Inguinal Hernia
These are the hernias that develop in the groin area. An inguinal hernia accounts for 75% of all hernias and is 25 times more common in men than in women.
There are three types called direct, indirect and femoral. In general, all three types are similar, but the indirect one can be seen at any age and can extend to the testicular sac.
A direct inguinal hernia is usually seen in middle and advanced age when the abdominal wall is weakened. Femoral hernias are rarer than other types. The same surgery is performed in the treatment of all three types.
Although an inguinal hernia usually looks harmless, your doctor will usually recommend surgery after examining it. Because the compression of the hernia and the complications that can develop afterwards can be intimidating, even life-threatening..
What Are The Symptoms Of An Inguinal Hernia?
Some inguinal hernias do not cause any complaints. Sometimes you don’t realize you have a hernia until it’s detected during a doctor’s examination.
There is often swelling in the groin area. This swelling is most evident when standing, pushing, or coughing.
By lying on your back, the swelling usually goes away. Sometimes there may be burning when bloating, a feeling of tight air, and pain. The feeling of pressure in the groin area can be painful and burning when lifting a heavy object.
In less cases, there may be swelling in the scrotum due to the hernia landing in the scrotum.
What is a Stuck Inguinal Hernia?
Most of the time, the hernia bulge flattens out when you lie on your back. This flattening occurs as a result of the return of the omentum or the small intestine, which enters the hernia sac, into the abdomen.
These organs cannot return to the abdomen and if they remain in the hernia sac it is called a stuck hernia. This condition is often painful.
This is called a strangulated hernia, which is the next step if the blood supply to the organs in the trapped area is cut off as a result of the compression. Strangulated hernias unfortunately require emergency surgery and can lead to life-threatening complications.
What are the Symptoms of a Squeezed Inguinal Hernia?
- Nausea, vomiting, loss of appetite
- Inability to perform gas and large ablutions
- Sensation of abdominal bloating and gas pain
- High temperature
- Increased pulse
- Rapidly exacerbating abdominal and groin pain
- Bruising or flushing may occur in the color of the swollen hernia.
Which are the Symptoms of Inguinal Hernia?
In some cases, there may not be a detectable cause. But the following can be counted among the causes of hernia:
- Increased intra-abdominal pressure
- Pre-existing weak points in the abdominal wall
- Heavy ablution or straining during urination (enlarged prostate and chronic constipation)
- Heavy lifting
- Fluid buildup in the abdomen (acidic fluid can build up in liver disease or heart failure)
- Pregnancy
- Overweight
- Chronic cough and sneezing
Why is Inguinal Hernia more common in men?
Men have congenital pubic duct weakness. In male infants, the testes form in the abdomen and then descend through the inguinal canal into the testicular sac. The canal closes soon after birth.
Sometimes this channel cannot close properly, where a weak spot forms. For this reason, inguinal hernia is more common in men.
What are the Risk Factors for the Formation of an Inguinal Hernia?
- Certain diseases (chronic lung disease, COPD, prostate disease, cirrhosis)
- Family history (if your loved ones have a history of hernia, you are more likely to have it than normal society)
- Chronic cough (smoking)
- Chronic constipation
- Being overweight (increases your intra-abdominal pressure)
- Pregnancy (weakens your abdominal muscles and increases intra-abdominal pressure)
- Certain occupations (occupations with long-standing and heavy physical working conditions and requiring heavy lifting)
- Being born prematurely
- Having previously suffered from a hernia on the opposite side
What are the Feared Complications of an Inguinal Hernia?
- The hernia grows over time and the testicular sac descends properly
- Compression of the hernia (may cause congested bowel obstruction)
- Strangulation of the hernia (bleeding from the trapped intestine is disturbed and gangrenous, and can develop into a life-threatening complication.
How is Inguinal Hernia Diagnosed?
Usually, only a hernia is diagnosed as a result of an examination. Sometimes very small hernias can be diagnosed by ultrasound.
Inguinal Hernia: Frequently Asked Questions
What is an inguinal hernia and why does it happen?
An inguinal hernia occurs when fatty tissue or a part of the bowel pokes through a weak spot or tear in the abdominal muscles in the groin area. It is specifically located in the inguinal canal.
Common causes include increased pressure within the abdomen, a pre-existing weak spot in the abdominal wall, straining during bowel movements, heavy lifting, or chronic coughing.
What are the typical symptoms of an inguinal hernia?
Not all hernias cause pain initially, but common signs include:
- Visible Bulge: A bump on either side of the pubic bone, which becomes more obvious when you cough or strain.
- Pain or Discomfort: Especially when bending over, coughing, or lifting objects.
- A Sensation of Heaviness: A dragging or weak feeling in the groin.
- Swelling: Occasional swelling or pain around the testicles if the protruding intestine descends into the scrotum.
Can an inguinal hernia heal on its own without surgery?
No, an inguinal hernia will not heal or go away on its own. Unlike a muscle strain, the hole or weakness in the abdominal wall is a mechanical issue that requires surgical repair.
While small hernias that don’t cause symptoms can sometimes be monitored (watchful waiting), they typically grow larger over time and may eventually require surgery to prevent complications.
What are the risks if an inguinal hernia is left untreated?
Leaving a hernia untreated can lead to serious, life-threatening complications, including:
- Incarceration: The tissue becomes trapped in the abdominal wall and cannot be pushed back in, often causing pain and nausea.
- Strangulation: The blood supply to the trapped tissue is cut off. This is a medical emergency that requires immediate surgery to prevent tissue death (gangrene).
What is the difference between open and laparoscopic hernia surgery?
There are two primary surgical approaches for repair:
- Open Hernia Repair: A single larger incision is made in the groin, and the hernia is pushed back or removed before the wall is reinforced with mesh.
- Laparoscopic (Minimally Invasive) Repair: Several small incisions are made, and a tiny camera (laparoscope) is used to guide the repair. This usually results in less post-operative pain and a faster return to daily activities.
How long is the recovery time after inguinal hernia surgery?
Most patients can return home the same day as their surgery. Full recovery generally follows this timeline:
- 1–2 Weeks: You can typically return to light activity and desk work.
- 4–6 Weeks: You can usually resume strenuous exercise and heavy lifting, depending on your surgeon’s clearance.
Recovery is often faster with laparoscopic surgery compared to open repair.
Is hernia mesh safe, and why is it used?
Surgical mesh is used in most hernia repairs because it significantly reduces the chance of the hernia returning (recurrence). It acts as a “scaffold” for new tissue to grow into, strengthening the abdominal wall.
While all surgeries carry risks, modern medical-grade mesh is considered the standard of care and is highly effective for long-term repair.
