Inguinal hernia : A guide to Hernias

This is the most common type of hernia. It develops in three out of four hernia cases and is more common in men than women. In fact, 98% of inguinal hernia cases occur in men.

An inguinal hernia occurs when intestinal tissue (the bowel) protrudes through the lower abdominal wall and into the groin.

In men, this tissue pushes through a weak junction in the abdominal wall called the ‘inguinal canal’. This hernia takes the form of a small lump in the groin or it may slip down into the scrotum, causing it to increase in size which is also painful.

In women, this hernia develops when connective tissue of the uterus protrudes into the opening to the vagina.

Older people are at more risk of developing this hernia which may be due to the fact that the abdominal muscles slacken with age.

Inguinal hernia and a brief overview of the inguinal canal

This canal contains blood vessels and also acts as a passageway for the descent of the testes into the scrotum. This descent occurs during the development of the male baby and is an essential part of that process but can also act as a weak spot. A section of the lower intestine can protrude into that canal, resulting in an inguinal hernia.

Two types of inguinal hernia

There are two type of inguinal hernia:

• Direct inguinal hernia
• Indirect inguinal hernia

Direct inguinal hernia

This type of hernia develops in both men and women. It is caused by the protrusion of a section of the lower intestine into the groin (inner fold).

Indirect inguinal hernia

This hernia develops in the inguinal canal (men only).

The causes of an inguinal hernia

An inguinal hernia is caused by any number of factors which include:

• Gender: more common in men than women
• Age: the risk of developing this hernia increases with age
• Carrying a heavy object or lifting a heavy weight
• Straining when on the toilet
• Excess coughing (often caused by smoking)
• Obesity

The symptoms of an inguinal hernia

These include a swelling in the groin and pain after lifting a heavy object or from bending forward. You may experience a heavy feeling in your groin or scrotum (men) or abdominal discomfort.

Reducing the symptoms of an inguinal hernia

In most cases surgery will be required to fix the hernia but there are a few things you can do which will help to ease the symptoms. These include:

• Losing weight (if you are overweight or obese)
• Eating a healthy diet with plenty of fibre
• Avoid straining on the toilet
• Avoid lifting heavy weights or objects

Complications of an inguinal hernia

If an inguinal hernia is not treated then there is every chance that it will increase in size, become more painful and in some cases, lead to a strangulated hernia.

A strangulated hernia is where the protruding section has become tightly squeezed to the extent that its blood supply has been cut off. If this is not restored then that area of tissue will die.

Diagnosing an inguinal hernia

If you have noticed a soft lump or swelling in your groin then this is likely to be a hernia. Arrange an appointment with your GP who will examine your groin to see if there is a telltale lump in that area. He or she will then refer you to an NHS surgeon unless you decide to opt for private treatment.

Whichever option you choose, there will be a few questions you will want to ask which include:

• What type of procedure will I need?
• What are the risks of this surgery?
• How long will it be before I can return to work?
• How much will this cost? (private treatment only)

Treatment for an inguinal hernia

A minor hernia can be pushed back into place but in most cases, surgery is the preferred option. There are two types of procedure available which are:

• Open surgery (with mesh repair)
• Keyhole surgery (laparoscopy)

Both of these procedures are discussed in greater detail in our treatment for hernias section.

Other types of hernia include:

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