Finally, it passed to the deep inguinal ring and through the
inguinal canal to enter the spermatic cord with the other constituents.
Inguinal hernia is the abnormal protrusion of a part or whole of the viscus through the
inguinal canal either via the deep inguinal ring (55%) or directly through the posterior wall (30%) of
inguinal canal or both (15%).
The weak and physiologically inactive posterior wall of
inguinal canal leads to hernia formation.
Despite the objections presented by some authors, [15,16] application of the external oblique muscle aponeurosis in the form of an undetached strip (which makes the posterior wall of the
inguinal canal stronger) has been established as a new concept in tissue based hernia repair.
INTRAOPERATIVE: Under spinal anaesthesia, rt parainguinal incision made,
inguinal canal opened and following findings noted:
Ultrasonography of abdomen and pelvis revealed 6x4cm mixed echogenic lesion in the right
inguinal canal without vascularity and 3x2cm oval mixed echogenic lesion in the left
inguinal canal without uterus and both ovaries in the pelvis.
This injection floods the enclosed
inguinal canal and anaesthetizes all three major nerves in this region.
The pampiniform plexus of veins condensed to form five veins in the
inguinal canal, near the deep inguinal ring.
In posterior repair techniques, complications related to the spermatic cord are reduced since the
inguinal canal is not dissected, and possibility of chronic inguinal pain is reduced since neural structures remain outside the surgical area (7).
Further evaluation and tracking of the object revealed it to be the left ureter extending into the
inguinal canal. The course of the ureter appeared to extend into the
inguinal canal, make a sharp turn approximately mid canal, and then to travel rostrally, where it eventually entered the bladder.
There is often a slight herniation towards the
inguinal canal. Massive hernias in which the bladder is completely located in the scrotum are much less common.
The herniation of the bladder into the
inguinal canal is very rare and the incidence is 1-3% among men over the age of fifty.
