Epidemiology

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Etiology

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Pathophysiology

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Indirect inguinal hernia

• Most commonly results from incomplete obliteration of processus vaginalis during fetal development (but can also be acquired).
• May not become apparent until adulthood despite being present since birth.
• Lateral to the inferior epigastric blood vessels (outside Hesselbach triangle)
• Runs from the deep inguinal ring through the inguinal canal to the superficial (external) inguinal ring (in men, along with the spermatic cord)
• Surrounded by the external spermatic fascia, cremasteric muscle fibers, and internal spermatic fascia
• Indirect inguinal hernia may be associated with a communicating hydrocele.

Clinical features

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Diagnostics

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Treatment

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Complications

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Postoperative complications

• Inguinodynia; paresthesia or anesthesia over the surgical site
  • Can be secondary to nerve injury during the surgical procedure (i.e., transection of the ilioinguinal nerve or genitofemoral nerve that traverse the inguinal region) or due to nerve entrapment within the mesh.
  • Genitofemoral nerve