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Inguinal hernia

An inguinal hernia occurs when soft tissue ??? usually part of the membrane lining the abdominal cavity (omentum) or part of the intestine ??? protrudes through a weak point in the abdominal muscles. The resulting bulge can be painful, especially when you cough, bend over or lift a heavy object.

An inguinal hernia isn’t necessarily dangerous by itself. It doesn’t get better or go away on its own, however, and it can lead to life-threatening complications. For this reason, your doctor is likely to recommend surgery to fix an inguinal hernia that’s painful or becoming larger. Inguinal hernia repair is a common surgical procedure.

Some inguinal hernias don’t cause any symptoms. Often, however, you can see and feel the bulge created by the hernia. The bulge is usually more obvious when you stand upright, especially if you cough or strain.

Inguinal hernia signs and symptoms include:

  • A bulge in the area on either side of your pubic bone

  • A burning, gurgling or aching sensation at the bulge

  • Pain or discomfort in your groin, especially when bending over, coughing or lifting

  • A heavy or dragging sensation in your groin

  • Weakness or pressure in your groin

Occasionally, pain and swelling around the testicles when the protruding intestine descends into the scrotum. Some inguinal hernias have no apparent cause. Others occur as a result of:

  • Increased pressure within the abdomen

  • A pre-existing weak spot in the abdominal wall

  • A combination of increased pressure within the abdomen and a pre-existing weak spot in the abdominal wall

  • Straining during bowel movements or urination

  • Heavy lifting

  • Fluid in the abdomen (ascites)

  • Pregnancy

  • Excess weight

  • Chronic coughing or sneezing

If your hernia is small and isn’t bothering you, your doctor may recommend a watch-and-wait approach. Enlarging or painful hernias usually require surgery to relieve discomfort and prevent serious complications.

There are two general types of hernia operations ??? open hernia repair and laparoscopic repair.

Herniorrhaphy

In this procedure, also called an open hernia repair, the surgeon makes an incision in your groin and pushes the protruding omentum or intestine back into your abdomen. The surgeon then sews together the weakened or torn muscle. The weak area often is reinforced and supported with a synthetic mesh (hernioplasty).

After the surgery, you’ll be encouraged to move about as soon as possible, but it may be four to six weeks before you’re fully able to resume your normal activities.

Laparoscopy

In this minimally invasive procedure, the surgeon operates through several small incisions in your abdomen. A small tube equipped with a tiny camera (laparoscope) is inserted into one incision. Guided by the camera, the surgeon inserts tiny instruments through another incision to repair the hernia using synthetic mesh.

Most people who have laparoscopic repair experience less discomfort and scarring after surgery and a quicker return to normal activities. Laparoscopy may be a good choice for people whose hernias recur after traditional hernia surgery because it allows the surgeon to avoid scar tissue from the earlier repair. Laparoscopy also may be a good choice for people with hernias on both sides of the body (bilateral inguinal hernias).