Congenital inguinal hernia

What is it?

When a male foetus is in the mother's womb, the testicles develop in the baby's abdomen. As the foetus grows, the testicles gradually descend to the lower abdomen. They then ‘push’ themselves through a weak spot in the wall of the lower abdomen (the inguinal canal), in order to arrive at their destination, in the scrotum, around the time of birth. The inguinal canal closes at birth.

In the case of a congenital inguinal hernia, the closure of this inguinal canal is not (yet) complete. This leaves an open connection between the testicle and the abdominal cavity. This is called a congenital inguinal hernia.

How is the diagnosis determined?

• Physical examination shows swelling on one side of the scrotum. Usually, congenital inguinal hernia involves variation in the volume of the swelling throughout the day. At certain times of the day, a clear, considerable swelling is visible, while at other times of the day, it seems to be not so bad. The swelling often disappears in the morning and is at its greatest in the evening.
• When ultrasound imaging is performed on the testicle, fluid accumulation can be seen around the testicle.

Treatment

A congenital inguinal hernia can close on its own until the age of 2. Afterwards, a spontaneous closure of the canal is no longer realistic and an operation is appropriate. This operation involves making a small incision in the groin. Through the groin incision, the fluid around the testicle is removed and the inguinal canal is closed by the surgeon.

After the operation, the testicle will continue to feel larger and firmer for a few months.

Latest publication date: 12/12/2023
Supervising author: Dr Ameye Filip