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Does spermatic cord "expand" at all with increased intra-abdominal pressure?
Out of curiosity, I was poking at my other side (the side without an obvious hernia) and felt an ever-so-slight “inflation” impulse just below where the external ring would be. Is any kind of expansion/inflation below the external ring necessarily the beginning of a hernia, or will increased intra-abdominal pressure cause the cord/vessels to do so? Absolutely no visual bulging, regardless of whether I am breathing in/bearing down/coughing, but I know these things can start very, very small.
Still need to get the “real” one evaluated, but want to know how closely I need to be watching the other side in the mean time.
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6 Replies
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Thanks! So is it particularly likely that, when bearing down, one would feel a slight protrusion when pressing on the inguinal triangle that is NOT a tiny hernia of some sort? With a finger in the right place I definitely feel a slight expansion, but there’s never any visible bulge either when bearing down or not.
I dont have much sense of how much “stretch” that fascia would have and remain intact.
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The spermatic cord itself does not expand.
As with almost all tissue in the body, except bone and ligament, there is a stretch capacity.
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quote Good intentions:Here is a web page describing the mechanism, or working action, of the inguinal canal. Easy to see how placing a piece of mesh over all of its complexity is an easier choice than working with the fine details and repairing it to resume normal function.
This is just one, I’ve seen others.
http://inguinalhernias.weebly.com/31-mechanisms-of-the-inguinal-canal.html
This made for a very interesting read. It’s one of the reasons I’ve been so hesitant to seek a repair of any kind; the mesh ones come with many potential complications, and the tissue ones seem to try and create barriers out of structures not intended for that purpose (and which won’t function like the original).
In theory, for a direct hernia, the idea of a prosthetic only slightly larger than the original defect, used in conjunction with defect closure, does make sense because it manages to leave other structures undisturbed. The problems would seem to be:
-Resistance to customizing the prosthetic size for each patient
-Finding the right material that didn’t create unwanted inflammation
-Proving that it will, in fact, be “enough” to prevent recurrence
-Getting people to look at a prosthetic in a wholly different way (make it as small as possible, not as large as tolerable; mimic the original structure as much as possible, not reinforce entire area)Someone will become very famous one day when they introduce a protocol for promoting tissue regeneration/healing that allows a surgeon to simply sew the fascia of a direct hernia back together with the confidence that it will regain an appropriate level of tensile strength
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Here is a web page describing the mechanism, or working action, of the inguinal canal. Easy to see how placing a piece of mesh over all of its complexity is an easier choice than working with the fine details and repairing it to resume normal function.
This is just one, I’ve seen others.
http://inguinalhernias.weebly.com/31-mechanisms-of-the-inguinal-canal.html
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Bumping this old guy, too…
To better clarify my earlier question (having taken a little more time to look at some anatomy diagrams): If the fascia covering the inguinal triangle feels as though it is “expanding” slightly upon bearing down/coughing, does that necessarily mean a small hernia is present, or is there some natural “give” in it that would cause this phenomenon?
This is on the right side (obvious hernia on left), there is no bulge, and the doctor I saw recently about the real hernia felt nothing in the righthand inguinal canal (pushing up through canal starting from scrotum).
I feel this when standing, bearing down, and pressing on the area that approximates to the inguinal triangle.
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I am concern about [h=2]spermatic cord in different way! I see in video..how they pull it out of normal position as the do surgery ?[/h]
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