An inguinal hernia occurs when tissue, usually part of the intestine or abdominal fat, pushes through a weakened area in the groin. It is the most common type of hernia, accounting for around 70% of all hernias, and is more common in men than women.
Why does an inguinal hernia occur?
They occur through the inguinal canal, a conduit where the testicle comes through on its way to the scrotum during the development of males. Men and women develop from the same basic pattern so there are anatomical similarities between men and women, meaning that women also have the inguinal canal.
But in women the inguinal canal is much smaller, and as a result inguinal hernias are much more uncommon than in men. A hernia develops when tissue pushes through weak areas in the abdominal muscles or surrounding connective tissue. Factors such as ageing, previous injury, or conditions that increase pressure inside the abdomen can contribute to the development of a hernia. Conditions such as chronic cough or chronic constipation can also increase the risk of developing an inguinal hernia due to repeated strain.
How do I know if I have an inguinal hernia?
The symptoms of an inguinal hernia can vary from person to person. You may see or feel a lump, bulge or swelling under the skin. You may notice a bulge in your groin that becomes more obvious when standing, coughing, sneezing, or straining.
It may be a bit uncomfortable. The swelling will often disappear completely when you lie down, as the contents of the hernia sac slip back through the hole into the abdominal wall. It may also be aggravated by coughing, sneezing, etc.
Sometimes there is hardly any swelling to see, but you may be conscious of a strange feeling in the groin area when you are standing or walking for any period of time.
Many hernias cause no pain at all, but that does not mean they are not there or that they are not in need of attention.
What should I do?
See a doctor to confirm an iguinal hernia diagnosis. The doctor will examine you (normally very simply) to confirm and will refer you to see a surgeon, ideally one who specialises in hernia.
Making or confirming the diagnosis
If there is an obvious swelling that disappears when you lie down, it is pretty conclusive that you have an inguinal hernia. You shouldn’t need any special tests.
See also Diagnosis & Treatment.
Different types of inguinal hernias
Inguinal Hernia - This is the most common hernia, accounting for around 70% of all hernias. An inguinal hernia occurs in the groin, the small area of the lower abdomen on each side just above the line separating the abdomen and legs.
Bilateral Hernia - A bilateral hernia occurs when hernias are present on both sides of the groin. Essentially, it’s an inguinal hernia that affects the left and right sides simultaneously.
Inguinoscrotal Hernia - An inguinoscrotal hernia is a type of inguinal hernia that extends into the scrotum in men. This can result in a visible swelling in the groin and scrotum and often develops over time if the hernia is left untreated.
An indirect inguinal hernia is another type that follows the pathway of the inguinal canal and is often related to the natural anatomy of the area.
These distinctions of an inguinal hernia help patients and clinicians understand the location, severity and treatment approach for different inguinal hernias.
Testicular involvement
There are many myths and rumours, even jokes, about hernia and testicles. The most common problem that really matters is that in a small number of cases, damage can be caused by the hernia (especially if neglected) or the repair if not performed well. Sometimes it is simply bad luck. We speak here of testicular atrophy – which means death of that tissue. That often requires the removal of the affected testicle.
The blood supply to the testicle runs through the inguinal canal. Careless or inexpert surgery can damage the blood supply or the blood supply could be compromised for several other reasons. Damage to the blood supply is more likely if re-operating for recurrent inguinal hernia because of the scar tissue, difficulty of recognising structures and the blood vessels not being in their ‘correct’ position
Treatment and inguinal hernia repair
There are always risks associated with any surgery, but repairing the hernia by an experienced specialist can help reduce complications and improve outcomes. Inguinal hernia repair is a commonly performed procedure designed to strengthen the weakened area and prevent the hernia from returning.
For some people, lifestyle adjustments such as avoiding heavy lifting may help reduce discomfort while waiting for treatment, although they do not repair the underlying hernia.
When is an inguinal hernia an emergency?
Seek urgent medical attention if the hernia becomes painful, cannot be pushed back, becomes firm or tender, or is associated with nausea, vomiting, or changes in bowel movements. These may be signs of an incarcerated hernia or strangulated hernia, which require prompt assessment.
How can The British Hernia Centre help?
The British Hernia Centre is the UK’s only dedicated specialist hernia centre, backed by over 30 years of expertise. With a proven track record, it now performs more hernia and inguinal hernia operations than any other surgical unit in the world. Contact our team today for more information or to book a consultation.