Inguinal Hernia

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An inguinal hernia is a bulge that develops in the groin area. The lump typically disappears when the individual lies down or when minimal pressure is applied.

Understanding inguinal hernia

Inguinal hernia occurs when a portion of the bowel pushes through a weak spot in the abdominal muscle wall and drops into the inguinal canal. The inguinal canal is a hollow tract located in the groin, below the abdomen.

Inguinal hernias are common, accounting for approximately 75 percent of all hernias. Both men and women can suffer from inguinal hernia, but about 90 percent of inguinal hernias occur in men, usually between the ages of 40 to 59.

Not all inguinal hernias require treatment, but surgical repair may be recommended for those that are painful or getting larger.

Symptoms of inguinal hernia

The primary symptom of inguinal hernias is a bulge in the groin area. The bulge or lump may increase with pressure caused by coughing or standing.

Other possible symptoms of inguinal hernia include:

  • Pain, especially when coughing, bending, lifting or straining
  • Burning sensation at the site of the bulge
  • Heaviness, pressure or feeling of fullness in the groin region

Risk factors for inguinal hernia

While a cause of inguinal hernia is not always apparent, there are a number of risk factors that can increase the risk of developing inguinal hernia. Those factors are:

  • Heredity
  • Abdominal wall weakness
  • Pregnancy
  • Being overweight or obese
  • Prolonged standing
  • Straining from chronic constipation
  • Strenuous activity, heavy lifting or other activity that increases pressure within the abdomen
  • Chronic coughing or sneezing
  • Premature birth or low birth weight
  • History of inguinal hernia or prior inguinal hernia repair
  • Being male

Inguinal hernia complications

Possible complicating factors that can occur with inguinal hernia:

  • Enlargement – hernias that continue to grow or enlarge can move into the scrotum causing swelling and/or pain
  • Incarceration – an incarcerated hernia occurs when the hernia becomes trapped in the groin and can no longer be reduced back into the abdominal wall. This can lead to bowel obstruction, pain, nausea and vomiting
  • Strangulation – if an incarcerated hernia inhibits blood flow, the bowel begins to die. This condition is a medical emergency

Diagnosis of inguinal hernia

Most inguinal hernias can be diagnosed through physical examination. Your physician will likely examine the lump and may ask you to cough or strain, causing the hernia to protrude through the opening.

Additional imaging tests may be needed to confirm the diagnosis or look for complicating factors. These include CT scan, ultrasound, or MRI.

Treatment of inguinal hernia

Inguinal hernias that are not painful and are not growing larger may not require immediate treatment. Your physician may recommend delaying treatment and instead watching the hernia.

When treatment is necessary, surgical repair may be done through an open procedure or laparoscopic repair. Open repair involves making an incision in the groin and pushing the herniation back into the abdomen. The opening in the abdominal wall is closed and may be reinforced with a synthetic mesh material.

The less invasive laparoscopic procedure is performed through a series of tiny incisions using miniature instruments.

Prevention of inguinal hernia

While it is not possible to prevent all inguinal hernias, there are steps you can take to lower your risk. These include:

  • Avoiding heavy lifting
  • Maintaining a healthful weight
  • Not smoking
  • Avoiding constipation by consuming a high-fiber diet and exercising

 

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