Inguinal hernia

This is the ‘common’ hernia – (about 70% of all hernias are inguinal hernias) – and when people say they have a hernia, or a relative or friend has a hernia, this is usually what they mean. They occur in the groin – the small area of the lower abdomen on each side just above the groin skin crease and pubic bone.

There is a lot of information about inguinal hernias on the internet and rather than repeat it all I am just going to highlight the main points and direct you to other sites that explain things further.

If you would like an easy to understand overview of inguinal hernia repair take a look at a recent article entitled 'Current options in inguinal hernia repair...' by a colleague of mine, Dr Kulacoglu, a surgeon in Turkey. It is an excellent overview, and easy to read.

Why do they occur there and why do they occur at all?

They occur through the inguinal canal, a special area where the testicle comes through on its way to the scrotum during the development of males. Men and women develop from the same basic pattern so there are anatomical similarities between men and women. But in women the inguinal canal is much much smaller, and as a result inguinal hernias are much more uncommon then in men.

What do I see / how do I know if I have an inguinal hernia?

You will see or feel a lump or swellng under the skin. It may be a bit uncomfortable. The swelling will often disappear completely when you lie down, as the ‘contents’ of the hernia sac slip back through the hole into the abdomen.

Sometimes there is hardly any swelling to see, but you may be conscious of a strange feeling in the groin when you are standing or walking for any period of time .

What should I do ? See a doctor to confirm that’s what it is.

Hopefully they will examine you – standing better than lying – to confirm – and usually send you off to see a surgeon.[ see – Is surgery always necessary? – below]

Making or confirming the diagnosis. If there is an obvious swelling that disappears when you lie down – that’s it – an inguinal hernia. You shouldn’t need any special tests.

Are there any special tests or xrays

Yes there are but they are not usually needed. There really is nothing else that appears as a swelling in the groin and that disappears when you lie down. ‘Special tests’ are helpful in a few situations

a) you have pain or discomfort in the groin with no obvious swelling
b) the swelling is not reducible – that is it does not go back when you lie down

I know I have an inguinal hernia – what should I do?

In general you should have an operation to repair the hole and stop the swelling coming out 
 
Is surgery always necessary? – usually yes - if you leave the hernia :-

a) It will get bigger
b) it will become more uncomfortable
c) there is a risk of strangulation

Please read the following overview of surgical options for inguinal hernia repair in fairly plain language read more

What about a ‘truss’or a belt?

Old fashioned, awkward and uncomfortable – and they rarely fit well enough to stop the hernia popping out. Trusses are ok if you really are too unwell or too scared to have an operation – but they are a poor solution to the problem.

The operations nowadays are really effective , and can be carried out under local anaesthetic so you don’t have to be asleep –‘knocked out’ – under a general anaestheic

Surgery to repair the inguinal hernia – what are my options – what do I need to know about?

You need to know about

a) the main types of repair – stitches or mesh, open repair or laparoscopic (keyhole)

b) types of anaesthetic

c) the expected recovery time – the ‘down time’ – off work , sport, sex etc.

c) the expected final result

d) potential problems