An inguinal hernia occurs when tissue, such as part of the intestine, protrudes through a weak spot in the abdominal muscles. The resulting bulge can be painful, especially when you cough, bend over or lift a heavy object. An inguinal hernia isn’t necessarily dangerous. It doesn’t improve on its own, however, and can lead to life-threatening complications. Your doctor is likely to recommend surgery to fix an inguinal hernia that’s painful or enlarging. Inguinal hernia repair is a common surgical procedure.
Inguinal hernia signs and symptoms include:
- A bulge in the area on either side of your pubic bone, which becomes more obvious when you’re upright, especially if you cough or strain
- A burning or aching sensation at the bulge
- Pain or discomfort in your groin, especially when bending over, coughing or lifting
- A heavy or dragging sensation in your groin
- Weakness or pressure in your groin
- Occasionally, pain and swelling around the testicles when the protruding intestine descends into the scrotum
If you aren’t able to push a hernia in, the contents of a hernia can be trapped (incarcerated) in the abdominal wall. An incarcerated hernia can become strangulated, which cuts off the blood flow to the tissue that’s trapped. A strangulated hernia can be life-threatening if it isn’t treated.
Signs and symptoms of a strangulated hernia include:
- Nausea, vomiting or both
- Sudden pain that quickly intensifies
- A hernia bulge that turns red, purple or dark
- Inability to move your bowels or pass gas
Signs and symptoms in children-
Inguinal hernias in newborns and children result from a weakness in the abdominal wall that’s present at birth. Sometimes the hernia will be visible only when an infant is crying, coughing or straining during a bowel movement. He or she might be irritable and have less appetite than usual.
In an older child, a hernia is likely to be more apparent when the child coughs, strains during a bowel movement or stands for a long period.
Some inguinal hernias have no apparent cause. Others might occur as a result of:
- Increased pressure within the abdomen
- A pre-existing weak spot in the abdominal wall
- A combination of increased pressure within the abdomen and a pre-existing weak spot in the abdominal wall
- Straining during bowel movements or urination
- Strenuous activity
- Chronic coughing or sneezing
Factors that contribute to developing an inguinal hernia include:
- Being male. Men are eight times more likely to develop an inguinal hernia than are women.
- Being older. Muscles weaken as you age.
- Being white.
- Family history. You have a close relative, such as a parent or sibling, who has the condition.
- A chronic cough, such as smoking.
- Chronic constipation. Constipation causes straining during bowel movements.
- Pregnancy. Being pregnant can weaken the abdominal muscles and cause increased pressure inside your abdomen.
- Premature birth and low birth weight.
- Previous inguinal hernia or hernia repair. Even if your previous hernia occurred in childhood, you’re at higher risk of developing another inguinal hernia.
Complications of an inguinal hernia include:
- Pressure on surrounding tissues- Most inguinal hernias enlarges over time if not repaired surgically. In men, large hernias can extend into the scrotum, causing pain and swelling.
- Incarcerated hernia- If the contents of a hernia become trapped in the weak point in the abdominal wall, it can obstruct the bowel, leading to severe pain, nausea, vomiting, and the inability to have a bowel movement or pass gas.
- Strangulation- An incarcerated hernia can cut off blood flow to part of your intestine. Strangulation can lead to the death of the affected bowel tissue. A strangulated hernia is life-threatening and requires immediate surgery.
- Open hernia repair- In this procedure, which might be done with local anesthesia and sedation or general anesthesia, the surgeon makes an incision in your groin and pushes the protruding tissue back into your abdomen. The surgeon then sews the weakened area, often reinforcing it with a synthetic mesh (hernioplasty). The opening is then closed with stitches, staples or surgical glue. After the surgery, you’ll be encouraged to move about as soon as possible, but it might be several weeks before you’re able to resume normal activities.
- Laparoscopy- In this minimally invasive procedure, which requires general anesthesia, the surgeon operates through several small incisions in your abdomen. Gas is used to inflate your abdomen to make the internal organs easier to see. A small tube equipped with a tiny camera (laparoscope) is inserted into one incision. Guided by the camera, the surgeon inserts tiny instruments through other incisions to repair a hernia using synthetic mesh. People who have laparoscopic repair might have less discomfort and scarring after surgery and a quicker return to normal activities. However, some studies indicate that hernia recurrence is more likely with laparoscopic repair than with open surgery.
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