Inguinal-scrotal hernia - the final stage

August 1, 2014

 inguinal-scrotal hernia
 Inguinal hernia, scrotal develops gradually and often against the background of oblique inguinal hernia. But it could be the final direct inguinal hernia Direct inguinal hernia - can only be purchased  Direct inguinal hernia - can only be purchased
 . It can be as congenital or acquired. As a result of the gradual extension of hernial ring hernial sac with the content falls into the scrotum.


Inguinal hernia, scrotal men

Inguinal-scrotal hernia - this is the final stage of development of inguinal hernia, often oblique. At the beginning of the disease is extremely hernial sac in the inguinal canal. This so-called channel or incomplete inguinal hernia Inguinal hernia - dangerous or not?  Inguinal hernia - dangerous or not?
 . Flexing and you can feel only introduced into the inguinal canal finger straining or coughing patient (symptom cough shock).

When the hernial protrusion, settling along the cord goes beyond the superficial inguinal ring, talking about full or complete hernia. If the hernial protrusion descends into the scrotum and stretch it to a large size, say inguinal-scrotal hernia.

Obliquity of the inguinal canal is characteristic of the initial stages of oblique inguinal hernia Oblique inguinal hernia - can be congenital and acquired  Oblique inguinal hernia - can be congenital and acquired
 . When hernias larger inguinal canal gradually takes the direct form, and superficial inguinal ring is almost on par with the deep. In these patients through a hernial can enter multiple fingers.

Direct inguinal hernia and is initially incomplete and then complete and proceeds to the inguinal-scrotal, but, unlike the oblique inguinal hernia, located outside of the spermatic cord.

The contents of inguinal-scrotal hernia can be any organ of the abdominal cavity. In most cases there are loops of the intestine, but may also be a bladder.

Inguinal hernia scrotal men are almost always appears in the background of congenital or age-related failure of the connective tissue and is associated with increased physical activity. For the development of oblique inguinal hernia is very important failure of the rear wall of the inguinal canal, which develops under the influence of the above factors. Changes to the front wall and the external inguinal holes tend to occur again, later, under the influence of the developing herniation.


Inguinal hernia, scrotal children

Hernias in children are most often congenital and occur in children immediately after birth. It was found that only a quarter of newborn boys is marked complete imperforate processus vaginalis of the peritoneum through which the testes descend into the scrotum. The other children processus vaginalis remains imperforate, which promotes the formation of a hernia.

Inguinal - scrotal hernia in the newborn develops when the vaginal process of the peritoneum is not obliterated (not imperforate) all over and hernial content goes down to the eggs, to the bottom of the scrotum. It ovarian congenital inguinal-scrotal hernia. In a normal egg in utero, passing through the inguinal canal descends into the scrotum. This process is the peritoneum, which stretched from the abdomen to the scrotum. Over time, the processus vaginalis of the peritoneum must grow together (obliterated), but in some cases it does not happen that leads to the development of diseases such as oblique inguinal-scrotal hernia. Against the background of inguinal-scrotal hernia can develop as hydrocele or hydrocele due to the fact that the liquid washing the abdominal cavity, through no imperforate processus vaginalis of peritoneum flows down into the scrotum, causing it to increase.

Acquired inguinal-scrotal hernia in infants is usually develops in the background of diseases associated with degeneration, cough, intestinal disorders. For very large inguinal-scrotal hernias marked straightening of the inguinal canal, and finger palpation the doctor can freely penetrate through enhanced inguinal ring into the abdominal cavity.


Inguinal-scrotal hernia - Treatment

Treatment of inguinal hernia, scrotal only operative, and the operation should be carried out as soon as possible. This is due to the fact that the inguinal ring over time more extended, and the contents of the hernial reduce a worse. Gradually, the hernial sac develop adhesions, and it makes a hernia nevpravimoy that significantly increases the risk of infringement.

There are several widows surgery for inguinal-scrotal hernia, which is selected determines the physician. When any kind of surgery, it involves several steps:

  • Access to the inguinal canal - with large inguinal-scrotal hernias occur through traditional dissection of its front wall (laparotomy), since the sparing laparoscopy Laparoscopy - why is it necessary?  Laparoscopy - why is it necessary?
   it will be difficult to carry out a qualitative operation;
  • isolation from the surrounding tissue of the hernia sac and its processing;
  • plastic inguinal canal, ie the closing of the opening through which the hernial content falls into the inguinal canal and scrotum.

Inguinal hernia, scrotal requires a mandatory elective surgery, otherwise require emergency surgery on a background of infringement of hernia.

Galina Romanenko

Article Tags:
  • hernia

Oxalate in the urine - the risk of kidney stones

July 16, 2014

 oxalates in the urine
 Oxalates in the urine of healthy people are always present, but in small quantities. If oxalate in the urine much increases the risk of kidney stones and urinary tract, development of urolithiasis Kidney stones - why women tolerate it harder?  Kidney stones - why women tolerate it harder?
   and reducing the renal function. The only way to prevent the development of complications - dieting.


What is the oxalate in the urine

Oxalate - a s oxalic acid. Excessive release of oxalate in the urine is called oxaluria. Oxalates in the urine in the human body as a result of metabolism Metabolism: The basis of life of all living things  Metabolism: The basis of life of all living things
   and only 5% of the oxalate formed from food. The bulk of the oxalate present in the blood (up to 95%) in the form of calcium oxalate excreted through kidneys in the urine.

Normally, the output up to 20-40 mg of oxalate per day.


Causes of urinary oxalate

Oxaluria can be primary and secondary. Primary oxaluria is a hereditary disease and is called oxalosis. Oxalosis due to violation of the exchange of glycine and glyoxylic acid and is characterized by symptoms of interstitial (with the defeat of the connective tissue of the kidneys), nephritis, kidney stones, with a gradual development of chronic renal failure and the serious condition of uremia, poisoning caused by toxic substances that leave the body through non-functioning kidney.

Secondary oxaluria occurs mainly due to excessive intake of foods rich in oxalic acid and its salts. A large number of oxalates in the diet also prevents the absorption of calcium and contribute to its accumulation in the blood, and this, in turn, is fraught with osteoporosis Osteoporosis - he threatens you?  Osteoporosis - he threatens you?
   - Lack of calcium in bone tissues and their fragility.

A large number of oxalate in the urine appears as a deficit of magnesium in the diet. This is due to the chemical antagonism of calcium and magnesium - the latter inhibits the formation of calcium oxalate. The source of oxalates may be ascorbic acid, but only if there have metabolic oxalate. Therefore, people with oxaluria recommended to limit the consumption of foods rich in ascorbic acid.

For higher content urinary oxalate leads following the reception of certain drugs, such as ascorbic acid, ethylene glycol, calcium preparations, gelatin. Lower allocation of oxalate in the urine - nifedipine and pyridoxine (vitamin B6).

Oxaluria may occur after resection of a large segment of the final ileum. This increases the absorption of oxalate from the diet. It may be associated with oxaluria hypervitaminosis D.


Symptoms of urinary oxalate

Oxaluria manifested in the form of micro and gross hematuria - the periodic appearance of blood in the urine, which in the first case can only be detected by microscopy, and the second is easy to see with the naked eye - the urine becomes kind of meat slops. Hematuria is indicative of that formed oxalate kidney stones, which are injured during the passage of the wall of the urinary tract.

Sometimes urolithiasis it is asymptomatic and can be detected by chance in the investigation of urine on radiography or sudden onset of renal colic. Renal colic manifests as a sudden attack of sharp-sided cramping pain associated with blood circulation in the wall of the ureter during the passage of the stone in it.

With long-term course of the disease is a significant accumulation of salts in the tissues of the kidneys and the development of chronic renal failure.


Analysis of urine oxalate

Oxaluria may be suspected on the basis of urinalysis: microscopy reveal oxalate precipitate, it is also possible presence of red blood cells (microscopic hematuria) and leukocytes (if there is inflammation in the urinary tract.

Determination of the amount of oxalate in the daily urine allows oxaluria confirm the diagnosis.

The rate of oxalate in the urine of women is 228-626 mmol / day (20-54 mg / day) for men - 228-683 mmol / day (20-60 mg / day). Before any analysis is necessary to specify how to pass a urine oxalate. For this the night before is not recommended to eat beets, carrots and other foods that may cause discoloration of urine. Before each urine collection should be carried out toilet of external genitals. Women should not take a urine test during menstruation. The first morning urine is not considered to be a note while urinating. The following portions of going for a day in a single container. Last urine collection is necessary to make the next morning in time marked the eve. Then, the urine should be shaken, to measure its total for the day, take away the dishes in about 200 ml, indicate on the label the daily amount, and deliver to the laboratory.


Treatment of urinary oxalate

Treatment oxaluria conducted mainly through diet. A large number of oxalic acid (50 mg per 100 g) contained in the sorrel, rhubarb, spinach, tea, coffee, chocolate, beets, citrus, sour apples, gooseberries, strawberries, nuts, beans, lentils. Therefore, all these products are advised to limit. Exclude or limit as much meat, fish, mushroom broth, spicy seasoning, smoked, salted and canned foods.

The diet should include foods rich in magnesium: oatmeal, buckwheat, millet cereal, dried fruit, bread from wheat flour.

To prevent crystallization of oxalates in the urine prescribed excessive drinking sodium citrate, potassium citrate and citric acid that alkalization urine. Inside designate preparations of magnesium, vitamin B6, infusions and decoctions of herbs that can dissolve salt (knotweed, fennel Dill: benefits and harms of fragrant spices  Dill: benefits and harms of fragrant spices
 , Strawberry leaves, horsetail, and others).

Calcium oxalate in urine is dangerous only when its amount exceeds the norm.

Galina Romanenko

Article Tags:
  • oxalates in the urine