Inguinal hernia (hernia) and hydrocele

Dr. Keidar Sergei Senior Pediatric Surgeon Head of the Pediatric Surgery Department at Edith Wolfson Hospital.

Inguinal hernia and hydrocele - everything that is important to know about the case and treatment!

Inguinal hernia is 5 times more common in boys than in girls, swelling in the groin as the first sign of a hernia is usually detected in the bath or shower and is not accompanied by pain. The diagnosis is made by a pediatric surgeon only and there is no need for any imaging.

When a testicle descends into the scrotum in the fetus in the last trimester of pregnancy, during its descent it pulls after it into the scrotum the layer of the abdominal cavity (peritoneum) and water that is in the abdominal cavity in the fetus. In most cases over 90% of the peritoneum branch closes near birth and the baby has no hernia. The water trapped around the testicle is hydrocele, a very common condition for many babies, when by the age of one year all the fluid is absorbed in most cases. When the amount of fluid or swelling in the testicle increases, it is a hydrocele that is connected to the opened abdominal cavity through the same thin channel , so the water comes from the abdominal cavity towards the testicle and stays around the scrotum. This condition after the age of one year requires follow-up and usually surgery of the same type that is performed for repair of the hernia.

Inguinal hernia and hydrocele

The treatment is surgery close to the diagnosis, because the hernia has a risk of incarceration, in girls the imprisoned organ is ovulated.

Before surgery for a healthy child with no background no blood tests are needed.

The purpose of the surgery is to connect a congenital canal that has not closed / an extension of the peritoneum, so there is no need to put a net as is customary in the elderly population.

The operation is short, about 15-20 minutes, performed under general anesthesia when one of the parents is with the child until he falls asleep.

A small skin incision about 1-2 cm in a fold of skin in the groin allows you to perform this simple and routine operation with a cosmetic skin closure with a dissolving suture. The parent visits the child immediately after the anesthesia and after 2-3 hours the child is released to his home, infants up to the age of 3-4 months remain under supervision until the next morning for monitoring after the anesthesia.

The house can be showered the day after the operation and no local treatment is required. Pain management is usually sufficient for 24 hours after surgery with paracetamol or Nurofen. The child can return to kindergarten after 2-3 days and for strenuous sports activities about two weeks after surgery.


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The rate of bilateral hernia is about 10-15% and surgeons on both sides only when the diagnosis of hernia on both sides is clear.

Recurrent hernia – a very rare phenomenon about 1 case per 500-1000 hernia surgeries.

Herniated hernia is a relatively common complication of the hernia when not treated in time, the treatment is the recurrence of the hernia by a pediatric surgeon and surgery to repair the hernia 24-48 hours after incarceration.

Combination of inguinal hernia and umbilical hernia – It is permissible to repair a bilateral inguinal / inguinal hernia with a umbilical hernia without additional risk in the same operation.

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