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About Inguinal hernia
An inguinal hernia is a condition in which intra-abdominal fat or part of the small intestine, also called the small bowel, bulges through a weak area in the lower abdominal muscles. An inguinal hernia occurs in the groin—the area between the abdomen and thigh. This type of hernia is called inguinal because fat or part of the intestine slides through a weak area at the inguinal ring, the opening to the inguinal canal. An inguinal hernia appears as a bulge on one or both sides of the groin. An inguinal hernia can occur any time from infancy to adulthood and is much more common in males than females. Inguinal hernias tend to become larger with time.

Types and Causes of inguinal hernia

Indirect inguinal hernia 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—starting from an intra-abdominal location—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 does not 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. In females, an indirect inguinal hernia is caused by the female organs or the small intestine sliding into the groin through a weakness in the abdominal wall.

Direct inguinal hernia are the most common type of inguinal hernia. Premature infants are especially at risk for indirect inguinal hernias because there is less time for the inguinal canal to close. Direct inguinal hernia. indirect inguinal hernias are caused by connective tissue degeneration of the abdominal muscles, which causes weakening of the muscles during the adult years. indirect inguinal hernias occur only in males. The hernia involves fat or the small intestine sliding through the weak muscles into the groin. An indirect hernia develops gradually because of continuous stress on the muscles.

One or more of the following factors can cause pressure on the abdominal muscles and may worsen the hernia:
• sudden twists, pulls, or muscle strains
• lifting heavy objects
• straining on the toilet because of constipation
• weight gain
• chronic coughing
Symptoms of inguinal hernia

• a small bulge in one or both sides of the groin that may increase in size and disappear when lying
down; in males, it can present as a swollen or enlarged scrotum
• discomfort or sharp pain—especially when straining, lifting, or exercising—that improves when resting
• a feeling of weakness or pressure in the groin
• a burning, gurgling, or aching feeling at the bulge

Scrotal
A wide variety of traumatic mechanisms have been reported to result in scrotal trauma, with a common endpoint of blunt and/or penetrating trauma to the scrotal area. In all cases but avulsion, this trauma manifests as scrotal swelling with intratesticular and scrotal hematoma and various degrees of scrotal wall ecchymosis. Immediate presentation is the standard for penetrating wounds, but blunt force trauma frequently has a delayed presentation if it is not associated with testicular dislocation or multisystem injury.
Problem

The topic of scrotal trauma includes the following 3 areas of discussion: scrotal injury avulsions, blunt and penetrating trauma, and injury to scrotal contents (ie, testes, epididymis, spermatic cord contents, urethra).Minor injuries that result in extensive scrotal pain, swelling, or ecchymosis must be considered for secondary testis torsion and managed per that algorithm (see Testicular Torsion). Painless hematoceles, especially in the pediatric population, can occur with abdominal injury (splenic laceration) and a persistent patent processus vaginalis (ie, indirect inguinal hernia)

Indications
Patients with trauma to the abdomen, pelvis, or lower extremity often have associated trauma to the scrotum and are managed per advanced trauma life support (ATLS) prioritization. In addition, isolated scrotal injuries, at times self-inflicted, are an indication for surgical intervention.

Bladder neck
Bladder Neck Incision is a surgical process carried out on a man’s bladder neck being narrowed with minimum prostate swelling or after a prostate operation to relieve the narrowing. The procedure is started by giving general anesthesia. Then, a cut is made on bladder neck. After that, an endoscopic instrument is passed through the opening of penis and that bladder neck cut. Again, a catheter is inserted to dampen the bladder with fluid. Sometimes, spinal anesthesia can also be given to numb the operating area.

Purpose
The purpose of carrying out bladder neck incision is to relieve urinary obstruction, blood in urine, dribbling after passing urine and to improve the flow of urine. This operation will not only help the patient to pass urine without any problem, but will also enable him to stay away from urinary infections.

Precautions

After the operation is done, the patients are asked by the doctor to take certain precautionary measures to safeguard themselves from possible risk factors. First of all, you will be asked to eat high fiber food, so as to avoid constipation. Another thing to take care is that you should stay away from lifting heavy items and driving for few weeks. You will also be asked to shun away from having alcohol for the time period.

Risk Factors

Like other surgical procedures, Bladder Neck Incision can be followed by possible risks, such as:
• Mild burning at the incision area
• Infection of bladder or kidney, calling for antibiotics
• Loss of urinary control
• Bleeding that may require blood transfusion
• Erectile dysfunction

Vasectomy
A vasectomy is a surgery to render a man unable to have children, or sterile. While surgery to sterilize women is more popular, the vasectomy surgery is far less invasive and offers a much quicker recovery. Insurance typically pays for a vasectomy, unless the plan does not pay for birth control of any kind. If the surgery will be paid for out of pocket, plan to pay $750 to $1,500 dollars in most areas. Unlike a tubal ligation, the comparable surgery for women, a vasectomy is performed in a doctor’s office, making it more affordable.

The vasectomy surgery works by preventing sperm from exiting the body. This is done by severing or blocking the vas deferens, the duct through which sperm travels from the testes and out of the body. Sperm is produced, but it cannot travel outside the body when a man ejaculates.

While the surgery is effective at preventing pregnancy, it does not alter the ability to have/maintain an erection. There is no change in the quality or quantity of semen, nor is there a change in the ability to ejaculate. This procedure is permanent, so the decision to have the surgery should not be made lightly. You need to be sure that you do not want to have children again, regardless of your marital situation.

It is best to assume that the procedure will mean life-long sterility. While there is a procedure to reverse a vasectomy, the success of that procedure is by no means guaranteed. A vasectomy reversal can also be very expensive as insurance does not typically cover the costs. A successful vasectomy prevents pregnancy; however, it does not prevent the spread of sexually transmitted disease. Condoms and appropriate precautions should be used to prevent STDs after the surgery.

Understanding the Risks of Surgery
If you are planning to have surgery your biggest concern should be the final outcome. Will your life be improved by the procedure or do the risks outweigh the rewards? No surgery is risk free, but understanding the possible complications can help you make a better decision. Immediately before your surgery the surgeon will meet with you and explain the potential risks for your surgery. This process is called “informed consent” and is absolutely necessary, but happens too late to assist in planning. A discussion of risks should take place well before the day of surgery. One of the best ways to lower risk is to choose a surgeon who performs the procedure regularly in a facility that is familiar with both the surgeon and the surgery.

Death Due to Surgery
All surgeries, whether elective or absolutely necessary, carry a risk of death. A surgery that requires stopping the heart will have a higher risk than a surgery to remove tonsils, but both can still result in death. Trauma surgery, an emergency surgery to safe the life of an injured patient who will die without an intervention, is an example of a very high risk surgery. In this case, the possibility of survival after surgery contrasts with the certainty of death without. When considering a non-essential procedure, such as plastic surgery, the seriousness of surgery should be considered when making the decision to the procedure.

Delayed Healing After Surgery Some patients take longer to heal than others, particularly people with more than one illness. A patient with a chronic illness, an immune system problem, or sickness in the weeks prior to surgery may have a lengthier hospital stay and a more difficult recovery period. Diabetics who have surgery typically have a longer healing time, especially if blood sugar levels are poorly controlled. For this reason, diabetics must carefully weigh the risks and rewards of having surgery, including the potential complications during recovery.