Femoral hernia : A guide to Hernias

A femoral hernia is less common than an inguinal hernia and tends to affect women, due to the wider female pelvis. It is caused by a protrusion of tissue into the top of the groin or the inside of the thigh.

This type of hernia occurs lower down the groin than where an inguinal hernia forms and tends to be smaller as well. This hernia is comprised of bodily tissue or part of the lower intestine and pushes through the abdominal wall via a weak spot called the ‘femoral canal’.

The femoral canal

This tubular shaped opening lies at the front of the thigh and near the top. It is the point at which major blood vessels and nerves pass from the abdomen into the leg.

Whilst this performs an important function it also has a downside in that it is a potential weak point in the abdominal wall. This is where a hernia is likely to develop.

Around 75% of femoral hernias cases occur in women.

The causes of a femoral hernia

If there is an underlying weakness in that area then a hernia will develop. If pressure is increased inside or outside the abdomen then that will also increase the risk of a hernia. These include excessive coughing especially if you are a smoker and straining during a bowel movement.

Other causes include:

• Obesity: excessive weight puts extra strain on the abdomen which can lead to the development of a hernia.
• Constipation: this can cause excessive straining on the toilet which is also risky.
• Lifting or carrying excessive loads.
• Pregnancy: a single or several pregnancies can weaken the abdominal muscles and so increase the risk of a hernia forming. This is usually the main reason why femoral hernias are more common in women.
• Growth in the bowel.

The symptoms of a femoral hernia

This type of hernia is much smaller than a hiatus hernia or an inguinal hernia and may not be noticeable. It is usually the size of a grape and shaped like a small loop.

As a result of the small size, most people don’t experience any symptoms and may not realise that they have a hernia unless complications arise. If a hernia is diagnosed then it may be mistaken for an inguinal hernia – which is due to the fact that it develops close to where inguinal hernias occur.

Any symptoms experienced will include a tired, ‘dragging’feeling around your lower abdomen/groin area or a dull ache in that area.

You may find that this hernia disappears when you lie down but reappears when you stand up or lean forward.

Can a femoral hernia be prevented?

There are a few measures you can put in place to reduce the risk of developing a femoral hernia. These include:

• Stopping smoking
• Eating a diet high in fibre, fresh fruit, vegetables and wholegrain foods. This will help to prevent constipation.
• Building strong abdominal muscles through exercise.
• Maintaining a healthy weight or losing weight if carrying a few extra pounds.
• Avoiding lifting heavy objects or if you have to, use lifting equipment or a proper technique.

Complications with a femoral hernia

A femoral hernia may be small enough to be pushed back into the abdomen. This is known as a ‘reducible’ hernia.

But in most cases it remains in the canal – known as an ‘irreducible’ hernia. The problem with this is that the blood supply to the hernia can become blocked which prevents it from receiving vital nutrients. This leads to a condition called a strangulated hernia which is potentially dangerous and requires immediate surgery to release the blocked tissue and restore a blood supply to that area.

How do you know if you have got a strangulated hernia? If you find that you feel sick or have been sick; are passing blood; have a painful or distended abdomen; feel weak and tired and have a racing heartbeat, then these are all signs that your hernia has strangulated.

If you experience any of these then seek medical advice urgently.

Diagnosing a femoral hernia

If you recognise any of the symptoms mentioned above then visit your GP. He/she will ask you about your lifestyle, medical history and will also examine the area where you have the hernia.

There is a high risk of strangulation with a femoral hernia, more than any other type of hernia, so surgery is necessary. At one time, a truss was advised as a means of support but this is no longer the case. Surgery is a very effective means of fixing this and any other type of hernia and can be performed as a day case.

Treatment for a femoral hernia

See above. A hernia can be fixed via a straightforward operation which is performed as day surgery. This means that you will be able to return home the same day.

There are two types of hernia surgery:

• Open ‘mesh’surgery
• Keyhole (laparoscopic) surgery

If you are unfortunate to suffer from a strangulated hernia then you will undergo a complex procedure which will mean a period of time spent in hospital. So, if you think that you have developed a femoral hernia then seek treatment as soon as possible.

Hernia surgery is discussed in more detail in our treatment for hernias section.

Other types of hernia include:

• Hiatus hernia
• Inguinal hernia
• Umbilical hernia
• Incisional hernia
• Epigastric hernia
• Spigelian hernia
• Sports hernia