What is a femoral hernia?
This is a type of hernia that can cause a lump or pain in the inside thigh near the groin. Femoral hernias can happen in men but are more common in women.
The intestines are held within the abdomen by a thin membrane and the tummy muscles. If a weak area forms in the muscle, then the intestine and thin membrane can push through this weakness - this is now called a hernia. The femoral canal is a passage near the groin crease that carries blood vessels and other structures - this is a common area that hernias develop, allowing the intestine to push into the groin.
Why do femoral hernias develop?
Raised pressure in the abdomen pushes the bowel against the muscle. Long-term pressure can eventually lead to the muscle giving way and letting the bowel herniate through. Such causes include long-term coughs, lifting heavy weights, and constipation (straining increases tummy pressure).
Weakness in the muscle wall can be caused by previous surgery or previous abdominal injury.
What problems can femoral hernias cause?
Usually femoral hernias are felt as lumps in the groin or upper inside thigh area and can cause aching or pain. The lump may disappear when lying down or when gently pushed back. Occasionally the hernia becomes trapped and cannot be pushed back, or may even have its blood supply cut off, leading to death of the involved bowel - this is very painful and can be life-threatening, so requires emergency surgery.
How can a femoral hernia be treated?
Occasionally a hernia can be managed by wearing a support (truss). Surgery is usually the best treatment method, though, and often recommended for femoral hernias due to their risk of becoming trapped.
The operation may be performed under general or local anaesthetic, and usually by 'open' technique (which leaves a scar near the groin).
The surgeon will push the bowel back into place, then stitch the passage opening to narrow it. A synthetic mesh may also be stitched over, further strengthening it and reducing the risk of recurrent hernia. The skin is then stitched closed.
What happens after femoral hernia surgery?
You can usually go home on the same day of surgery, but should rest for a number of days. You can usually return to work after a few weeks but should avoid heavy lifting for at least six weeks. You should check with your specialist before returning to normal activities, driving and work.
What risks are involved with femoral hernia surgery?
Hernia operations are one of the most common operations to be performed, and most people have no, or very minor, postoperative problems. Certain problems can occur, though, some of which include:
Infection - this may require antibiotics, or rarely further surgery.
Injury to other structures - injury to bowel, nerves or blood vessels is rare in femoral hernia surgery but can occur, which may need further surgery.
Difficulty passing urine - if this happens you may need a tube (catheter) for a day or two to help you pass water.
Recurrence - despite best efforts, the hernia can occasionally recur and further surgery may be needed.
Blood clots in the legs - clots in the calf (deep vein thrombosis / DVT) can usually be treated with medication, but a DVT can (rarely) move to the lungs. This can cause breathing difficulty, or even be life threatening.
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You may also be interested to read our article on inguinal hernias
Any procedure involving skin incision can also result in unfavourable scarring, wound infection, or bleeding. This list of risks is not exhaustive, and you should discuss possible complications with your specialist. Whilst these risks will seem very worrysome, and indeed can be serious, it should also be borne in mind that many people have no postoperative problems whatsoever.
The information provided is as a guide only and you should discuss matters fully with your specialist before deciding if this is the right procedure for you. Please also read our disclaimer