Not necessarily dangerous in themselves, inguinal hernias can be painful and lead to serious complications. But surgical repair is now easier than it once was.
They occur when soft tissue — usually part of the intestine — protrudes through a weak point in the groin, where the abdomen meets the thigh. The resulting bulge can be painful — sometimes excruciatingly so — especially when you cough or lift a heavy object.
Some people develop or acquire the abdominal weakness that leads to a hernia in adulthood. But more often the weakness occurs at birth, when the abdominal lining (peritoneum) doesn't close properly. And although far more men than women have inguinal hernias, no one is immune — including infants, pregnant women and older adults.
Although not necessarily dangerous in themselves, inguinal hernias can lead to life-threatening complications. For that reason, your doctor is likely to recommend surgical removal of a hernia that's painful or growing larger. The good news is that it's not the same hernia operation your father may have had, with a large abdominal incision, a long hospital stay and weeks of immobility. Instead, many inguinal hernias now can be successfully repaired with a technique that uses several small incisions (laparoscopy), leading to a faster, less painful recovery.
Signs and symptoms
Some inguinal hernias don't cause any symptoms, and you may not know you have one until your doctor discovers it during a routine medical exam. Often, however, you can see and feel the bulge created by the protruding intestine. The bulge is usually more obvious when you stand upright.
Other signs and symptoms of an inguinal hernia include:
Signs and symptoms in children
Some hernias have no apparent cause. But many occur as a result of increased pressure within the abdomen, a pre-existing weak spot in the abdominal wall or a combination of the two.
In men, the weak spot usually occurs along the inguinal canal. This is the area where the spermatic cord, which contains the tube that carries sperm (vas deferens) as well as blood vessels and nerves, enters the scrotum.
In women, the inguinal canal carries a ligament that helps hold the uterus in place, and hernias sometimes occur where connective tissue from the uterus attaches to tissue surrounding the pubic bone.
Men are more likely to have an inherent weakness along the inguinal canal than women are because of the way males develop in the womb. In the male fetus, the testicles form in the abdomen and then move down the inguinal canal into the scrotum. Shortly after birth, the inguinal canal closes almost completely, leaving just enough room for the spermatic cord to pass through, but not enough to allow the testicles to move back into the abdomen.
Sometimes, however, the canal doesn't close properly, leaving a weakened area. There's less chance that the inguinal canal won't close after birth in female babies. In fact, women are more likely to develop hernias in the femoral canal, an opening near the inguinal canal where the femoral artery, vein and nerve pass through.
Weaknesses can also occur in the abdominal wall later in life, especially after an injury or certain operations in the abdominal cavity.
With or without a pre-existing weakness, extra pressure in the abdomen can cause a hernia. This pressure may result from straining during bowel movements or urination, from heavy lifting and from pregnancy or excess weight. Even chronic coughing or sneezing can cause abdominal muscles to tear.
You're far more likely to develop an inguinal hernia if you're male. Nearly 10 times more men than women have inguinal hernias, and the vast majority of newborns and children with inguinal hernias are boys.
Other risk factors include: