Inguinal Hernia: Signs and When Surgery Is Needed

Inguinal hernias are the most common type of hernia, and about one in four men will have one at some point. They happen when fatty tissue or part of the bowel pushes through a weak spot in the lower tummy wall, near the groin.

Imagine noticing a soft lump in your groin while getting out of the shower. It’s bigger when you stand and seems to vanish when you lie down. It aches a little after a long day. A quick examination confirms a hernia, and you plan a routine repair at a time that suits you.

Signs of an inguinal hernia

• A bulge or lump in the groin, which may extend into the scrotum
• The lump gets bigger when standing, coughing or straining
• It may disappear or can be gently pushed back when lying down
• An aching, dragging or heavy feeling in the groin

Risk factors include being male, getting older, a family history, a chronic cough, constipation and straining, heavy lifting and previous abdominal surgery. Babies, especially those born early, can also get them.

Does it need surgery?

Hernias don’t heal on their own. Surgery is the only way to repair one, usually as a day case using keyhole or open techniques with a mesh. For adults with a small hernia that causes no symptoms, doctors sometimes suggest “watchful waiting”. In women and children, repair is usually recommended because the risk of complications is higher.

Most people return to light activities within one to two weeks and to heavy lifting after about four to six weeks, depending on the type of operation.

But when is a hernia an emergency?

Get emergency help if the lump becomes firm, tender or can’t be pushed back, especially with sudden severe pain, vomiting, being unable to pass wind or poo, or the lump turning red, purple or dark. This may mean the hernia is strangulated, cutting off the blood supply to the bowel, and it needs surgery the same day.

Sources: NHS (Inguinal hernia repair), Mayo Clinic (Inguinal hernia), American College of Surgeons, Royal College of Surgeons of England.