A B C D E F G H I J K L M N O P R S T U V W

INGUINAL / FEMORAL HERNIA

What is an Inguinal Hernia ?

A hernia usually consists of a pouch from inside the abdominal wall. It protrudes completely through a weakness in the muscles and contains fatty tissue and loops of bowel. At the start of the trouble, you may have noticed a sudden pain in the groin. This is then followed by the development of a swelling in that area, either immediately or over the next few weeks. At times, this swelling may slide back or can be pushed back. It is then called reducible. If it cannot be pushed back, it is called irreducible. An inguinal and femoral hernia are virtually the same. The names only refer to different parts of the lower abdominal wall in which the weakness has developed.

How does an Inguinal Hernia occur ?

Because of a weakness in the wall of the abdomen, a small pouch of the abdomen lining pushes outwards. The pressure in the abdomen makes this pouch gradually bigger. Soon there is room for it to contain a loop of bowel.

Why does an Inguinal Hernia occur ?

A weakness in the muscles overlying the groin region is the basic fault. This can be congenital, as when a baby is born with a hernia, or the weakness can develop in later life. It is then due to excessively straining the muscles of the groin region. This may happen as a result of chronic cough. Some people tend to be constipated and therefore strain to have their bowels open, or they may strain to pass urine because of a prostate gland enlargement. The weakness may also occur as a result of excessive straining while lifting heavy objects.

Treatment Involved for an Inguinal Hernia

The ideal treatment for hernias is surgical repair. However, because of age or other medical reasons, it may be decided that your hernia is unsuitable for surgery. Provided the contents of the pouch can be reduced (returned into the abdominal cavity), a truss may then be worn. This is a pad over the site of the weakness in the muscle wall. It should be worn when you are walking around. This then prevents the pouch from protruding through the weakness. Surgical repair is usually done in hospital under a general anaesthetic. Sometimes a local anaesthetic may be used and you will then only need to be in hospital for a day. The incision is usually over the site of the swelling in the groin region. The pouch of the hernia is first dealt with, and its contents returned to the inside of the abdominal cavity. The pouch is then removed and the weakness in the muscle wall strengthened. This is usually done with some strong stitches but may require a patch of nylon material to be inserted.

During Treatment for an Inguinal Hernia

If the truss being worn is not holding back the swelling, you should either not wear it or else have it changed for a more effective one. Damage to the bowel inside the pouch may otherwise occur. Some people have to wait a while for their operation. If the hernia becomes irreducible, blockage of the bowel can occur. This leads to bowel obstruction which causes vomiting and abdominal pain. In that case, you must let your doctor know immediately.

After Treatment for an Inguinal Hernia

There will be some discomfort and tenderness where the cut was made. It is important that you try to walk normally from the first possible opportunity, and overcome the stoop which comes rather naturally from having had an operation in that region of your body. Simple painkilling tablets will relieve most of the discomfort and the stitches will be removed after one week. It is usually advisable not to put excessive stress on the operated area for 3 to 4 weeks after the operation. This means avoiding driving, cycling, or lifting heavy weights until the wound is completely healed. If your work does not involve heavy lifting or violent exercise, then a return to work could be as soon as 2 weeks. If it does, then it is safer to wait for a further 2 to 3 weeks. If this advice is not heeded, the repair could break down and the hernia will recur.

If an Inguinal Hernia is Left Untreated

The weakness in the muscle wall would get greater. More of the bowel would protrude into the pouch causing the hernia to get larger, unsightly and uncomfortable. Eventually obstruction of the bowel might occur which would then require an emergency operation.