Inguinal hernia

What is an inguinal hernia? 

An inguinal hernia, the most common type of hernia, is where fatty tissue or part of your bowel pushes through into your groin at the top of your inner thigh. This presents as either a lump or swelling, and the resulting bulge may be painful when you cough or strain.  

Inguinal hernias aren’t always dangerous but, left untreated, they can develop into life-threatening complications. That’s why we often recommend hernia repair surgery if you’re experiencing symptoms or your hernia is worsening.

Our specialists at St Thomas’ and Evelina London Children’s hospitals treat various types of hernias in adults and children and offer personalised advice on how to prevent them.

Who is at risk of an inguinal hernia? 

Anyone can develop or be born with an inguinal hernia, but you may be more at risk if:  

• you smoke regularly 
• you’re male 
• you’re over 50 
• you’re pregnant 
• you have a chronic cough or constipation 
• you have a family history of inguinal hernia 
• you’ve previously had an inguinal hernia or hernia repair 
• your baby is born prematurely or has a low birth weight

Types of inguinal hernia

The 2 types of inguinal hernia are direct and indirect. A direct inguinal hernia protrudes through the back of your inguinal canal (a passage in your lower abdominal wall). It typically occurs in adults due to weakened abdominal muscles and pressure on the muscular wall.   

An indirect inguinal hernia is generally a congenital birth defect (something you’re born with) and is where the hernia enters the inguinal canal through the inguinal ring.  

Inguinal hernia symptoms 

Although inguinal hernias do not always have symptoms, they can cause:  

• a bulge in your groin or upper thigh that’s more noticeable when you cough or strain 
• aching or burning around the bulge 
• pain or discomfort in your groin 
• pain or swelling of testicles in men 

If you or your child are experiencing symptoms of an inguinal hernia, book an appointment with one of our specialists who can help with a diagnosis.

Symptoms of inguinal hernia in children 

Inguinal hernias in newborns or children usually are congenital. You might not notice your child’s hernia, especially if it doesn’t cause significant symptoms.  

However, you may spot a lump or bulge in your child’s groin when they cry, cough or strain. Older children may also complain of symptoms, such as groin discomfort or a new lump in that area.  

What causes inguinal hernia? 

Some inguinal hernias do not have an apparent cause. However, in many people, they’re a result of a weakened abdominal wall that’s either congenital or has developed over time. 

Inguinal hernias are usually caused by:  

• a weakened spot in the abdominal wall 
• chronic coughing or sneezing 
• intense and strenuous activity 
• pregnancy 
• pressure in the abdomen 
• repeated straining when using the bathroom

Complications of inguinal hernia 

Inguinal hernias can sometimes cause complications if left untreated. This is because some hernias worsen over time.  

Some of the main potential complications of inguinal hernias can include:  

• an incarcerated hernia where the hernia becomes trapped and obstructs your bowel 
• hernia strangulation – the surrounding muscles cut the blood supply to an incarcerated hernia (a life-threatening complication) 
• pressure on surrounding tissues, causing pain and swelling 

Signs of an incarcerated inguinal hernia may include: 

• a fever 
• failure to pass wind or have a bowel movement 
• redness around the lump 
• severe or sudden hernia pain 
• the inability to push your lump back in 

Always seek emergency medical care if you experience incarcerated hernia symptoms.  

If you feel you or your child may be at an increased risk incarcerated inguinal hernia, contact our team using our online enquiry form to book an appointment with one of our specialists.   

Inguinal hernia treatment 

Not all inguinal hernias require treatment immediately. In some patientsy, we may recommend watching and waiting to see if it becomes symptomatic, before deciding to operate. However, enlarged or painful hernias generally require hernia repair surgery to prevent further complications.  

We can perform hernia repair surgery as open surgery or use keyhole techniques.  

In most open inguinal hernia repair procedures, we’ll use general anaesthetic so you’ll be asleep throughout. However, local anaesthetic can be offered in select cases. The surgeon will make an incision in your groin and push the protruding tissue back up into your abdomen. In adults, mesh reinforcement is the standard of care for most inguinal hernia repairs. A synthetic mesh reinforces the weakened area of your abdominal wall and helps minimise the risk of hernia recurrence. Finally, the surgeon will close the incision with dissolvable stitches.  

Surgeons can also perform an inguinal hernia repair using a minimally invasive keyhole technique. In this procedure, we’ll also use general anaesthetic. We’ll make 3 small 1cm incisions in your abdomen and insert a laparoscope (a tiny camera) and surgical instruments into them. Your surgeon can then repair the hernia without making open incisions, enhancing your recovery. Ahead of the surgery, your surgeon will discuss the best approach for the hernia repair with you, based on your individual case. 

Our adult gastrointestinal (GI) surgery services offer open and keyhole hernia repair surgery, ensuring you receive the correct treatment for your needs. Our expertise in hernia repair surgery provides patients with effective treatment and improved recovery rates.

To learn more about the treatment options for you or your child and discuss them with one of our specialists, simply get in touch.

Inguinal hernia repair recovery 

You can resume normal activities as soon as you feel comfortable to do so – most patients build up back to their pre-surgery levels over a few weeks. It’s normal to feel some discomfort during your initial healing, but with the recommended pain relief medication and over time, this should soon disappear. 

It’s also important to follow your aftercare instructions carefully to minimise the risk of infection and prevent other complications.

Treating inguinal hernia in children

If your child is born with an inguinal hernia or develops one as they get older, we recommend hernia repair surgery. Depending on your child’s needs, we can perform hernia repair surgery as either open or keyhole surgery. 

We’ll perform your child’s hernia repair surgery under general anaesthetic so they’ll be asleep and safe throughout.  

Our team of paediatric surgeons forms our children’s general surgery service, where we offer expert inguinal hernia treatment.

Helping your child recover at home 

Following your child’s surgery, we’ll provide all the aftercare advice you need to support their recovery after we’ve discharged them from the hospital.  

They should be able to go home either the same day or next day following their surgery. We do not routinely arrange follow-up for these cases but, if required, the surgeon will arrange this for you.   

While it can take up to 6 weeks for your child to fully recover, they should start to feel back to normal within 1-2 weeks.