Inguinal and Femoral Hernias

What is a hernia?

Hernia is caused by weakness or damage in a tissue layer, resulting in bulging out of tissue held in by that damaged layer.

Hernias happen at various points in the body. Inguinal or femoral hernias occur in the groin region where the thigh and trunk meet. Inguinal hernias are higher in groin than the femoral hernia. Both inguinal and femoral hernias can form a sac holding intestinal loops or omentum (fat pad pieces that normally sit inside the abdomen). The sac can also hold reproductive organs in females.

What are the symptoms of a groin hernia?

Groin hernias are usually asymptomatic. However, they may present with symptoms like:

  • Tugging or heavy feeling in groin
  • Dull pain in the region, getting worse on coughing, straining, weight lifting or using muscles around groin
  • Lump or bulge in groin

Hernias can get very painful and dangerous, especially when the tissue inside the sac gets trapped and can’t slide back into the abdomen. This can result in loss of blood supply to the trapped tissue due to pressure on blood vessels, resulting in damage or death of the tissue part. This is more common in femoral hernias than inguinal hernias.

Should I see a doctor?

Consult with a doctor if you:

  • See or feel a bulge in groin
  • Feel pull or pain in groin even without any bulge

Hernia can usually be diagnosed on physical examination without any investigation. The doctor, while pressing on the bulge, may ask you to cough to feel the hernia.

Usually the content of hernia sac can be reduced manually by gently pushing it back into the abdomen. However sometimes it may get trapped and the tissue get strangulated.

If you feel pain around the hernia or feel sick, immediately go to the hospital, as it can be an emergency.

How are hernias treated?

Some hernias need immediate treatment and repair while others don’t. Usually, femoral hernias need repair, as they’re more likely to cause tissue damage than the inguinal hernias.

Groin hernias can be repaired in 2 ways. The best option depends on individual case based on the size of hernia, was it repaired before or not and what’s the general health of the patient. Options include:

Open surgery

Open surgery includes one large incision near the hernia followed by pushing back the bulging tissue in its place. The weak tissue is then sewed back so that the tissue under it can’t bulge through again. Some hernias may need a mesh to be places, making it more secure so that the hernia is less likely to recur.

Laparoscopic surgery

Laparoscopic surgery includes multiple incisions, all smaller than the open surgery, allowing the surgeon to insert thin and long tools into the region to repair the hernia. Tools include a laparoscope that has a camera and light at the end connected to a TV screen, allowing the surgeon to see the region from inside without opening it up. Then the surgeon uses long tools to stitch the weak tissue layer and may place mesh when needed too.

In case the part of intestine was stuck in the hernia sac and died, your doctor might have to remove it and connect the two ends together.