What is inguinal hernia repair?
An inguinal hernia occurs when soft tissues protrude through an area of weakness or a defect in your lower abdominal muscles. It’s often in or near the groin area. Anybody can get an inguinal hernia, but it’s more common in men than women.
During inguinal hernia repair, your surgeon pushes the bulging tissues back into the abdomen while stitching and reinforcing the portion of the abdominal wall containing the defect. This procedure is also known as inguinal herniorrhaphy and open hernia repair.
Surgery isn’t always necessary, but hernias generally don’t improve without it. In some cases, an untreated hernia can become life-threatening. While there are some side effects and risks associated with surgery, most people have positive results.
The cause of inguinal hernias isn’t always known, but they could be the result of weak spots in the abdominal wall. Weaknesses can be due to defects present at birth or formed later in life.
Some risk factors for inguinal hernia include:
- fluid or pressure in the abdomen
- heavy lifting, such as weightlifting
- repetitive straining during urination or bowel movements
- chronic cough
Both adults and children can get inguinal hernias. Men are more likely to develop an inguinal hernia. People with a history of hernias are at increased risk of having another hernia as well. The second hernia usually occurs on the opposite side.
The symptoms of an 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. Men may also have swelling around the testicles.
You can sometimes gently push back the bulging tissue of a hernia when you lie on your back. You may not notice any symptoms if your inguinal hernia is small.
See your doctor if you suspect you might have a hernia.
Immediate surgery isn’t always recommended when a hernia isn’t causing a problem. However, it’s important to note that most hernias won’t resolve without treatment. They may also become larger and more uncomfortable over time.
Most people find the bulge from a hernia to be painless. Coughing, lifting, and bending might cause pain and discomfort, though. Your doctor may suggest surgery if:
- your hernia gets larger
- pain develops or increases
- you have difficulty performing daily activities
A hernia can become very dangerous if your intestines become twisted or trapped. If this happens, you may have:
- increased heart rate
- darkening of the bulge
- inability to push (reduce) your hernia back into the abdomen when you previously could
If you have any of these symptoms, contact your doctor immediately. This is a life-threatening condition requiring emergency surgery.
The risks involved in any surgery include:
- breathing difficulties
- allergic reactions to anesthesia and other medications
The following are some of the risks specific to inguinal hernia repair:
- 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.
When you meet with your doctor before the surgery, bring a list of all the prescription and over-the-counter medications you take. Make sure you ask for instructions about which medications you need to stop taking before surgery. This usually includes drugs that interfere with the blood’s ability to clot, such as aspirin. It’s also important to tell your doctor if you’re pregnant or think you may be pregnant.
Ask your doctor for specific instructions regarding the procedure and your medical condition. You’ll probably need to stop eating or drinking after midnight on the night before your surgery. You’ll also need to arrange for someone to drive you home from the hospital after surgery.
Open surgery or surgery with a laparoscope can usually repair an inguinal hernia.
Your surgeon will put you under general anesthesia to keep you asleep during the surgery and so you don’t feel any pain. They might decide to use local anesthesia if the hernia is small. In this case, you’ll be awake for the procedure, but you’ll receive medications to numb the pain and help you relax.
Your surgeon will make an incision, locate the hernia, and separate it from surrounding tissues. Then they’ll push the herniated tissue back into place in your abdomen.
Stitches will close up the tear or strengthen weak abdominal muscles. More than likely, your surgeon will attach mesh to strengthen the abdominal tissues and reduce the risk of another hernia.
Not using mesh will significantly increase the likelihood of getting a hernia in the future. In fact, despite recent negative press regarding use of abdominal mesh, use of mesh in an inguinal hernia repair remains the standard of care.
Laparoscopy is useful when the hernia is small and easy to access. This method leaves smaller scars than regular surgery, and recovery time is faster. Your surgeon will use a laparoscope — a thin, lighted tube with a camera on the end — and miniaturized instruments to do what would otherwise be done in open surgery.
Your doctor will probably encourage you to get up about an hour after surgery. Men sometimes have difficulty urinating in the hours following surgery, but a catheter can help. A catheter is a tube that drains urine from the bladder.
Inguinal hernia repair is often an outpatient procedure. This means you can go home the same day as the surgery. However, if there are complications, you may have to remain in the hospital until they resolve.
If you have open surgery, it may take up to six weeks for a full recovery. With laparoscopy, you’ll probably be able to get back to your normal activities within a few days.