Inguinal Hernia Overview

An inguinal hernia is a hernia that occurs in the abdomen near your groin area.

It develops when fatty or intestinal tissues push through a weakness in the abdominal wall near the right or left inguinal canal. Each inguinal canal resides at the base of the abdomen.

All people have inguinal canals. In males, the testes usually descend through their canal by around a few weeks before birth. In females, each canal is the location of passage for the round ligament of the uterus.

If you have a hernia in or near this passageway, it results in a protruding bulge. It may be painful while moving.

Many people don’t seek treatment for this type of hernia because it may be small or not cause any symptoms. However, prompt medical treatment can help prevent further protrusion and discomfort.

Inguinal hernias are most noticeable by their appearance. They cause bulges along the pubic or groin area that can appear to increase in size when you stand up or cough.

This type of hernia may be painful or sensitive to the touch.

Symptoms may include:

• pain when coughing, exercising, or bending over
• burning sensations
• sharp pain
• a heavy or full sensation in the groin
• swelling of the scrotum in men

There isn’t one cause of this type of hernia.

Weak spots within the abdominal and groin muscles are thought to be a major contributor. Extra pressure on this area of the body can eventually cause a hernia.

Some risk factors can increase your chances of this condition. These include:

• heredity
• a prior inguinal hernia
• being male
• premature birth
• overweight or obesity
• pregnancy
• cystic fibrosis
• chronic cough
• chronic constipation

If left untreated, an inguinal hernia can become stuck or strangulated.

A stuck (or “incarcerated”) hernia is when contents of the hernia become trapped in the abdominal wall. If a doctor is unable to move it back into place, a bowel obstruction can occur and it becomes difficult to have a bowel movement. An obstruction can cause other symptoms, too, like abdominal pain, vomiting, and nausea.

Sometimes, though, a stuck hernia cuts off blood flow to the intestines and abdomen, resulting in tissue death. This is a life threatening emergency requiring surgery.

Even when tissue death doesn’t occur, a growing hernia can lead to pressure in the groin area. This can cause pain, swelling, or a heaviness in this part of the body.

Inguinal hernias can be indirect or direct, incarcerated, or strangulated.

Indirect inguinal hernia

An indirect inguinal hernia is the most common type. It often occurs in premature births, before the inguinal canal becomes closed off. However, this type of hernia can occur at any time during your life. This condition is most common in males.

Direct inguinal hernia

A direct inguinal hernia most often occurs in adults as they age. The popular belief is that weakening muscles during adulthood lead to a direct inguinal hernia. This type of hernia is much more prevalent in men.

Incarcerated inguinal hernia

An incarcerated inguinal hernia happens when tissue becomes stuck in the groin and isn’t reducible. This means it can’t be pushed back into place.

Strangulated inguinal hernia

Strangulated inguinal hernias are a more serious medical condition. This is when an intestine in an incarcerated hernia has its blood flow cut off.

Medical emergency

Strangulated hernias are life threatening and require emergency medical care. Call 911 and go to the nearest emergency room if you believe you have this condition.

A doctor can usually diagnose an inguinal hernia during a physical exam. During the exam, they will ask you to cough while standing so they can check the hernia when it’s most noticeable.

When it’s reducible, you or your doctor should be able to easily push an inguinal hernia back into your abdomen when you’re lying down on your back. However, if this is unsuccessful, you may have an incarcerated or strangulated inguinal hernia.

Surgery is the primary treatment for inguinal hernias. This is a very common and highly successful operation when done by a well-trained surgeon.

Surgery options include:

• Open inguinal herniorrhaphy. In open inguinal herniorrhaphy, one larger incision is made over the abdomen near the groin.
• Laparoscopic inguinal herniorrhaphy. In laparoscopic inguinal herniorrhaphy, multiple smaller abdominal incisions are made. A long, thin tube with a lighted camera on the end helps the surgeon see inside your body to perform the surgery.

The goal of either surgical approach is returning the internal abdominal tissue back into the abdominal cavity and repairing the abdominal wall defect. Mesh is commonly placed to reinforce the abdominal wall. Once structures are put into their proper place, your surgeon will close the opening with sutures, staples, or adhesive glue.

There are potential pros and cons to either procedure.

Although you can’t prevent genetic risk factors, it’s possible to reduce your risk of occurrence or the severity of abdominal hernias. Follow these tips:

• Maintain a healthy weight for you.
• Eat a high-fiber diet.
• Quit smoking cigarettes. Quitting is often difficult, but a doctor can help build a cessation plan that works for you.
• Avoid heavy lifting.

Early surgical treatment can help cure inguinal hernias.

However, there’s always the slight risk of recurrence and complications. These can include infection after surgery or poor surgical wound healing.

Call a healthcare professional if you experience new symptoms or if side effects occur after treatment.