Inguinal Hernia(Groin Hernia)

An inguinal hernia occurs when abdominal tissue — such as fat or a loop of intestine — protrudes through a weakness or opening in the lower abdominal wall into the inguinal canal. The inguinal canal is a passageway running along both sides of the pelvis into the reproductive organs.
Inguinal hernias are the most common type of groin hernia. “Inguinal” refers to the groin area. They may cause pain, pressure, or a visible bulge, especially when standing, lifting, coughing, or straining. While common in adults, inguinal hernias can also occur in infants and children. If untreated, they may enlarge or lead to serious complications such as bowel obstruction or strangulation.
There are two main types: direct and indirect, which differ based on their anatomical pathway.

Typical signs and symptoms of an inguinal hernia include:

A visible bulge on either side of the pubic bone, more noticeable when standing, coughing, or straining
Burning or aching sensation at the bulge
Groin pain or discomfort, especially with bending, coughing, or lifting
A heavy or dragging feeling in the groin
Weakness or pressure in the groin
Pain and swelling around the testicles if intestine descends into the scrotum

An inguinal hernia forms when a weakness or opening in the lower abdominal wall allows abdominal contents to push through. Contributing factors include:

Congenital openings present at birth
Differences in connective‑tissue strength (e.g., collagen disorders)
Weak spots from previous abdominal surgeries
Chronic coughing or sneezing
Chronic straining during urination or bowel movements
Repeated heavy lifting, strenuous exercise, or manual labor
Multiple pregnancies or regularly carrying children
Occupations requiring prolonged standing
Increased intra‑abdominal pressure due to obesity
Age‑related weakening of tissues

Factors that increase the likelihood of developing an inguinal hernia include:

Male sex
Family history of hernias
Chronic cough (smoking, lung disease)
Pregnancy
Obesity
Straining with constipation or urinary issues
Prior hernia or prior abdominal surgery
Aging

A physical exam is usually sufficient. The healthcare provider will:

Inspect and palpate the groin area for a bulge
Ask the patient to stand, cough, or strain to make the hernia more prominent

If the diagnosis is unclear, imaging tests may be ordered:

Abdominal ultrasound
CT scan
MRI

Watchful Waiting
If the hernia is small and asymptomatic, monitoring may be recommended. A supportive truss may help, but only with professional guidance.
Manual Reduction (In Children)
Pressure may be applied to gently push the herniated tissue back until surgery is considered.
Surgical Options
Most symptomatic or enlarging hernias require surgery.

1. Open Hernia Repair

Performed under local anesthesia with sedation or general anesthesia
A groin incision is made
Protruding tissue is pushed back
Weak area is reinforced, often with synthetic mesh (hernioplasty)
Incision closed with stitches, staples, or adhesive
Early mobilization encouraged; full recovery may take several weeks

1. Minimally Invasive Repair (Laparoscopic or Robotic)

Requires general anesthesia
Uses several small abdominal incisions
A camera‑equipped laparoscope guides mesh repair
Benefits: less pain, less scarring, quicker recovery
Often preferred for recurrent hernias or bilateral hernias
Return to normal activity generally faster than with open repair