What is an inguinal hernia, and what causes it?

An inguinal hernia is a bulge in the groin area which can be incredibly sore and painful, leaving a burning sensation which can become debilitating. Caused by tissue pushing through the groin muscle, inguinal hernias are common amongst pregnant women who have a lot of pressure around the abdomen. Likewise, men who undertake strenuous activities such as heavy lifting, bending or vigorous coughing are also prone to inguinal hernias. Obesity can also be a contributory factor.

The hernia itself may emerge as a bulge or lump around the groin area, which can appear suddenly or take weeks to fully develop. Swelling and tenderness around the groin area is the usually the first sign that an inguinal hernia is developing, although 1 in 3 inguinal hernia cases report no noticeable symptoms other than the growth itself. If the pain caused by the inguinal hernia becomes intolerable a doctor should be consulted as soon as possible; this could indicate that part of the intestine or testicle has become trapped by the hernia, which can result in the blood supply to the area being cut off.

 


What are the symptoms of an inguinal hernia?

Around 66% of hernia patients will encounter symptoms to a varying extent, which may include:

  • Bulging in the groin or scrotum area
  • Swelling
  • Sensitivity or tenderness
  • Pain and discomfort, particularly when bending or lifting.
  • Nausea and vomiting

abdominal examination


How is an inguinal hernia treated?

The majority of cases whereby the hernia is not causing any pain or discomfort do not require treatment, although many people choose to have an inguinal hernia treated to prevent any future complications.

If you are experiencing pain and discomfort then surgical removal of the inguinal hernia is the only method of treatment. Before any treatment is undertaken, however, your doctor will most likely perform a series of tests to confirm whether a hernia is in fact present. A physical exam carried out by your GP is usually the most effective way of diagnosing a hernia. Further tests will then be taken to rule out the possibility of other conditions being mistaken for a hernia. A urine test, for example, can highlight whether kidney stones may be causing the groin pain. Similarly, tests should be carried out to assess whether there are any other conditions present which may be contributing to the appearance of the hernia, such as colon or prostate cancer.

Once it has been established that an inguinal hernia is present, preparations can be made for surgical removal. Unless there is a suspicion that the intestines are being strangulated by the hernia there is generally no need to rush surgery. When strangulation of the intestines is suspected then surgery is advised immediately.

The surgical procedure itself beings with a single incision to the groin area where the hernia is located. Most inguinal hernia surgeries nowadays are performed laparoscopically, which results in a much smaller incision and allows the surgeon greater accuracy. There are two different types of inguinal hernia: a direct hernia and indirect hernia. If a direct hernia (emerging through the wall of the abdomen) is present, the lump is usually just pushed back into place rather than removed. An indirect hernia, which can be found in the inguinal canal, is usually removed surgically and tied to prevent further eruption.

If the inguinal hernia has developed due to a weakness of the muscle wall, the surgeon may choose to sew healthy tissue into the wall in order to strengthen it. Modern surgical techniques for inguinal hernia repair increasingly make use of synthetic materials, sewn over the damaged or weakened tissues. The material is able to absorb the tension placed upon the wall of the abdomen or groin and reduces the chances of a hernia re-appearing.

The recovery period following inguinal hernia repair is relatively short. An overnight stay is usually required but you should be able to return home the following day. Strenuous activity and exercise should be avoided for at least 4 weeks following the procedure, and you will probably be unable to drive for around 2 weeks. Mild pain and swelling is to be expected following hernia surgery.

There are a number of ways you can prevent an inguinal hernia from reappearing, the primarily by maintaining a healthy weight. Promoting overall muscle strength is also important, as is the avoidance of activities which put a great deal of strain upon the muscles around the groin and abdomen areas.


How much does an inguinal hernia cost?

Inguinal hernia repair surgery is a fairly complex procedure and must be carried out by a specialist surgeon or specialist and can therefore be expensive. The cost of the procedure can vary hugely depending on a number factors, with the geographic location of the clinic or hospital the main influencer.

The average cost of inguinal hernia around the world (USD):

  • Poland – $1,600
  • Hungary – $2,700
  • Mexico – $3,000
  • Thailand – $3,200
  • India – $3,200
  • United Arab Emirates – $3,300
  • Germany – $3,900

Inguinal hernia statistics

  • Inguinal hernias are much more prevalent in men, who have a 27% chance of developing one in their lifetime. Women, on the other hand, have only a 3% chance of developing an inguinal hernia.
  • If you are over the age of 45, the chances of an inguinal hernia developing doubles.
  • 33% of people with an inguinal hernia have no painful symptoms  
  • Around 5% of inguinal hernias result in intestinal strangulation and emergency surgery
  • The majority of inguinal hernias appear on the right hand side of the body – around 60%

How long is the waiting time for inguinal hernia repair?

NHS guidelines in the UK state that surgeries such as inguinal hernia repair should be completed within 18 weeks, and statistics indicated that the current waiting time is around 98 days. In the United States, around 60% of patients are able to undergo hernia repair within 3 months.

By looking abroad for hernia repair surgery you may be able to avoid extended waiting times. Many patients travel to countries such as India, Mexico or Hungary for inguinal hernia repair, where hospitals are able to offer flexible surgery appointments and short waiting lists.