What to Do About a Groin Hernia

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An inguinal hernia is when a section of the intestine bulges through a weak spot in the inguinal canal. The inguinal canal is a passageway through the abdominal wall near the groin.

The first sign of an inguinal hernia is usually an unexplained bulge in the groin area. This type of hernia can be present at birth or develop over time.

This article looks at the causes, symptoms, and risk factors of an inguinal hernia, and how they are treated.

Protecting Your Incision After Inguinal Hernia Surgery

Verywell / Ellen Lindner

Symptoms

Symptoms of an inguinal hernia may include:

  • A bulge in your groin to the left or right of your pubic bone
  • A feeling of heaviness or pressure
  • Pain when lifting something, bending over, or straining
  • Pain when coughing
  • Pain that radiates from your pelvis to your leg

Inguinal hernias don't always have symptoms. When they do, the symptoms may be present at some times and not at others.

Inguinal hernias can differ in size. Initially, the hernia may only be a small lump in the groin but can grow much larger over time.

Some hernias may be so small that only the peritoneum—the lining of the abdominal cavity—protrudes from the muscle wall. In severe cases, portions of the intestines may push through the hole in the muscle and fill the inside of the scrotum.

An inguinal hernia may also appear to grow and shrink with different activities.

Increased abdominal pressure during activities, such as straining to have a bowel movement or sneezing, may push more of the intestines into the herniated area, making the hernia appear to grow temporarily.

Lifting heavy objects, working out, and exercises that use the abdominal muscles can also make the hernia bulge.

Causes 

An inguinal hernia is caused by a weakness in the muscle of the groin. It can be present at birth due to a small muscle defect or can develop over time.

Repetitive straining to have a bowel movement can cause a hernia. So can straining to urinate, as often happens with prostate problems. A chronic cough, from lung disease or from smoking, can also contribute to a hernia.

Obesity can increase the chances of developing a hernia, too. For some people, losing weight may prevent a hernia from forming or growing in size, while exercise can make hernias temporarily bulge to an even larger size.

Types

An inguinal hernia is a hernia located above the inguinal ligament. It can be hard to tell from a femoral hernia, which is a hernia located below the inguinal ligament.

Sometimes a specialist is needed to confirm which type of hernia you have. In fact, it is possible you may not know which type of hernia you have until surgery.

Healthcare providers use different terms to describe the location of a hernia and its status and severity:

  • Direct: With a direct hernia, the bulge is in the back of the inguinal canal.
  • Indirect: With an indirect hernia, the bulge is in the inguinal ring.
  • Incarcerated: A hernia that gets stuck in the “out” position is called an "incarcerated hernia." This is a common complication of inguinal hernias. An incarcerated hernia is not an emergency, but it should be addressed, and medical care should be sought.
  • Strangulated: A strangulated hernia means blood flow has been cut off to the incarcerated tissue. It can be identified by the deep red or purple color of the bulging tissue. It may be accompanied by severe pain, but it is not always painful. Nausea, vomiting, diarrhea, and abdominal swelling may also be present.

An incarcerated hernia is an emergency when it becomes strangulated. This can cause the death of the tissue that is bulging through the hernia.

Risk Factors

Inguinal hernias are eight to 10 times more likely to occur in males than females. Pregnant females have a higher risk of developing a hernia than females who are not pregnant.

Those who are also at higher risk include:

  • People with a family history of inguinal hernias
  • Older age
  • Chronic constipation
  • Males. Men are eight times more likely to form a hernia than women.

Inguinal hernias are present at birth in up to 5% of all children.

Treatment

An inguinal hernia will not heal by itself and requires surgery to be repaired.

Hernia Surgery

Inguinal hernia surgery is typically performed using general anesthesia. It can be done on an inpatient or outpatient basis. The surgery is performed by a general surgeon.

The surgery can be done with an open incision, laparascopically, or robot-assisted.

The surgeon isolates the “hernia sac,” the portion of the abdominal lining that is pushing through the muscle. The surgeon returns the hernia sac to its proper position inside the body, then repairs the muscle defect.

If the defect in the muscle is small, it may be sutured closed. The sutures are placed to prevent the hernia from returning.

For large defects, suturing may not be adequate. In this case, a mesh graft will be used to cover the hole. The mesh is permanent and prevents the hernia from returning, even though the defect remains open.

When defects the size of a quarter or larger are sutured, there is an increased chance of recurrence. The use of mesh in larger hernias is the standard of treatment, but it may not be appropriate if the person has a history of rejecting surgical implants or a condition that prevents the use of mesh.

Once the mesh is in place or the muscle has been sewn, the laparoscope is removed and the incision can be closed. This is done in one of several ways:

  • With sutures that are removed at a follow-up visit
  • With a special form of glue that holds the incision closed without sutures
  • With small sticky bandages called "steri-strips"

Recovery

Most people are able to return to their normal activity within two to four weeks after hernia surgery. The area will be tender, especially for the first week. During this time, the incision should be protected during any activity that increases abdominal pressure. To do this, apply firm but gentle pressure on the incision line.

Activities during which the incision should be protected include:

  • Moving from a lying position to a seated position or from a seated position to standing
  • Sneezing
  • Coughing
  • Crying
  • Bearing down during a bowel movement
  • Vomiting
  • Lifting heavy objects (which should be avoided during the recovery process)

Summary

An inguinal hernia happens when part of the intestine protrudes through a weak spot in the muscle. It usually appears as a bulge in the groin.

Males are more likely to get inguinal hernias than females. Some inguinal hernias can be present at birth.

The only way to repair an inguinal hernia is with surgery. The surgery is usually done with a laparoscope. Recovery time is typically around two to four weeks. 

A Word From Verywell

If you have a hernia, the first step to treatment is to have a consultation with a surgeon who regularly repairs inguinal hernias. Surgery may or may not be recommended, depending on symptoms, your health, and any risk factors that may be present.

For those with minor symptoms, the risk of surgery may outweigh the benefits of the procedure. Others may feel the procedure is absolutely necessary for cosmetic reasons rather than symptom management.

Frequently Asked Questions

  • What does a hernia in the groin look like?

    An inguinal hernia in the groin looks like a bulge or bump. When you stand or bear down for a bowel movement, the bulge may be more noticeable. It may also grow larger over time.

  • What can be mistaken for a hernia?

    Most abdominal bulges turn out to be hernias, but a couple of other conditions can have a similar appearance. In females, hernias are sometimes misdiagnosed as ovarian cysts, endometriosis, or fibroids. In rare cases, a lump in the abdomen could be a tumor.

  • How long does hernia surgery take?

    Hernia surgery usually takes between 30 and 90 minutes, depending on the size and type of hernia. You will probably spend one or two hours in the recovery room afterwards. Most people can go home the same day. 

  • What happens if you lift too much after hernia surgery?

    Lifting too much, too soon after hernia surgery can cause the hernia to recur. Most surgeons will advise you to avoid lifting anything heavier than 15 pounds for up to six weeks after your surgery. Heavy lifting should be avoided for six months. 

  • How much does hernia surgery cost?

    Like all medical procedures, the cost of hernia repair varies depending on where you live, whether you have insurance, and if you have the procedure at a hospital or outpatient surgery center. The national average for hernia surgery is $7,750, though the cost can be as low as $3,900 or as high as $12,500.

10 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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Additional Reading
  • National Institutes of Health. Hernia.

By Jennifer Whitlock, RN, MSN, FN
Jennifer Whitlock, RN, MSN, FNP-C, is a board-certified family nurse practitioner. She has experience in primary care and hospital medicine.