An inguinal hernia occurs when part of the small intestine protrudes through a tear or weakness in your groin (the area between your abdomen and your thigh). Anybody can get an inguinal hernia, but it is more common among males.
Inguinal hernia repair, inguinal herniorrhaphy, and open hernia repair are various names for the surgery used to correct this condition. During the procedure, the bulging tissue is forced back into the abdomen. Stitches are used to provide strength and support to the abdominal wall.
Surgery is not always required, but hernias generally do not improve without it. In some cases, an untreated hernia can become life-threatening. While there are some side effects and risks to surgery, most people get positive results from this procedure.
Inguinal hernia can be diagnosed by physical exam. Their cause is not always known, but hernias could be the result of weak spots in the abdominal wall. Weaknesses can be due to congenital defects (present at birth) or formed later in life. Some risk factors for inguinal hernia include:
- fluid or pressure in the abdomen
- heavy lifting
- straining during urination or bowel movements
- chronic cough
Both adults and children can get inguinal hernias, but at all ages the rate is highest among males. People who have already had one hernia are at increased risk of having another. The second hernia usually occurs on the other side.
Symptoms of inguinal hernia include a bulge in the groin area and pain, pressure, or aching at the bulge—especially when lifting, bending, or coughing. These symptoms usually subside during rest periods. Men may also have swelling around the testicles.
The bulge of a hernia can sometimes be gently pushed back when lying flat on your back. If an inguinal hernia is small, you may not notice any symptoms at all.
If you suspect a hernia, but have not been diagnosed, you should see your doctor.
When a hernia does not cause a problem for the patient, immediate surgery is not always recommended. However, it is important to note that most hernias will not resolve without treatment. They may also become larger and more uncomfortable over time.
Most people find the bulge from a hernia very painful. Coughing, lifting, and bending usually increase pain and discomfort. Your doctor may suggest surgery if:
- your hernia is getting bigger
- pain is increasing
- you have having difficulty performing daily activities
If your intestines become twisted or trapped, a hernia can become very dangerous. You may develop fever, increased heart rate, pain, nausea, and vomiting. The bulge may turn dark.
If you have any of these symptoms, contact your doctor immediately. This is a life-threatening condition requiring emergency surgery.
When you meet with your doctor before the surgery, bring a list of all prescription and over-the-counter medications you take. Make sure you ask for instructions about which medications you need to stop taking before surgery. Usually this includes drugs that interfere with the blood’s ability to clot, such as aspirin. It is also important to tell your doctor if you are pregnant or think you may be pregnant.
Ask your doctor for specific instructions regarding the procedure and your medical condition. You will be probably advised to stop eating or drinking after midnight on the night before your surgery. You will also need to arrange for someone to drive you home from the hospital after surgery.
An inguinal hernia can be repaired with traditional surgery or with a laparoscope (a thin, lighted tube with a camera on the end).
General anesthesia will be used, so you will not be awake during the surgery. Your surgeon might decide on a local anesthesia if the hernia is small. In this case, you will be aware, but will receive medications to numb the pain and help you relax.
The surgeon will make an incision, locate the hernia, and separate it from surrounding tissues. The herniated tissue will be pushed back into place in your abdomen.
Stitches will be used to close up the tear or strengthen weak abdominal muscles. Sometimes mesh is attached to strengthen the abdominal tissues and reduce the risk of another hernia.
Laparoscopy can be used when the hernia is small in size and easy to access. This method leaves smaller scars than regular surgery, and recovery time is faster. The procedure is the same as for open surgery, only using a laparoscope and miniaturized instruments.
You will probably be encouraged to get up about an hour after surgery. Men sometimes have difficulty urinating in the hours following surgery, but this can be relieved with a catheter (a tube that drains urine from the bladder).
This surgery is often performed as an outpatient procedure. However, if there are complications, you may have to remain in the hospital until they resolve.
If you have traditional surgery, it may take up to six weeks for a full recovery. With laparoscopy, you will probably be able to get back to your normal activities within a few days.
The prognosis following this surgery is usually very good. The hernia comes back for less than three out of 100 patients, according to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK ).
Risks involved in any surgery include:
- breathing difficulties
- allergic reactions to anesthesia and other medications
There are also some risks specific to inguinal hernia repair. For example:
- The hernia may eventually come back.
- You may experience prolonged pain at the site.
- There could be damage to blood vessels. In men, the testicles could be harmed if connecting blood vessels are damaged.
- There could be nerve damage or damage to nearby organs.