Groin (inguinal) hernia
A bulge in the groin that grows when you stand or cough and shrinks when you lie down. What a hernia is, when surgery is needed, how open and laparoscopic repair differ, and what the mesh does.
What is a groin hernia?
The abdominal wall has natural weak spots in the groin. A hernia happens when fatty tissue or part of the bowel pushes out through one of them. Groin hernias are far more common in men, but women have them too.
What are the signs?
- A bulge in the groin or scrotum that grows when you stand, cough or strain
- The bulge shrinks or disappears when you lie down
- Heaviness or pain in the groin, especially when lifting
Some hernias cause no pain at all and are found only in the shower or at an examination.
When is it urgent?
If the bulge suddenly becomes hard and painful and will not go back, especially with nausea, vomiting or no passing of wind or stool, the hernia may be trapped. Sometimes the blood supply to the trapped part is cut off, and this needs emergency surgery. Do not wait for an appointment: go to the emergency department or call 115.
How is it diagnosed?
Most groin hernias are diagnosed by examination. The doctor examines the groin while you stand, and sometimes while you cough. If the diagnosis is unclear, an ultrasound or other imaging helps.
Is surgery needed?
A hernia in an adult does not heal by itself, and surgery is the only way to repair it. But not everyone needs surgery at once. A hernia that causes pain or limits you is usually offered repair. For a man with a small hernia and no symptoms, watching it is also an accepted choice.
A femoral hernia is a less common type that lies below the groin ligament and is seen more in women. It is more likely to become trapped, so repair is usually offered sooner.
Two ways to repair it
- Open surgery: a cut is made over the groin, the hernia is put back and the wall is strengthened. It can sometimes be done under local or spinal anaesthesia.
- Laparoscopy: a camera and slim instruments go in through a few small cuts, and a mesh is placed behind the wall over the weak spot. It usually needs general anaesthesia.
Neither is better for everyone. The type of hernia, a hernia on both sides or one that has come back, earlier abdominal surgery and other illnesses all play a part. The right method for you is decided at your visit.
What is mesh?
Mesh is a thin medical net that strengthens the weak spot. It is used in most adult hernia repairs because it lowers the chance of the hernia coming back. There is more in the article What is mesh, and what should I ask?
Risks and recovery
Like any operation, this one has risks: bruising and swelling, wound infection, temporary difficulty passing urine, numbness or long-lasting pain in the area, injury to nearby structures, and the hernia coming back. Go through these with the doctor before surgery.
When you can go back to work and lifting depends on the operation and your job. See the guide on activity and work.
Frequently asked questions
If my hernia does not hurt, do I still need surgery?
Not always. Some small hernias without symptoms can be watched. The decision depends on the type of hernia, your sex, your age and your other illnesses, and it is made after an examination.
Can a hernia come back after surgery?
It can. The chance is small but not zero, and it depends on the type of hernia, the repair and things like smoking and obesity.
The first step is a calm examination.
Go to the booking page or talk to the support team. Either way, we are here with you.