A femoral hernia is a bulging located near the groin and thigh that occurs when a small part of intestine pushes through the wall of the femoral canal. The femoral canal houses the femoral artery, smaller veins, and nerves. It is located just below the inguinal ligament in the groin.
A femoral hernia can also be called a femorocele.
Women are three times more likely than men to suffer from a femoral hernia, according to researched published in American Family Physician. Overall, however, femoral hernias are not common. Only four percent of all hernias in American adults are femoral (Bax, Sheppard, & Crass, 1999).
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:
- 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 do not 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. Hip pain can also be a symptom of a femoral hernia due to its location.
Severe symptoms can indicate that a femoral hernia is obstructing your intestines. In this case, blood flow to the intestines can be cut off. This is a very serious condition called strangulation. Strangulation causes intestinal and bowel tissue to die, which can put your life in danger. Symptoms of hernia can include stomach pain, nausea, and vomiting. Seek immediate medical attention if you suffer from these symptoms. Emergency treatment can fix the hernia and save your life.
Your doctor will perform a physical examination by gently palpating 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 pain.
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 the surgeon’s expertise, the type of hernia, anesthetics (painkillers), anticipated recovery time, and cost. 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.
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 doctor 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 (Bax, Sheppard, & Crass, 1999).
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 repair itself is very safe with little risk.
The recurrence of a femoral hernia is very low, according to the National Institutes of Health. Only three percent of femoral hernia patients develop another hernia (NIH, 2011).