Inguinal Hernia

What is a groin hernia?

The groin is the area where your abdomen (tummy) meets your thighs. A groin hernia is a protrusion of the fat or bowel from within your abdomen because of weakness of the muscles of your abdominal wall. Two types of hernias can occur in the groin. One type is called an inguinal hernia. The other type is called a femoral hernia.

What is an inguinal hernia?

An inguinal hernia is the commonest type of hernia in the groin. The groin has a special arrangement of muscles, in a tunnel-like formation called the inguinal canal. In men, the inguinal canal contains the vas (the tube that carries sperms) and the arteries and veins of the testis. In women, the inguinal canal contains the round ligament of the uterus. The inguinal canal is an area of natural weakness through which hernias can occur.

What causes an inguinal hernia?

An inguinal hernia is a common problem at all ages. It is far commoner in men than in women. A definite cause for inguinal hernias is not known. It is believed that long-term heavy work, smoking, a family history of hernia and chronic obstructive pulmonary disease (COPD), abdominal aortic aneurysm, ascites and open surgery for removal of the appendix can increase the risk for inguinal hernias.

What is a femoral hernia?

A femoral hernia is another type of groin hernia. Femoral hernias are less common than inguinal hernias. Femoral hernias are commoner in women than in men because of the wider shape of the female pelvis. Femoral hernias develop through an area of natural weakness called the femoral canal. An important difference between inguinal and femoral hernias is that femoral canal is far narrower than the inguinal canal. As a result, the risks for complications like bowel obstruction and strangulation are higher in femoral hernias than in inguinal hernias.

How is a groin hernia diagnosed?

A hernia usually becomes noticeable as an obvious lump or swelling in the groin. It can be painful, or just uncomfortable, or painless. Groin hernias usually reduce (drop back into the abdomen) on lying down or by pressing on the lump. Coughing and straining during bowel movement can make the hernia pop out or become bigger. In most cases, your doctor can make a firm diagnosis by examination only. But, an ultrasound scan may be needed if there is doubt about the diagnosis.

Can a groin hernia lead to complications?

Yes. Bowel can become trapped in the hernia, and cannot be pushed back into the abdomen. This condition is called an irreducible hernia. The trapped bowel may become blocked (obstructed) and can cause severe pain, bloating vomiting and constipation. The trapped bowel may lose its blood supply and get strangulated.

Do all inguinal hernias need an operation?

An operation is the best solution if the hernia is painful. But, there may be no urgency for an operation if the hernia is painless. Waiting and watching can be considered if the hernia is painless. The wait and watch approach is most suitable for men without any special risk factors. For those who wait and watch, about 1 in 4 will need an operation in the next two years and most will need an operation in the next 10 years. Waiting and watching delays rather than avoids surgery. Waiting does not seem to impair the final outcome of the operation but there is a small risk that a complication may happen during the waiting period. Wait and watch is not recommended for women because the risk of bowel blockage and strangulation is higher for women than for men.

Do all femoral hernias need an operation?

Unlike inguinal hernias, surgery is recommended for all femoral hernias, even if the hernia is painless. The reason is that the risk of complications is far higher with femoral hernias than with inguinal hernias. Wait and watch is not advised for femoral hernias because of the higher risk of complications.

What are bilateral inguinal hernias?

If you have inguinal hernias on both sides, the condition is called bilateral inguinal hernias.

What is a recurrent inguinal hernia?

A recurrent inguinal hernia is an inguinal hernia that has come back (recurred) after an operation on the hernia. Every hernia repair operation carries some risk for recurrence. The risk of recurrence with every operation is greater than the risk for the previous operation.

More Information

British Hernia Society

NICE

 

Print this page | Last updated: 22/07/2016