A hernia occurs when an internal part of the body pushes through a weakness in the muscle or surrounding tissue wall.
Your muscles are usually strong and tight enough to keep your intestines and organs in place, but sometimes they are not, which causes a hernia.
What is an inguinal hernia?
An inguinal (pronounced "ingwanal") hernia is the most common type of hernia. The hernia can appear as a swelling in your groin or as an enlarged scrotum (the pouch containing the testicles), which may be painful. The swelling will often appear when you are lifting something and disappear when you lie down.
There are two types of inguinal hernia:
- An indirect inguinal hernia is the most common type of hernia, which can occur at any age and is more likely to cause pain in the scrotum.
- A direct inguinal hernia is more common in older men and rare in children.
What causes an inguinal hernia?
An inguinal hernia usually occurs when fatty tissue or a part of your bowel, such as the intestine, pokes through into your groin at the top of your inner thigh.
It pushes through a weak spot in the surrounding muscle wall (the abdominal wall) into the inguinal canal. The inguinal canal is a channel through which blood vessels to the testicles pass in men and through which the round ligament passes in women.
Straining, for example on the toilet, increases pressure inside the abdomen and can trigger a hernia. Other triggers include:
Inguinal hernias occur mainly in men. Most are thought to be due to ageing. This is because as you get older, the muscles surrounding your abdomen can become weaker.
When is surgery needed?
An inguinal hernia repair is an operation to push the bulge back into place and to strengthen the abdominal wall. The operation may be recommended if symptoms are severe, last for a long time, or if there are complications.
The section of bowel can become:
- stuck in the inguinal canal, causing an obstruction – this causes nausea, vomiting and stomach pain, as well as a painful lump in the groin
- trapped and have its blood supply cut off (known as a strangulated hernia) – emergency surgery within hours is essential to release the trapped tissue and restore its blood supply so it does not die
Surgery will get rid of the hernia and prevent any serious complications.
What happens during surgery?
There are two ways that an inguinal hernia repair can be performed:
- open surgery – where one cut is made to allow the surgeon to push the lump back into the abdomen
- keyhole surgery – a less invasive but more difficult technique where several smaller cuts are made, allowing the surgeon to use various instruments
There are advantages and disadvantages to both methods. The type of surgery you have will depend on which method suits you and your surgeon’s experience. Read more information about how an inguinal hernia repair is performed.
When recovering from an inguinal hernia repair, you should be able to go home the same day or the day after surgery. It's important to follow the hospital's instructions on how to look after yourself. This includes eating a good diet to avoid constipation, caring for the wound and not straining yourself too soon.
Are there any risks from the operation?
An inguinal hernia repair is a routine operation with very few risks. However, around 1% of inguinal hernias will return after the operation.
Although complications due to an inguinal hernia repair are rare, they can include:
- blood or fluid building up in the space left by the hernia (this will usually get better without treatment)
- painful swelling and bruising of the testicles
- pain and numbness in the groin area caused by damage of a nerve during surgery
- stitches trapping a nerve, mesh applied too tightly, or scar tissue forming (this is more common after open surgery)
Complications are more likely if you are over 50 or you have another illness, such as heart disease or breathing problems.
For information on other types of hernia see:
