Inguinal Hernia


What is it? The term “inguinal hernia” is used to describe a hole on the muscles in the area of the groin.
Why it happens: It develops because of increased pressure in the abdomen. This increased pressure can be the result of a wide range of activities such as heavy manual handling, exercise or weight lifting but also coughing, laughing, sneezing of being chronically constipated.
Frequency: An inguinal hernia can develop in either side of the body. It is much more common in men than in women because of the presence of testicles. The muscles in the area of the groin of men have a pre-existing opening through which the testicles descent in the scrotum (that is the sac that holds the testicles).
Types: There are 2 types of inguinal hernias; indirect and direct. The indirect is a much more common type of hernia and can be present from birth. This type of inguinal hernia can extend to the scrotum and in extreme cases the scrotum can have the size of a football ball. A direct hernia is the result of weakening of the abdominal muscles. It is more likely seen in adults.


The main symptom is that of a bulge in the area of the groin. The bulge may or may not be painful. Some hernias may slide back and forth – when this is the case the bulge may not be visible all the time, particularly when lying flat. Some patients are able to massage the bulge back to the abdomen on their own. Other symptoms include an increase in the size of the bulge, a sudden pain in the groin or scrotum when straining, or a feeling of weakness, burning, aching or pressure in the groin.


In most cases a careful medical history and a physical examination will diagnose the hernia. Sometimes it may be required to have some radiology imaging, either an ultrasound or an MRI scan.


There is no medication for hernias and therefore management is either watchful waiting (observing the hernia if it causes no symptoms) or surgical repair. A support belt (hernia belt/truss) may be used to keep the hernia in most of the time however; this is only offering symptomatic control as essentially the hernia remains in place. There are different options on how to repair an inguinal hernia:
Open mesh repair of inguinal hernias – This is the single most frequently performed operation worldwide. An incision is made through the skin to the groin area. The surgeon pushes the bulge back into the abdomen and then uses a synthetic mesh to strengthen the closure.
Open non mesh repair of inguinal hernias – It is a technique where you are following steps very similar to the mesh repair. When the time to strengthen the closure comes, instead of using a mesh the surgeon is using native tissue from the area of the groin.
Laparascopic repair of inguinal herniasThis type of surgery uses small incisions and a scope/camera. The surgeon repairs the hernia while working through the scope and a synthetic mesh is used to strengthen the repair.

Follow Up

If you had surgery for inguinal hernia 
  • It is important to follow all your doctor’s instructions, take any medication prescribed regularly and keep your follow-up appointments.
  • Getting out of bed and walking is an important part of recovery and helps prevent complications.
  • Take steps to avoid becoming constipated. Eat lots of fiber, drink plenty of fluids, exercise, and go to the bathroom when you feel the urge.
  • Try avoiding heavy lifting and other strenuous activity. Ask your doctor what types of activities are safe and for a timed plan on when to resume your normal lifestyle. You should also ask when you can return to work which will depend on the type of your job.
  • Do not drive before you feel safe to emergency break – check with your insurance company for any small prints in your policy
If you have a hernia that is being watched
  • Take steps to avoid becoming constipated. Eat lots of fiber, drink plenty of fluids, exercise, and go to the bathroom when you feel the urge.
  • Try avoiding heavy lifting and other strenuous activity whenever possible.
  • Call your doctor if your inguinal hernia symptoms get worse or if the bulge becomes bigger
Seek immediate medical attention if
  • You have a painful bulge that can’t be pushed back inside
  • If you have increasing pain, swelling, or redness
  • If you have nausea, fever, or vomiting along with hernia pain