What is an inguinal hernia?
This is a common type of hernia that can cause a lump or pain in the groin. They can happen in both men and 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 inguinal canal is a passage in the groin crease that carries blood vessels and other structures - this is the common area that hernias develop, allowing the intestine to push into the groin. In men, this can lead to the hernia pushing into the scrotum.
Why do inguinal 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 inguinal hernias cause?
Usually inguinal hernias are felt as lumps in the groin 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 an inguinal hernia be treated?
Occasionally an inguinal hernia can be managed by wearing a support (truss). Surgery is usually the best treatment method, though.
The operation may be performed under general or local anaesthetic, and may be by 'keyhole' technique or by 'open' technique (which leaves a longer scar).
The surgeon will push the bowel back into place, then stitch the overlying muscle to strengthen it. A synthetic mesh may also be stitched over the weak muscle, further strengthening it and reducing the risk of recurrent hernia. The skin is then stitched closed.
What happens after inguinal surgery?
You can usually go home on the same day, 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 inguinal 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 during hernia surgery but can occur, which may need further surgery.
Damage to the testicle vessels - this is very rare, but can result in a non-functioning testicle on the damaged side.
Difficulty passing urine - there is about a 1 in 10 chance of this happening and 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 femoral 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