An inguinal hernia is a bulge that forms when fatty tissue or part of the small intestine pushes through a weak spot in the abdominal wall in the groin. It is much more common in men than in women. Most inguinal hernias eventually need surgery to repair.
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What Is an Inguinal Hernia?
An inguinal hernia is a bulge that occurs when fatty tissue or part of the small intestine pushes through a weak spot in the abdominal wall in the groin.
This condition typically occurs in one of the passages in the lower abdomen — one on each side of the groin — called inguinal canals.
Inguinal hernia is 10 times more common in men than in women and more likely to develop in older adults.
When a man has an inguinal hernia, it's often caused by fatty tissue or part of the small intestine.
In women and girls, an inguinal hernia can also be caused by part of the reproductive system, like an ovary, pushing through the abdominal wall.
What are the types of inguinal hernia?
- Direct inguinal hernia — This kind of hernia is caused by a weak spot in the inguinal canals that develops later in life. Inguinal canals are passages in the abdominal wall located on either side of the groin. These hernias mostly occur in men.
- Indirect inguinal hernia — This kind of hernia is caused by a defect in the inguinal canal that can be present at birth or develop over time. The inguinal canals typically close before birth, but in people who have this defect, the canals remain open. The opening allows a hernia to form. These can also develop over time with pressure leading to opening and dilation of the inguinal ring.
How common is inguinal hernia?
Inguinal hernias are fairly common. About 27% of men and 3% of women will develop an inguinal hernia at some point in their lives.
What causes inguinal hernia?
Inguinal hernias happen when fatty tissue, part of the small intestine, or a reproductive organ — like an ovary — pushes through the lower abdominal wall in the groin. This creates a bulge that is often painful.
Usually, the hernia happens in one of the inguinal canals. These are passages in the abdominal wall on either side of the groin.
Sometimes, a defect leaves one or both of the canals open, allowing a hernia to form. In other cases, a weak spot develops in the canals over time.
Other conditions that may lead to inguinal hernia include:
- Health conditions that cause pressure in the abdomen, such as a chronic cough, obesity, or chronic constipation.
- Repeated activities that cause pressure in the abdomen, such as heavy lifting.
- Weak connective tissue.
Inguinal hernia risk factors
Anyone can develop an inguinal hernia, but it is more common in:
- Men.
- Older adults.
- People with a connective tissue disorder.
- People with a family history of inguinal hernia.
- Premature infants.
Inguinal hernia complications
Inguinal hernias may start out small and cause little discomfort. Over time, however, they are likely to grow and may become painful.
Rarely, a hernia will become stuck or strangulated, which cuts off the blood supply. Strangulation is a life-threatening condition that can lead to intestinal obstruction or tissue death. It requires emergency surgery.
See your doctor immediately if you experience any of these symptoms:
- Bloating.
- Fever.
- A hernia you can no longer push back into the abdomen.
- Nausea or vomiting.
- Redness in the area of the hernia.
- Sharp pain.
- Sudden growth of the hernia.
How can I prevent inguinal hernia?
You can’t prevent a hernia that occurs because of a defect in the inguinal canal. But you may be able to reduce your risk of a hernia that occurs because of a weak spot abdominal wall.
To lessen the chances of developing a weak spot, you can:
- Lift heavy objects with proper form to prevent twisting or straining.
- Maintain a healthy weight.
- Strengthen your abdominal — or core — muscles.
- Stop smoking.
What Are the Signs and Symptoms of Inguinal Hernia?
The most common signs of inguinal hernia are:
- A bulge or lump in the groin, scrotum, or lower abdominal area.
- Irritation or numbness around the bulge.
- Mild pain around the bulge.
If the bulge suddenly grows or you have sharp pain or vomiting, it can be a sign that the hernia is stuck or strangulated. This which can cut off the blood supply or cause a blockage/obstruction. Strangulation is a life-threatening condition that requires emergency surgery. You should see a medical provider right away.
When should I see a doctor about my inguinal hernia symptoms?
If your hernia suddenly grows or you experience sharp pain or vomiting, see a medical provider right away. Your hernia could be stuck or strangulated, which cuts off blood supply. It is a life-threatening condition that requires emergency surgery.
If you have signs of a hernia, you should make an appointment with your provider, even if the hernia is small and causes little discomfort. Over time, the hernia is likely to grow and become painful. Providers will often suggest surgery before the hernia gets too large and more difficult to fix.
How Do You Diagnose Inguinal Hernia?
Most hernias are relatively easy to diagnose because providers can see or feel them during a physical exam. However, some hernias don’t create a noticeable bulge. To be certain, your doctor may order an imaging test.
Tests to diagnose inguinal hernia
- CT scan — A CT scan uses a series of x-rays to create a three-dimensional image the tissues and organs in your lower abdomen. It is painless and noninvasive.
- MRI — An MRI uses a powerful magnetic field to create a detailed image of your tissues and organs. It is painless and noninvasive.
- Ultrasound — An ultrasound uses sound waves to create an image of your tissues and organs. It is painless and noninvasive.
Inguinal hernia outlook
When treated with surgery, most inguinal hernias are repaired, and the pain stops. Sometimes, a recurrence will happen, meaning the hernia will return, requiring another surgery.
According to the American Society of Anesthesiologists, about 10% of patients with inguinal hernia may end up having chronic pain. Chronic pain is more common in people who have recurrent hernia or who undergo open surgery.
How Do You Treat Inguinal Hernia?
Lifestyle changes
These lifestyle changes cannot fix or prevent inguinal hernia. But they can reduce your risk of developing a hernia or a recurrence of your hernia:
- Lift heavy objects with proper form to prevent twisting or straining.
- Maintain a healthy weight.
- Strengthen your abdominal, or core, muscles.
- Stop smoking.
Nonsurgical treatment for inguinal hernia
Surgery is the only way to repair a hernia. But if your hernia is small and you are not uncomfortable, your doctor may suggest “watchful waiting.” This is when you and your doctor watch the hernia for changes and act when necessary.
Watchful waiting can be considered for asymptomatic inguinal hernias. But they are likely to progress over time. Over two-thirds of people ultimately pursue surgery over the next 10-year period due to the development of symptoms.
Surgery for inguinal hernia
Surgery is the only way to repair a hernia. According to the Food and Drug Administration, more than 1 million hernia surgeries take place in the United States each year. This makes it one of the most common surgeries.
Typically, your doctor will use one of two surgical methods to repair your hernia:
- Minimally invasive (laparoscopic or robotic) surgery — Your doctor will make several small incisions in your abdomen and use tiny instruments and a camera to repair your hernia. Minimally invasive surgery usually means less pain and faster healing time.
- Open surgery — Large or more complicated hernias may need open surgery. Some open procedures can take place under sedation, which may make an open procedure a better option for patients with certain conditions. In this type of surgery, doctors make one long incision in your lower abdomen or groin to repair the hernia. They close the incision with stitches and sometimes surgical mesh to strengthen the weak spot.
What happens during surgery for inguinal hernia?
Most hernia surgeries occur in a hospital under general anesthesia. You many need to stop eating, drinking and taking certain medications in the hours before your surgery.
Smoking increases your risk of infection after hernia surgery and impairs wound healing. Your surgeon may recommend quitting in the weeks before surgery.
During surgery your doctor will:
- Push the bulging tissue or organ back into place.
- Repair the weak spot in your abdominal wall.
- Use surgical mesh to strengthen the abdominal wall and prevent another hernia. Mesh is used in most cases.
If you have laparoscopic surgery, your procedure will take about 60 minutes. You may be able to go home the same day. You're also likely to have less pain than those who have open surgery.
If you have open surgery, you're more likely to have pain at the incision site. Most pain can be managed with over-the-counter pain medications, like acetaminophen or ibuprofen, or a prescribed narcotic. Pain usually begins to improve in about 72 hours.
Typically, you can go home the same day as your surgery, as long as your pain is adequately controlled. If you have significant medical comorbidities, your doctor may choose to watch you in the hospital for the night.
You should call your doctor right away if you experience any of these symptoms after your hernia surgery:
- Abdominal pain and swelling.
- Continuous vomiting.
- Fever.
- Foul-smelling or pus-like drainage from your incision.
- No bowel movement after two to three days.
- Pain that gets worse and cannot be controlled with medication.
- Swelling, redness, or bleeding near the incision site.
Is hernia surgery right for me?
Surgery is the only way to repair an inguinal hernia. Even if the hernia starts small and causes little pain, it is likely to grow and require surgery within a few years.
People who smoke, have diabetes, or are overweight have an increased risk of complications after hernia surgery. If you have these health concerns, speak with your surgeon about whether hernia surgery is right for you.
How long does it take to recover after surgery for inguinal hernia?
Depending on your overall health, the size of your hernia, and the type of surgery you received, you may be able to resume some activities in the days after your surgery. Light activity can help to prevent blood clots and pneumonia.
Full recovery takes several weeks. Your doctor will give you specific post-operation instructions.
Why Choose UPMC for Hernia Surgery?
At UPMC, we provide expert care for inguinal hernias. You can expect:
- Access to new and innovative treatment — Nearly all our surgeons take part in clinical or laboratory research. Their discoveries ensure that patients receive the latest treatments using the most advanced techniques.
- Expert care — Our team is available around the clock to consult, diagnose, and treat patients with the most advanced care available. All of our surgeons are certified by the American Board of Surgery. Many are nationally renowned for the comprehensive care they provide patients.
- Locations close to home — We provide care to patients at locations in Pennsylvania, New York, and Maryland. That means you never have to travel far to receive the world-class care you need.
