Inguinal hernia and sports hernia: differences and treatments

These are two disorders that have specific causes and symptoms. And they involve different interventions; from surgery to conservative technique. Discover the differences…

Roberto De Filippis

Even if they occur in the same part of the body, i.e. the groin, theinguinal hernia and Pips (Pubic inguinal pain syndrome) are two different disorders, each of which has specific causes and symptoms and for which they are intended different therapies. Despite this, unfortunately still today they get confused and those who suffer from it happen to be subjected to the wrong treatments, which not only do not solve the problems, but actually make the situation worse.

causes and symptoms of inguinal hernia

An inguinal hernia consists of the protrusion of part of theintestine in the groin area. Considerably more frequent in men for anatomical reasons, this problem is not a consequence – as many still believe – of intense physical effort, but of a constitutional fragility of the connective tissues of the abdomen. Initially small in size, as time passes the hernia tends to grow and become more and more evident. “When it is small, the hernia mainly causes pain, burning and feeling of weight in the groin. Typically, the discomfort is felt especially when standing or sitting. Usually, these symptoms precede any swelling” explains the Professor Giampiero Campanelli, director of the Hernia Center of the Casa di Cura La Madonnina in Milan and head of the General Surgery Day & Week Surgery service of the Irccs Galeazzi-Sant’Ambrogio Hospital in the Lombardy capital and full professor of Surgery at the University of Insubria (Varese) . Paradoxically, the larger the hernia, the less discomfort it causes.

causes and symptoms of pips

Although it is called a “sports hernia,” Pips is very different from an inguinal hernia. First of all, It’s not really a hernia, as there is nothing protruding from the abdominal wall. At the root of this problem are the thickening and excessive tension of the tendons of theadductor and the rectus muscle. Those who suffer from it warn pain in the groin and pubis, which tends to appear to the touch, particularly when you bend or raise your legs while lying down, and after physical activity. “Simplifying, we could say that Pips can be heard but not seen, while the inguinal hernia can be felt and seen” summarizes Professor Campanelli. In case of discomfort in the groin, the first test that is recommended to undergo isabdominal ultrasound. “Sometimes, in the presence of Pips, from this check, a very small hernia emerges which is not the cause of the complaints complained of. The operation, therefore, would not be necessary, but unfortunately in some circumstances it is performed anyway” continues the expert. In such circumstances not only is no benefit obtained, but the situation can even worsen because the intervention can give rise to a chronic neuralgia.

treatment

Actually, inguinal hernia And Pips they involve two different therapeutic paths. On the one hand, in fact, the treatment of inguinal hernia is purely surgical. When the hernia is only on one side and is not recurring, it can be resorted to minimally invasive techniques under local anesthesia, which do not require sutures, but only a plaster; with the operation the hole in the abdominal wall is “closed” with a mesh. However, if the hernia is bilateral or recurrent, then they are used laparoscopic techniqueswith or without the help of a robot, with which the hole in the abdomen is always “closed”. On the other hand, the treatment of Pips consists primarily of treatment sessions physiokinesitherapy and in stretching exercises with the aim of lengthening and relaxing the rectus muscle and the adductor, also useful in a preventive function. “In this sentence, it is advisable to suspend sporting activity, which can be resumed once the discomfort has disappeared” underlines Professor Campanelli. Unfortunately, such treatments are not always successful. In these cases, surgical intervention is necessary. “However, the operation is different from that of an inguinal hernia. In fact, it consists of decompression of the nerves of the pubic area that cause the discomfort and in the insertion of a mesh in the back part of the inguinal canal, so as to reinforce it” specifies the expert. After such an operation, the most suitable activity to regain confidence with sport is swimming.



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