Discomfort and Diagnosis
Considering hernia syndromes from an anamnestic point of view, most patients report about a swelling in the groin area, which is often, but not always combined with a sensation of pressure, tearing or radiating pain. These complaints are increased by coughing, sneezing, or increased pressure caused by standing up or sitting down or alternatively caused by lifting, e.g. during physical exercise (sport). The above listed symptoms may also be indicators of other diseases.
The patient is examined whilst standing up. An experienced doctor, however, can also check the hernial orifices and inguinal canal, by either examining the scrotum, in case of a male patient, or by examining the skin in the groin area in case of a female patient, by using his index and small fingers (palpation). It is also possible to discover invisible hernias by provoking the patients’ body, e.g. through coughing or increased pressure.
If the doctor discovers another internal inguinal ring as well as a slack posterior wall, the patient suffers from a softened inguen.
Femoral hernias, on the other hand, are usually not discovered by examining the affected area. Sometimes the previous doctor or even the patient himself believes that the articular constrictions of the peritoneum are in fact enlarged lymph nodes or fatty tissue. To confirm the diagnosis, an ultrasound examination (sonography conducted with a 7,5 MHz linear transducer) is carried out. This method is also an extremely helpful aid in relation to overweight patients and secures an objective approach towards the pre-surgical findings as well as the post-surgical outcomes (hematoma, seroma, abscess), in addition to eliminating other diseases.
Further examinations of the patient are usually not necessary. In order to determine whether the patient is capable of undergoing surgery, as well as planning the course of surgery (out-patient or in-patient treatment, open or laparoscopic surgery, with or without a mesh) further information is indeed needed. Further examinations in form of laboratory check-ups, ECG, pulmonary function test etc, might also be required.
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