Your muscles are usually strong enough to keep your intestines and organs in their proper place. Sometimes, however, your intra-abdominal tissues can be pushed through a weakened spot in your muscle when you overstrain. If a portion of tissue pushes through the wall of the femoral canal, it’s called a femoral hernia. A femoral hernia will appear as a bulge near the groin or thigh. The femoral canal houses the femoral artery, smaller veins, and nerves. It’s located just below the inguinal ligament in the groin.
A femoral hernia can also be called a femorocele.
Women are more likely than men to suffer from a femoral hernia. Overall, femoral hernias are not common. Less than 5 percent of all hernias are femoral. Most femoral hernias do not cause symptoms. However, they can occasionally lead to severe problems if the hernia obstructs and blocks blood flow to your intestines. This is called a strangulated hernia — it is a medical emergency and requires prompt surgery.
The exact cause of femoral and other hernias are unknown most of the time. You may be born with a weakened area of the femoral canal, or the area may become weak over time.
Straining can contribute to the weakening of the muscle walls. Factors that can lead to overstraining include:
- chronic constipation
- heavy lifting
- being overweight
- difficult urination due to an enlarged prostate
- chronic coughing
You may not even realize you have a femoral hernia in some cases. Small- to moderate-sized hernias don’t usually cause any symptoms. In many cases, you may not even see the bulge of a small femoral hernia.
Large hernias may be more noticeable and can cause some discomfort. A bulge may be visible in the groin area near your upper thigh. The bulging may become worse and can cause pain when you stand up, lift heavy objects, or strain in any way. Femoral hernias are often located very close to the hip bone and as a result may cause hip pain.
Severe symptoms can signify that a femoral hernia is obstructing your intestines. This is a very serious condition called strangulation. Strangulation causes intestinal and bowel tissue to die, which can put your life in danger. This is considered a medical emergency. Severe symptoms of a femoral hernia include:
- severe stomach pain
- sudden groin pain
Call 911 and seek immediate medical attention if you suffer from these symptoms. If the hernia obstructs the intestines, blood flow to the intestines can be cut off. Emergency treatment can fix the hernia and save your life.
Your doctor will perform a physical examination by gently palpating, or touching, the area to determine if you have a femoral hernia. In many cases, the bulging can be felt.
Ultrasound of the abdominal and groin area can confirm the diagnosis. Imaging technology can show the hole in the muscle wall, as well as the protruding tissue.
Femoral hernias that are small and asymptomatic may not require specific treatment. Your doctor might monitor your condition until symptoms progress. Moderate- to large-sized femoral hernias require surgical repair, especially if they are causing any level of discomfort.
Surgical hernia repair is performed under general anesthetic. This means you will be asleep for the procedure and unable to feel pain. Femoral hernia repair can be done as either an open or laparoscopic surgery. An open procedure requires a larger incision and a longer recovery period. Laparoscopic surgery uses three to four keyhole-sized incisions that minimize loss of blood. The type of surgery chosen depends on a few factors, including:
- the surgeon’s expertise
- the type of hernia
- anticipated recovery time
Laparoscopic surgery, for instance, involves less pain and scarring than open surgery, as well as a shorter time required for healing. However, it is a more costly procedure than open surgery.
In both surgeries, your surgeon will make incisions in your groin area to access the hernia. The intestine or other tissue protruding from the femoral area is returned to its proper position. The surgeon will sew the hole back together, and may reinforce it with a piece of mesh. The mesh strengthens the wall of the canal. Some procedures called “tension-free repairs” are minimally invasive and do not require the use of general anesthesia.
Femoral hernias are generally not life-threatening medical conditions.
Strangulation of the hernia can become life-threatening, however, and must be treated through emergency surgery. The British Hernia Centre estimates that the bowel will only survive for roughly eight to 12 hours following strangulation, which makes it imperative to seek immediate medical attention if you have symptoms. The repair itself is very safe with little risk. Most people can return to light activities within two weeks. Most people fully recover within six weeks.
The recurrence of a femoral hernia is very low. The Royal United Hospital estimates that only 1 to 5 percent of people who have had a femoral hernia will have a recurring hernia.