Inguinal Hernia – Diagnosis and Treatment
Diagnosis
Doctors usually find an inguinal hernia by doing a physical examination. The patient stands and may be asked to cough or use the Valsalva maneuver.
This helps show any bulge in the groin area. If symptoms are uncertain or the bulge cannot be found, doctors may order imaging tests like ultrasonography, CT scan, or MRI.
These tools help doctors detect both direct and indirect hernias. They also help check the accuracy of the findings.
In some cases, the doctor may assess for complications, such as a strangulated hernia, which requires urgent treatment. Signs of a strangulated hernia include severe pain, nausea, vomiting, and redness or tenderness over the bulge.
Doctors may also review the patientโs medical history, symptoms, and any history of heavy lifting, chronic cough, or prior abdominal surgery, as these can increase hernia risk.
Treatment
Traditional Surgery with a Single Cut
In this type of hernia repair, a surgeon uses either local numbing medicine with sedation or puts the patient fully to sleep. The doctor makes a cut in the groin area.
The surgeon gently pushes the bulging tissue back inside the belly. The doctor then covers the weak part of the muscle wall with a special mesh to make it stronger.
This mesh helps prevent the hernia from coming back. Doctors call this operation open hernia repair or open herniotomy.
The surgeon closes the cut with staples, stitches, or medical glue. After surgery, most people are encouraged to stand up and walk as soon as possible.
It might take a few weeks before people can return to all their normal activities.
Possible issues:
- Pain in the area for a short time
- The hernia returning (recurrence)
- Bleeding or infection
- Rarely, damage to nearby parts inside the body (complications)
Some patients may need another operation if their hernia comes back. The chance of a hernia coming back after open repair is small, but not zero.
Keyhole Surgery with Small Cuts
A newer type of hernia surgery uses several small incisions instead of one big cut. Doctors call this minimally invasive or laparoscopic hernia repair.
General anesthesia keeps the patient comfortable during the operation. A camera, called a laparoscope, goes in through one of the small openings.
The doctor uses the camera to see inside the belly. The surgeon uses tiny tools through other cuts to push the tissue in place and cover the weak spot with mesh.
Gas is pumped in to make more space for the repair.
Benefits:
- Smaller scars
- Usually less discomfort after surgery
- May lead to a quicker recovery
When it may be used:
- If the hernia has returned after earlier surgery
- If there are hernias on both sides of the groin
Some people may have pain, infection, or other problems, but serious complications are rare. Most people return to normal activities faster, but full recovery still takes a few weeks.
| Surgery Type | Main Features | Possible Complications | Mesh Used | Recovery Time |
|---|---|---|---|---|
| Traditional Repair | Larger cut, single site | Bleeding, infection, recurrence | Yes | Weeks |
| Laparoscopic Repair | Small cuts, uses camera | Pain, infection, recurrence | Yes | Usually quicker |
Getting Ready for Your Visit
Steps to Take Before Seeing Your Provider
Write down any symptoms you have, along with when they started and if they’ve changed. Note if you have a chronic cough, smoke, or have had problems with abdominal pressure or constipation.
These factors can raise your risk for hernias. Include on your list:
- All medications, vitamins, and supplements you use, with doses.
- Any recent changes in your life or family health history.
- Your questions for the doctor about causes, tests, treatments, surgery, and prevention.
Bringing a friend or family member can help you remember important details shared at the appointment.
Sample questions to ask:
| Topic | Questions You Might Consider |
|---|---|
| Symptoms | What might be causing my symptoms? |
| Diagnosis | Are there tests I need to confirm my hernia? |
| Treatment Options | What are the treatment choices? |
| Surgery & Recovery | What can I expect if I need surgery? |
| Risk Factors | How do factors like smoking or constipation affect my risk? |
What the Doctor Will Want to Know
The health provider will likely ask about your symptoms, including how long you’ve had them and if they’ve gotten better or worse. They may ask about any pain in your abdomen or groin, what makes it worse or better, and if you have a history of constipation or chronic cough.
Questions may include:
- When did your symptoms begin?
- Have the symptoms changed?
- Have you noticed any bulge changing color?
- Have you ever had an inguinal hernia before?
- Do you smoke or have you smoked in the past?
- What physical activities do you do at work or home?
Be ready to share honestly about your daily routine. Activities that put pressure on your abdomen, as well as smoking or bowel habits, can impact your condition.
Things to Do While Waiting for Your Appointment
If you have a hernia, avoid heavy lifting or activities that strain your abdomen. If you smoke, consider cutting back or quitting, because smoking can make healing harder and is a risk factor for hernias.
Manage any constipation by eating high-fiber foods and drinking enough water. If you have a chronic cough, try to control it with your usual medications or treatments.
Seek emergency care right away if you start to feel very sick, have a fever, feel severe pain, or if the bulge turns red, purple, or dark. These could be signs of complications and need quick attention.
Additional Details
Different types of hernias can occur in the abdominal wall. The most common kinds include inguinal, femoral, and umbilical hernias.
Each type has features based on where it appears and who it affects. Inguinal hernias happen most often in men and usually develop near the groin.
Femoral hernias are less common and often seen in women. These appear just below the groin area, where the femoral artery passes into the upper thigh.
Umbilical hernias show up around the belly button and can affect both children and adults.
Classification of Hernias:
| Type | Location | Common In |
|---|---|---|
| Inguinal | Groin area | Men |
| Femoral | Upper thigh, below groin | Women |
| Umbilical | Around belly button | Children, Adults |
All hernias have one thing in common: part of the tissue pushes through a weak spot in the muscles of the abdominal wall. They may cause discomfort, especially when coughing, lifting, or standing for a long time.
