence.
Some key points to consider when evaluating inguinal hernias in females include:
- The importance of maintaining a high index of suspicion when examining females with inguinal hernias to ensure accurate diagnosis and management of tubo-ovarian hernias 2
- The use of ultrasonography and magnetic resonance imaging to diagnose occult hernias or assess for complications after repair 3
- The effectiveness of laparoscopic repair in reducing recovery time, pain, and recurrence rates compared to open repair 1, 3
- The need for careful consideration of the potential for female genital organs to be involved in the hernia, as seen in cases of indirect inguinal hernias containing the ovary and fallopian tube 2
Overall, the diagnosis and management of inguinal hernias in females require careful consideration of the potential for indirect inguinal hernias and the importance of maintaining a high index of suspicion to ensure accurate diagnosis and effective treatment.