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Definition
A groin hernia is an external bulge in the groin area that contains fat, connective tissue, and/or a portion of intestine. There are two main types of groin hernias:
Inguinal hernia occurs when there is a weak spot in the area where the abdomen meets the thigh on both sides (most common type)
Femoral hernia occurs much less frequently and is located in the upper thigh
A groin hernia that pushes through the abdominal wall can trap a section of intestine. This may lead to dangerous complications such as intestinal obstruction or strangulation. Both require immediate surgery.
Inguinal Hernias
2008 Nucleus Medical Art, Inc.
Causes
Anything that causes weakness or tears in the abdominal wall can cause a groin hernia, including:
- Defects at birth
- Prolonged wear and tear such as lifting, straining, or coughing
- Age-related weakness of the abdominal wall
- History of previous surgery in the area
Risk Factors
A risk factor is something that increases your chance of getting a disease or condition. Risk factors include:
- Advancing age
- Sex: male (Groin hernias are about 10 times more common in men, but the less common type, femoral hernias, are more common in women.)
- Increased pressure within the abdominal cavity due to:
- Lifting heavy objects
- Straining to urinate or pass stools
- Severe or prolonged coughing
- Obesity
- Pregnancy
Symptoms
Symptoms include:
A bulge in the groin area when standing or strainingPain in the groin area when strainingA bulge that may extend into the scrotum in menPain, a heavy feeling, or discomfort in the groin (Sometimes there is no pain.) More serious symptoms associated with a groin hernia that may require immediate medical care include: Severe pain in the groin or abdomenFeverRapid heart beatAbdominal swellingNauseaVomiting DiagnosisThe doctor will ask about your symptoms and medical history, and perform a physical exam. TreatmentMost inguinal hernias eventually require surgery. For small hernias that can be pushed back into place, a truss or external pad against the weak spot may temporarily provide support. If the hernia bulge can be pushed back in place, surgery may not be needed right away. However, even small hernias eventually need to be repaired. After surgery, hernias sometimes recur in the same place or you may have one on the opposite side. Hernia repair can cause irritation of inguinal nerves leading to pain post-surgery. This complication causes significant disruption in quality of life, but is fortunately rare.Surgeries include:Herniorrhaphy to repair the defect in the abdominal wall Hernioplastyto reinforce the weak area with steel mesh or wire
Bowel resectionto remove a section of the intestine This procedure may be used when part of the intestine becomes twisted or blocked or turns gangrenous and dies.Laparoscopic hernia repair surgerydone through several tiny incisions in the groin or abdomen Recovery may be faster and patients can often resume physical activity earlier. Prevention The following strategies may help to prevent a groin hernia: Lose weight, if you are overweight.Exercise regularly to keep the abdominal muscles strong.Warm up before exercising to avoid straining your muscles.Learn to lift properly and ask for assistance with heavy weights.Always wear a protective belt when lifting heavy weights or moving heavy objects.Eat more fiber to prevent constipation.Stop smoking, especially if you have a chronic cough. Seek medical care if you: Strain when passing stools or urineCough or sneeze a lot RESOURCES: American College of Physicianshttp://www.acponline.org National Institute of Diabetes and Digestive and Kidney Diseaseshttp://www.niddk.nih.gov CANADIAN RESOURCES: Canadian Institute for Health Informationhttp://www.cihi.ca/cihiweb/dispPage.jsp?cw_page=home_e Simcoe MuskokaDisctrict Health Unit
http://www.simcoehealth.org/index.asp References: American College of Physicians Complete Home Medical Guide . DK Publishing; 1999. Hawn MT, Itani KM, Giobbie-Hurder A, McCarthy M Jr, Jonasson O, Neumayer LA. Patient-reported outcomes after inguinal herniorrhaphy. Surgery . 2006 Aug;140(2):198-205. Last reviewed October 2007 by Robert E. Leach, MDPlease be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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