Where do inguinal hernias descend in relation to the spermatic cord and testes?

• A. They descend behind the spermatic cord and testes
• B. Inguinal hernias descend in front of the spermatic cord and testes
• C. They ascend into the abdomen when standing
• D. They do not involve the inguinal canal

Answer: (B)

A hernial sac that tracks through the inguinal canal to reach the scrotum sits anterior to the spermatic cord and testes. As the sac descends through the canal, the bulge appears in front of these structures, which is why the description used is that inguinal hernias descend in front of the cord and testes. The two common types differ in relation to the inferior epigastric vessels (indirect is lateral to them, direct is medial), but the general arrangement within the canal is that the hernial sac lies anterior to the cord and testis.