Inguinal Hernia

What is an inguinal hernia?

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An inguinal hernia is an abdominal hernia. It occurs in the right or left inguinal canal. These canals are at the base of the abdomen. An inguinal hernia is intestinal or fatty tissue that forces through a weakness in the abdominal wall.

All people have inguinal canals. For people with male sex organs, the testes lower around the inguinal canal just before birth. For people with female sex organs, the inguinal canal is a spot of passage for the uterus’s round ligament. A hernia in or near this passage presents as a noticeable bulge that causes pain during movement.

Most inguinal hernias are small and asymptomatic, which means many people will not seek treatment. However, a professional assessment and treatment plan can put a stop to prolonged pain or increased protrusion.

What causes an inguinal hernia?

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There is no definite cause of inguinal hernias. Some possible causes are:

  • Intense physical activity
  • An existing weak portion of the abdominal wall
  • Pregnancy
  • Straining during urination or bowel movements
  • Chronic sneezing or coughing
  • Increased pressure in the abdomen

An abdominal wall weakness that can potentially cause an inguinal hernia develops often prior to birth, when a weakness in the abdominal wall does not close correctly. Inguinal hernias that develop as you age occur because of intense physical activity, aging, or chronic coughing from smoking. Injuries and abdominal surgery can also create weaknesses in the abdominal wall that can then develop into inguinal hernias.

For people with male sex organs, the abdominal wall weakness often occurs at the point in the inguinal canal where the spermatic cord enters the scrotum. For people with female sex organs, the abdominal wall weakness often occurs where the uterus’s connective tissue connects to the tissue surrounding the pubic bone.

What are symptoms of an inguinal hernia?

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Inguinal hernias are most identifiable from the following symptoms:

  • A bulge on either side of the pubic bone that becomes more noticeable while you are up right, or if you strain or cough
  • Aching or burning sensation in the bulge on either side of the pubic bone
  • Weakness or pressure in the groin
  • Discomfort or pain in the groin, specifically while lifting, bending over, or coughing
  • Dragging or heavy sensation in the groin
  • Possible swelling or pain around the testicles

Children and newborns can also develop inguinal hernias. As mentioned above, some people are born with a weakness in the abdominal wall.  An inguinal hernia is most noticeable when an infant is coughing, crying, or straining during a bowel movement. If the infant has an inguinal hernia, they might eat less or become easily agitated. It is easier to notice an older child’s inguinal hernia when they are coughing, straining during a bowel movement, or standing for a long time.

What is a strangulated hernia?

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If you are unable to push the hernia inwards, it means that the contents of the inguinal hernia might be stuck in the abdominal wall. An incarcerated hernia has the potential to develop into a strangulated hernia. When a hernia becomes strangulated, it cuts off blood flow to the trapped tissue. A strangulated hernia can be fatal without proper treatment.

Symptoms of a strangulated hernia include:

  • A bulge turning purple, red, or dark
  • Fever
  • Nausea or vomiting
  • Intensifying pain
  • Constipation or an inability to pass gas


Are there any risk factors or groups for inguinal hernias?

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The following risk factors and groups can increase risk of developing an inguinal hernia:

  • Premature birth or low birth weight
  • Being male
  • Heredity
  • Being overweight
  • Pregnancy
  • Cystic fibrosis
  • Chronic constipation
  • Chronic cough
  • A history of inguinal hernias or hernia repair

How is an inguinal hernia diagnosed?

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During a physical exam, a doctor will typically check for inguinal hernias in two different ways. First, the doctor will check the groin area for a bulge. If the doctor finds something, they will then ask you to cough while standing.  This allows the doctor to observe the hernia at a time when it is most noticeable.

If necessary, a CT scan, MRI or abdominal ultrasound can help the doctor make a firm diagnosis. Imaging is not usually part of the diagnostic process for inguinal hernias but could be helpful if the patient is experiencing pain and the doctor cannot find a bulge during the physical exam.

How is an inguinal hernia treated?

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Inguinal hernia treatment depends largely on the severity of the hernia. If the bulge is small and does not cause pain or discomfort, a doctor might suggest holding off on a treatment plan and watching for developments.

A doctor might recommend using a supportive truss to relieve inguinal hernia symptoms. Supportive trusses require proper fit and appropriate usage to provide adequate support, so please only consider using one at the recommendation of a doctor.

Inguinal hernias that continue to grow or cause pain typically require surgery. The two most common types of inguinal hernia surgery are minimally invasive hernia repair and open hernia repair. Surgery helps to reduce pain or discomfort and keep the inguinal hernia from progressing into more serious complications.


What is included in a minimally invasive (laparoscopic) hernia repair?

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In a minimally invasive hernia repair, also called a laparoscopic hernia repair, a surgeon makes several small incisions in the abdomen. The surgeon will use gas to inflate the abdomen and view the internal organs more clearly. A small camera feeds through one of the incisions, and laparoscopic or robotic instruments will repair the hernia with synthetic mesh.

This surgery often results in less scarring and discomfort, and a shorter recovery time than an open hernia repair. However, both surgeries yield similar, positive results.

What is an open hernia repair?

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In an open hernia repair, a surgeon makes an incision in the groin and pushes the inguinal hernia tissue, or the bulge, back into the abdomen. After reinforcing the affected area with synthetic mesh, the surgeon will close the incision with surgical glue, staples, or stitches.

This surgery has a longer and more uncomfortable recovery time with the potential for more scarring, but it yields the same results as a minimally invasive hernia repair. It is up to you and your care team to determine which option works best for your inguinal hernia treatment.

What are lifestyle changes that could help prevent an inguinal hernia?

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Some inguinal hernias are a result of genetics and cannot be prevented. However, there are some strategies that can help reduce the risk of developing non-hereditary inguinal hernias:

  • Stop smoking
  • Avoid lifting heavy items
  • Eat a high-fiber diet
  • Exercise and eat well to maintain a healthy weight
  • Familiarize yourself with inguinal hernia symptoms and regularly check for any developments in your abdomen or groin


Should you see a doctor for an inguinal hernia?

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A doctor can identify inguinal hernias with a regular physical exam, so make sure to schedule your physical each year. Many inguinal hernias are asymptomatic and largely unnoticeable. Keep an eye out for any irregular symptoms and let your doctor know about new developments.

You should see a doctor as soon as possible if you develop a noticeable or painful bulge in your groin. If you already have an inguinal hernia, see a doctor right away if the hernia turns purple, red, or dark. Read the list of strangulated hernia symptoms above and seek immediate care if any of those symptoms develop.

What is the outlook for people living with an inguinal hernia?

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Oftentimes, an inguinal hernia does not present any symptoms or bother the person who has it. Treatment for many asymptomatic inguinal hernias simply involves a doctor pushing the hernia back into the abdomen.

If the inguinal hernia is symptomatic, you should contact a doctor immediately. A doctor will treat you with a supportive truss and/or surgery. A postoperative recovery can take a few weeks to a few months, but you will likely regain your full range of motion. There is the possibility of recurrence, as people who have inguinal hernias are at a higher risk of developing another inguinal hernia.