Inguinal Hernia

An inguinal hernia occurs when abdominal tissue, such as fat or part of the intestine, pushes through a weak area in the lower abdominal wall near the groin. It is the most common type of hernia and occurs much more frequently in men than women.

An inguinal hernia may cause a noticeable groin bulge, pressure, aching, or pain that becomes more noticeable with coughing, lifting, bending, or straining. Some cause few symptoms, while others may require surgical repair.

What Is an Inguinal Hernia?

The inguinal canal is a passage through the lower abdominal wall near the groin. In men, the spermatic cord passes through this canal. In women, the canal contains a ligament associated with the uterus.

An inguinal hernia develops when fat, intestine, or other abdominal tissue enters this area through a weak point in the abdominal wall. The hernia may appear on either side of the groin and, in men, may sometimes extend into the scrotum.

What Are the Types of Inguinal Hernias?

There are two main types of inguinal hernia.

Indirect Inguinal Hernia

An indirect inguinal hernia follows a pathway through the inguinal canal that is related to fetal development. It may be associated with an opening that did not completely close before birth.

Although the underlying weakness may be present from birth, symptoms can appear later in life.

Direct Inguinal Hernia

A direct inguinal hernia develops through an area of weakness in the abdominal wall near the inguinal canal.

This type is generally acquired over time rather than caused by an opening present from birth.

Both types can produce similar symptoms, and most patients do not need to determine the type themselves before seeking an evaluation.

What Are the Symptoms of an Inguinal Hernia?

The most recognizable symptom is a bulge in the groin.

Other symptoms may include:

• A lump or bulge on either side of the pubic bone
• Groin pressure or heaviness
• Aching, burning, or discomfort
• Pain that worsens with coughing, lifting, bending, or straining
• A pulling or dragging sensation in the groin
• Swelling that becomes more noticeable while standing or active
• A bulge that becomes smaller when lying down
• Swelling that extends into the scrotum in some men

Some inguinal hernias cause little or no discomfort.

What Causes an Inguinal Hernia?

An inguinal hernia develops when abdominal tissue pushes through an area of weakness in the lower abdominal wall.

Some people are born with an anatomical weakness that increases their risk, while others develop weakness over time.

Factors that may contribute include:

• Aging and weakening of abdominal tissues
• Chronic coughing
• Chronic constipation or repeated straining
• Pregnancy
• Increased abdominal pressure
• Repeated heavy lifting
• Previous weakness in the groin region

Heavy lifting or straining does not necessarily create a hernia by itself, but it can make an existing weak area or hernia more noticeable.

Inguinal Hernia vs. Femoral Hernia: What Is the Difference?

Both inguinal and femoral hernias occur in the groin, but they pass through different anatomical areas.

A physical examination and, when necessary, imaging can help distinguish between them.

Learn more about femoral hernias.

How Is an Inguinal Hernia Diagnosed?

Diagnosis usually begins with a physical examination.

A healthcare provider may examine the groin while you are standing and may ask you to cough or strain. Increasing pressure inside the abdomen can make a hernia easier to detect during the examination.

If the diagnosis is uncertain, imaging may be recommended.

Possible tests include:

• Ultrasound
• CT scan
• MRI in selected cases

Imaging can also help evaluate other possible causes of groin pain or swelling.

Does an Inguinal Hernia Need Surgery?

Not every inguinal hernia requires immediate surgery.

For some men with an inguinal hernia that causes few or no symptoms, watchful waiting may be an appropriate option. This involves monitoring the hernia and seeking reevaluation if symptoms develop or worsen. Research summarized by NIDDK indicates that many men who initially choose watchful waiting eventually develop symptoms and undergo repair.

Surgical repair may be recommended when:

• The hernia causes pain or discomfort
• Symptoms interfere with work or everyday activities
• The hernia is increasing in size
• The hernia becomes difficult to reduce
• Complications are suspected
• The patient prefers repair after discussing treatment options

Treatment recommendations may differ for women because groin hernias in women require careful evaluation for femoral hernia and associated complications.

How Is an Inguinal Hernia Repaired?

Inguinal hernia surgery can be performed using open or minimally invasive techniques.

Open Inguinal Hernia Repair

During open repair, the surgeon makes an incision in the groin, returns the protruding tissue to its appropriate position, and repairs the weakened area of the abdominal wall.

Mesh is commonly used in adult inguinal hernia repair, although the specific technique depends on the patient and hernia.

Laparoscopic or Robotic Inguinal Hernia Repair

Laparoscopic and robotic-assisted approaches use small abdominal incisions and specialized instruments to repair the hernia.

The appropriate surgical approach depends on factors such as:

• Whether the hernia is on one or both sides
• Whether it is a first-time or recurrent hernia
• Previous abdominal surgery
• Hernia size and anatomy
• Overall health
• Surgeon recommendation and patient preference

Learn more about laparoscopic hernia surgery.

What Are Incarcerated and Strangulated Inguinal Hernias?

Most inguinal hernias are not emergencies, but complications can occur.

An incarcerated hernia occurs when tissue becomes trapped and cannot move back into the abdomen.

A strangulated hernia occurs when the blood supply to trapped tissue becomes compromised. This requires emergency medical treatment.

Learn more about incarcerated hernias.

When Is an Inguinal Hernia an Emergency?

Seek immediate medical attention if a groin hernia is accompanied by:

• Sudden or severe pain
• A painful or increasingly tender bulge
• Nausea or vomiting
• Rapidly increasing swelling
• A bulge that can no longer move back into the abdomen
• Redness or darkening of the skin over the hernia
• Rapidly worsening symptoms

These symptoms may indicate incarceration, obstruction, or strangulation and require prompt medical evaluation.

What Is Recovery Like After Inguinal Hernia Surgery?

Recovery varies based on the surgical technique, complexity of the repair, the patient's health, and the physical demands of work and daily activities.

After surgery, patients may receive instructions about:

• Walking and light activity
• Incision care
• Pain management
• Lifting restrictions
• Driving
• Returning to work
• Resuming exercise
• Follow-up appointments

Your surgeon will provide individualized recommendations for returning to normal activity.

Inguinal Hernia Surgery in the East Bay

Hernia Innovations provides evaluation and surgical treatment for inguinal and other groin hernias throughout the East Bay.

Our board-certified surgeons evaluate each patient's symptoms, hernia anatomy, medical history, and treatment goals to determine whether monitoring or surgical repair may be appropriate.

When surgery is recommended, treatment may include open, laparoscopic, or robotic-assisted inguinal hernia repair based on the patient's individual condition.

Call (925) 940-1025 or request an appointment online.

Frequently Asked Questions About Inguinal Hernias

Can an inguinal hernia go away on its own?

An inguinal hernia does not typically repair itself. However, some men with small inguinal hernias that cause few or no symptoms may be able to monitor them rather than having immediate surgery.

What does an inguinal hernia feel like?

An inguinal hernia may cause a groin bulge along with pressure, heaviness, aching, burning, or discomfort. Symptoms can become more noticeable during coughing, lifting, bending, or straining.

Where is an inguinal hernia located?

An inguinal hernia develops in the lower abdomen where tissue enters the inguinal region near the groin. In men, larger hernias may sometimes extend into the scrotum.

Is an inguinal hernia serious?

Many inguinal hernias are not immediately dangerous, but complications can occur if tissue becomes trapped or loses its blood supply. Sudden severe pain, vomiting, or a painful hernia that no longer reduces requires prompt medical evaluation.

Does every inguinal hernia need surgery?

No. Some men with minimally symptomatic inguinal hernias may be candidates for watchful waiting. Surgery is commonly considered when symptoms develop, worsen, interfere with daily activities, or complications are suspected.