Does Hernia Surgery Effect On Sexual Functions?

A hernia, simply put, is very much similar to trespassing. An organ crosses its defined boundaries in the body via a weakened tissue, muscle or the layer of fat surrounding it, which ultimately results in invasion of some other cavity in the body.

For any form of hernia to occur, two things are a must:

​ Stimulus in the form of pressure

​ Weakening in the body cavity

A combination of these factors is enough to send any organ invading the other space.

Hernia can happen anywhere in the body. Let us take a look at a few types:

​ Inguinal Hernia –

The most common type of hernia, here a part of the intestine protrudes through the abdominal cavity into the inguinal canal. The inguinal canal carries the spermatic cords in males and the round ligament of uterus in females.

​ Incisional Hernia –

An incompletely healed or weak surgical wound gives way to the protrusion of an organ or tissue. Most commonly seen along the line starting from the lower part of sternum to the pubic bone.

​ Hiatus Hernia –

This one happens when the stomach protrudes through a very large muscle called diaphragm, which separates it from the lungs. It may or may not show any symptoms, but in cases where clues can be seen, it’s in the form of heartburn, chest pain, palpitations and recurrent acid reflux.

​ Femoral Hernia –

A type of inguinal hernia, but with the femoral canal (in the thigh region) serving as an exit route.

​ Umbilical Hernia –

Here a section of intestine comes out of the umbilical (belly button) opening of abdominal muscles. A small bulge appears on the belly-button area as a result. Though this one is more common in children, it can be seen in adults too.

​ Epigastric Hernia –

Epigastrium, also known as the upper abdomen, is the site where this type of hernia occurs. A portion of fat pushes past its boundaries in the abdominal cavity. They can happen more than one at a given point of time. Some of these hernias may pain, some do not.

​ Spigelian Hernia –

A kind of abdominal hernia, with high risk of strangulation of surrounding structures.

​ Diaphragmatic Hernia –

Mostly this is a congenital type of hernia where a large hole exists in the diaphragm since birth. Because of this, one or more organs from the abdominal cavity can go across the diaphragm and enter the chest cavity, resulting in serious breathing and cardiac problems. In the acquired version, a blunt trauma or serious injury to the chest cavity can result in a similar condition.

These trespassers can manifest themselves in the form of following symptoms:

​ Pain is felt on lifting heavy things

​ The bulging region pains with increasing intensity

​ Bowels may feel blocked

​ Increase in bulge-size

​ Heartburn, acidity

​ Dull pain

We will restrict our discussion to inguinal hernias in this article.

A type of groin hernia, the inguinal variety accounts for majority cases of organ protrusions. Males are more to this by carrying a risk of 27% as compared to 3% in females. It happens as a result of a weakening in the abdominal wall which causes the protrusion of intestines or tissues in to the inguinal canal. Based on the location of origin of inguinal hernia, it can be classified into :

​ Direct hernia

​ Indirect hernia

How does an inguinal hernia present?

​ In the form of a bulge in the groin region, which appears in standing up and disappears on lying down.

​ Most of the cases are asymptomatic, however, very few people complain of pain in the groin area.

​ There may be discomfort in the bulge area when doing some work or any othermoderate activity.

​ It can occur either on one or both sides (humans have two inguinal canals).

Once you approach your clinician with such a complaint, you will be thoroughly assessed for the presence and extent of hernia. Coughing in standing position is one of the best ways to diagnose an inguinal hernia. An ultrasound test helps it to differentiate it from other types of swellings in the area.

Hernias can be treated using two approaches. Depending on the status of occurrence of hernia, it can be treated directly via reduction (where it occurs intermittently), where the doctor will directly try to push it back using gentle manipulation of the hands over the hernia.

Now in cases where the hernia has decided to keep ‘hanging around,’ a surgical approach is the best option. In times of emergency, an open surgical repair is the most preferred option, because of its ease of technique. It can be easily performed under local anesthesia, as well as general anesthesia, depending on your condition. But a local anesthesia used will ensure a shorter post-operative recovery time. The surgeon will make an incision over the region of hernia using a surgical blade. Once the area is exposed, a special mesh like structure is properly placed over the weakened cavity wall. After this, the repaired area is closed in layers using dissolvable sutures.

Elective cases of surgical hernia repair can be carried out using laparoscopic technique. This approach is especially useful if hernia is present on both the sides. Carried out under general anesthesia, small incisions are made over the abdomen, through which special instruments and a thin tube with a camera on its tip are inserted. The camera helps in visualizing the abdominal cavity which can be seen on a monitor. Now the instruments inserted through the other incisions will help pulling the hernia back in its original place. This technique, though taking long in the operation theater, is actually beneficial when it comes to duration of post operative recovery.

A common hernia repair surgery will at the most take about a week to two to successfully complete its recovery period.

As with any other surgical technique, a few complications are likely to be expected such as:

​ Improper wound healing

​ Localized pooling of blood in the region of scrotum, also known as hematoma

​ Anesthesia associated problems such as headache, dizziness, nausea, vomiting, respiratory distress, etc.

​ Nerve associated pain

​ Infection at the site of the wound

​ Recurrence of hernia (less common, but possible)

​ Chronic pain

​ In instances of laparoscopic technique, there are chances of accidentally damaging nearby structures

Because of the proximity of the reproductive organs to the hernia, the long standing question of effect of hernia surgery on sexual function arises. To tell the truth, it is a gray zone, a blurry area. There have been several instances of a hassle free recovery as well of patients, especially men, who complain of issues in achieving an erection, ejaculation and an orgasm. What is to be blamed is a matter of question. The clinician should be careful in evaluating the possibility of any risk factors that may be present before the operation takes place, like structural abnormalities or the general health of a person. Also, there is a possibility of accidental injury to nearby structures while the surgery is being performed.

About 0.3% of adults are at risk of infertility following an inguinal hernia repair because of injury to the vas deferens whereas children risk this even more. Testis injury can happen in approximately 0.5% of the time and the ones with a recurrent hernia risk infertility 10 times more than the ones having it for the first time.

It is best to discuss your problem clearly and clear all doubts with your doctor. Once you feel you are ready, go ahead. Hernia repairs significantly increase the quality of life. Any decision should be taken after careful consideration only.

You can find the list of cities in India that provide hernia surgery along with their respective prices Here

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  2. Testis damage can occur in roughly 0.5% of the time and the ones with an intermittent hernia chance fruitlessness 10 times more than the ones having it out of the blue.

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