HERNIAS

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What causes an inguinal hernia

An inguinal hernia usually occurs when fatty tissue or a part of your bowel, such as the intestine, protrudes 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 an area called the inguinal canal.

Inguinal hernias occur mainly in men. Most are thought to result from ageing, although they can occur at any age.

This is because as you get older, the muscles surrounding your abdomen can become weaker.

Inguinal hernias can sometimes appear suddenly after putting pressure on the abdomen, such as straining on the toilet if you have constipation or carrying and pushing heavy loads.

They have also been linked to having a persistent, heavy cough.

When is surgery needed

Inguinal hernias can be repaired using surgery to push the bulge back into place and strengthen the weakness in the abdominal wall with a mesh patch.

The operation is usually recommended if you have a hernia that causes pain, severe or persistent symptoms, or if any serious complications develop.

Complications that can develop as a result of an inguinal hernia if not treated and include:

  • obstruction – where a section of the bowel becomes stuck in the inguinal canal, causing nausea, vomiting and stomach pain, as well as a painful lump in the groin

  • strangulation – where a section of bowel becomes trapped and its blood supply is cut off; this requires emergency surgery within hours to release the trapped tissue and restore its blood supply so it doesn't die

Surgery gets rid of the hernia to prevent any serious complications, but there's a chance it could return after the operation although this is very small.

What happens during surgery

There are 2 ways an inguinal hernia repair can be performed:

  • open surgery – where a cut is made to allow the surgeon to push the lump back into the abdomen

  • laparoscopic (keyhole) surgery – a less invasive, but more difficult, technique where several smaller cuts are made, allowing the surgeon to use various special instruments to repair the hernia

There are advantages and disadvantages to both methods. The type of surgery you have depends on which method suits you and the nature of your hernias.

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.

Most people make a full recovery from inguinal hernia repair within 6 weeks, although many people can return to driving within 7 days, work and light activities within 2 weeks.

Are there any risks from the operation

An inguinal hernia repair is a routine operation with very few risks. But a small number of hernias can come back at some point after surgery.

Other potential complications of an inguinal hernia repair include:

  • blood or fluid building up in the space left by the hernia (this  usually gets better without treatment)

  • painful swelling and bruising of the testicles or the base of the penis (in men)

  • pain and numbness in the groin area caused by a nerve being damaged or trapped during surgery

  • damage to the blood supply to the testicle

  • damage to the vas deferens (the tube that carries sperm to the testicles)

Complications are more likely if you, smoke or have another illness, such as heart disease or breathing problems or are on anti-coagulants. Our surgeons might suggest a local anaesthetic approach.