An inguinal hernia happens when tissue, such as part of the intestine, pokes through a weak spot in the abdominal muscles. The resulting bulge can be painful, especially when coughing, bending over or lifting a heavy object. However, many hernias do not cause pain.
An inguinal hernia isn't necessarily dangerous, but it doesn't get better on its own. It also can lead to life-threatening complications. A healthcare professional is likely to recommend surgery to fix an inguinal hernia that's painful or getting bigger. Inguinal hernia repair is a common surgical procedure.
Inguinal hernia symptoms include:
Inguinal hernias in newborns and children result from a weakness in the abdominal wall that's present at birth. Sometimes the hernia will be seen only when a baby is crying, coughing or straining during a bowel movement. The baby might be irritable and have less appetite than usual.
In an older child, a hernia is likely to be more noticeable when the child coughs, strains during a bowel movement or stands for a long period.
If a hernia can't be pushed in, the contents of the hernia may be trapped in the abdominal wall. This is known as an incarcerated hernia. An incarcerated hernia can become strangulated, which cuts off the blood flow to the tissue that's trapped. A strangulated hernia can be life-threatening if it isn't treated.
Symptoms of a strangulated hernia include:
Seek care right away if a hernia bulge turns red, purple, or dark or if you notice any other symptoms of a strangulated hernia.
See a healthcare professional if you have a painful or noticeable bulge in your groin on either side of your pubic bone. The bulge is likely to be more noticeable when you're standing, and you usually can feel it if you put your hand directly over the affected area.
Some inguinal hernias have no apparent cause. Others might happen because of:
In many people, the abdominal wall weakness that leads to an inguinal hernia happens before birth when a weakness in the abdominal wall muscle doesn't close properly. Other inguinal hernias form later in life when muscles weaken or break down due to aging, strenuous physical activity or coughing that accompanies smoking.
Weaknesses also can happen in the abdominal wall later in life, especially after an injury or abdominal surgery.
In men, the weak spot usually occurs in the inguinal canal, where the spermatic cord enters the scrotum. In women, the inguinal canal carries a ligament that helps hold the uterus in place, and hernias sometimes happen where connective tissue from the uterus attaches to tissue surrounding the pubic bone.
Factors that contribute to forming an inguinal hernia include:
Complications of an inguinal hernia include:
You can't prevent the congenital defect that increases your risk of an inguinal hernia. You can, however, reduce strain on your abdominal muscles and tissues. For example:
A physical exam is usually all that's needed to diagnose an inguinal hernia. A healthcare professional will check for a bulge in the groin area. Because standing and coughing can make a hernia more prominent, you'll likely be asked to stand and cough or strain.
If the inguinal hernia isn't readily seen, a care professional might order an imaging test, such as an abdominal ultrasound, CT scan or MRI.
If the hernia is small and isn't causing problems, a healthcare professional might recommend watchful waiting. Sometimes, wearing a supportive truss may help relieve symptoms. A health professional can help make sure the truss fits properly and is being used appropriately. In children, a care professional might try applying manual pressure to reduce the bulge before considering surgery.
Hernias that are painful or getting bigger usually need surgery to relieve discomfort and prevent serious complications.
There are two general types of hernia operations — open hernia repair and minimally invasive hernia repair.
In this procedure, the surgeon makes a cut in the groin and pushes the protruding tissue back into the abdomen. The surgeon then sews the weakened area, often reinforcing it with a synthetic mesh. This is called a hernioplasty. The opening is then closed with stitches, staples or surgical glue. Open hernia repair might be done with local anesthesia and sedation or general anesthesia.
After the surgery, you'll be encouraged to move about as soon as possible, but it might be several weeks before you're able to resume regular activities.
In this procedure requiring general anesthesia, the surgeon operates through several small cuts in the belly. The surgeon may use laparoscopic or robotic instruments to repair the hernia. Gas is used to inflate the belly to make the internal organs easier to see.
A small tube with a tiny camera, called a laparoscope, is placed into one cut. Guided by the camera, the surgeon places tiny instruments through other small cuts and repairs the hernia using synthetic mesh.
People who have a minimally invasive repair might have less discomfort and scarring after surgery and a quicker return to regular activities. Long-term results of laparoscopic and open hernia surgeries are about the same.
Minimally invasive hernia surgery allows the surgeon to avoid scar tissue from an earlier hernia repair, so it might be a good choice for people whose hernias come back after open hernia surgery. It also might be a good choice for people with hernias on both sides of the body, called bilateral hernias.
As with open surgery, it may be a few weeks before you can get back to your usual activity level.
You'll likely start by seeing someone on your primary healthcare team. Here's some information to help you get ready for your appointment.
Make a list of:
Take a family member or friend along, if possible, to help you remember the information discussed during the appointment.
For an inguinal hernia, some basic questions to ask include:
Don't hesitate to ask other questions you may have.
You'll likely be asked a few questions, such as:
Get emergency medical care if you have nausea, vomiting or fever or if your hernia bulge turns red, purple or dark.
