Inguinal Hernias/Hydroceles in Children

A bulge or painful lump in your child’s groin or scrotum could be a hernia.

What are Inguinal Hernias and Hydroceles in Children?

An inguinal hernia is a bulge that occurs in your child’s groin or scrotal region, which is the area between the lower part of the abdomen and the thigh. Inguinal hernias in children are almost always congential, caused by a small defect in the abdominal wall that allows fluid and/or bowel to enter the groin or scrotum. Hernias may fluctuate in size, some are larger than others. Hydroceles are collections of fluid in the scrotum which typically don’t go away. An inguinal hernia and hydroceles may be evident from birth, or may not appear until your child grows. Inguinal hernias are more common in males than females. Left untreated, they tend to become larger.

What causes an Inguinal Hernia or Hydrocele in Children?

The vast majority of pediatric hernias are known as indirect inguinal hernias. Indirect inguinal hernias are congenital hernias and are much more common in males than females because of the way males develop in the womb. In a male fetus, the spermatic cord and both testicles normally descend through the inguinal canal into the scrotum, the sac that holds the testicles. Sometimes the entrance of the inguinal canal at the inguinal ring doesn’t close as it should just after birth, leaving a weakness in the abdominal wall. Fat or part of the small intestine slides through the weakness into the inguinal canal, causing a hernia.

Premature infants are especially at risk for indirect inguinal hernias because there is less time for the inguinal canal to close while in the womb.

One or more of the following factors can put pressure on the abdominal muscles and cause or worsen the hernia:

  • Sudden twists, pulls, or muscle strains
  • Lifting heavy objects
  • Straining because of constipation
  • Weight gain
  • Chronic coughing

Indirect inguinal hernias usually slide back and forth spontaneously through the inguinal canal and can often be moved back into the abdomen with gentle massage.

What are the symptoms of Inguinal Hernia or Hydrocele in Children?

Symptoms may include:

  • A small bulge in one or both sides of the groin or scrotum that may get larger, but disappear when lying down; in males, it can look like a swollen or enlarged scrotum
  • Discomfort or sharp pain; especially when straining, lifting, or exercising, that improves when resting
  • Feeling of weakness or pressure in the groin
  • Burning, gurgling, or aching feeling at the bulge

Symptoms of a strangulated hernia include:

  • Extreme tenderness and redness in the area of the bulge
  • Sudden pain that worsens in a short period of time
  • Fever
  • Rapid heart rate

If a strangulated hernia is left untreated, nausea, vomiting, and severe infection can occur. If surgery is not performed right away, the condition can become life threatening, and the affected intestine may die. Then that portion of the intestine must be removed.

How is Inguinal Hernia or Hydrocele in Children diagnosed?

Your Michigan Institute of Urology physician, located in Southeast Michigan, will conduct a thorough exam. Your child, if able, will be asked to stand and cough so the doctor can feel the hernia as it moves into the groin or scrotum. The doctor will check to see if the hernia can be gently massaged back into its proper position in the abdomen. An ultrasound may be needed.

How is Inguinal Hernia or Hydroceles in Children treated?

Most hernias or hydroceles won’t go away on their own (with the exception of newborn hydroceles) and ultimately require surgery.

Surgical techniques include both classic open procedures and laparoscopic procedures, depending on circumstance. All methods of surgical repair are very successful and very well tolerated.

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