Inguinal hernia

An inguinal hernia occurs because the abdominal wall has weakened at this spot and abdominal contents bulge through it, most often fatty tissue or part of the bowel. That is why it shows as a small lump that gets bigger when you strain, cough or lift, and often disappears at night or when lying down.

Many people first notice it as a dragging feeling or pressure after standing for a long time, as a dull ache at the end of the working day or as a burning feeling when lifting a child. Sometimes the lump only becomes visible when you specifically look for it.

A hernia does not go away on its own and, as a rule, gets bigger over time. This does not mean it has to be operated on straight away, but it does mean it deserves an examination while it is small.

Why it develops

Some people are born with a weaker spot in the groin area. In others the wall weakens with age or after previous abdominal operations.

Anything that raises pressure in the abdomen over a long period contributes: heavy physical work and lifting loads, a chronic cough, long-term constipation with straining, problems passing urine and increased body weight.

Hernias are more common in men, but they also occur in women and children. In women, groin pain is more often due to something else, which makes an examination all the more important.

When it is an emergency

If the hernia suddenly can no longer be pushed back, becomes hard and very painful, the skin over it turns red, and this is joined by nausea, vomiting, a tense abdomen and no longer passing wind or stool, call 112.

This picture means an incarcerated hernia. Part of the bowel is trapped and its blood supply is at risk of being cut off, which is an emergency.

Do not try to force the hernia back and do not wait for the pain to settle on its own. Until help arrives, do not eat or drink, as this would get in the way of carrying out a possible operation.

What the examination involves

A surgeon usually diagnoses a hernia by examination. The examination is done standing and lying down, because the bulge often retreats when you lie down and reappears when you cough or strain.

Ultrasound is considered when the finding is unclear, for smaller hernias or when groin pain needs to be distinguished from other causes. These include muscle strain, hip problems, enlarged lymph nodes and conditions of the reproductive organs or testicles.

The surgeon assesses the size and position of the hernia, assesses the risk and explains what it means if you wait before having a procedure. This is a conversation about your everyday physical demands, not just about the finding.

Treatment options

With a small hernia that causes no problems, watchful waiting is an acceptable route, as long as you know the signs of incarceration and when to act.

When a hernia hurts, is getting bigger or gets in the way of your work, treatment is surgical. The procedure is done open or laparoscopically, and the weakened spot is, as a rule, reinforced with a synthetic mesh. Which technique is more suitable depends on the type of hernia, on previous operations and on your general condition.

Hernia belts and trusses do not treat a hernia. They can ease symptoms, but at the same time they give a false sense of security, as they do not protect against incarceration.

Surgical care at Medicinski center Ljubljana is self-pay; you do not need a referral. Appointments are booked with the clinic that runs the service.