MEN'S HEALTH MATTERS:Your health questions answered
Q I AM 34 years old and have recently noticed a lump in my groin. There is only slight discomfort and my doctor says that it is an inguinal hernia. What exactly does this mean and what are my options. Is it possible to have this repaired with keyhole surgery?
AA hernia is an abnormal protrusion of an organ or other bodily structure through the wall that contains it. The groin is the commonest site to find a hernia known as an inguinal hernia and, although they can present in females, they are more commonly found in males due to a natural weakness in the muscles of the groin where the blood supply to the testicles passes from the abdomen to the scrotum.
Although more often than not an inguinal hernia is uncomplicated, it is advisable in someone of your age to have it repaired. Internal structures such as the bowel may protrude out into the hernial sac causing a small bulge in the groin, which may or may not be associated with discomfort.
In this instance, the bowel may pass in and out of the hernial sac - however, on occasion, it can become trapped and not disappear back into the abdomen.
The commonest method of repairing a hernia employs the use of a synthetic mesh, which acts like a patch. Repair can be carried out via keyhole (laparoscopic) surgery or conventional open surgery.
Laparoscopic surgery has been shown to be particularly beneficial in those who have a hernia on both sides and those who have had a previous hernia repair on the affected side.
A simple analogy is to think of a tyre and a tube. The tyre represents the muscle and if there is a hole the tube will protrude. The tube represents the lining of the abdomen.
In carrying out a repair, the bulging tube is replaced and the tyre patched using a mesh. With conventional surgery the mesh is placed on the outside of the tyre and in keyhole surgery the mesh is placed between the tyre and the tube. The surgery can often be done in a day although in some circumstances you will be admitted overnight. The time it takes to resume full activity depends on the type of repair.
Q Although we read about prostate cancer regularly in the papers I understand that non-cancerous conditions of the prostate are more common. Is this true?
AYou are correct in what you say about the primary focus being prostate cancer and that the most common conditions of the prostate are benign. It is, however, very important to rule out prostate cancer before labelling a condition as benign. Benign prostatic hyperplasia (BPH) is the commonest condition of the prostate gland and this is a spongy-type enlargement whereas prostatitis, the other common condition, is an inflammation of the prostate.
As men get older, the prostate gland increases in size and as it surrounds the water passage this enlargement may cause some delay to the flow of urine.
The most common symptoms experienced include difficulty initiating the flow of urine, a diminished flow, urinary frequency and having to pass water during the night. A combination of these symptoms, commonly referred to as lower urinary tract symptoms, may be relieved with tablets. These can be obtained from your GP once an underlying cancer has been ruled out.
Prostatitis on the other hand may present with symptoms suggestive of a urinary tract infection, like a chronic dull ache behind the scrotum and in front of the back passage.
There is no evidence that prostatitis or BPH causes cancer, but it is possible for a man to have one or both of these conditions and to develop prostate cancer as well. PSA (prostate specific antigen - a blood test for the prostate) levels alone do not give doctors enough information to distinguish between benign prostate conditions and cancer.
However, the doctor will take the result of the PSA test into account when deciding whether to check further for signs of prostate cancer.
•This column is edited by Thomas Lynch, consultant urological surgeon, St James's Hospital, Dublin with a contribution from Martin Caldwell, consultant general surgeon, Sligo General Hospital
•Send your questions to healthsupplement@irish-times.ie