Hernia is a common condition that occurs when an organ pushes through a weakness in its surrounding wall of muscle or tissue.

Hernia appears as a bulge or lump under the skin, usually in the abdominal region. About 75 per cent of abdominal hernias are inguinal hernias, which means in the groin area. Men are especially prone to them.

Inguinal hernia symptoms

An inguinal hernia occurs when part of your intestine protrudes through a weak section near the pubic bone. Inguinal hernia can take months to develop and can cause the following symptoms

  • Pain, particularly when lifting something heavy, bending, straining, coughing, laughing
  • Heaviness. feeling of pressure, burning sensation
  • Weakness
  • In men, there may be pain and swelling around the testicles,if the protruding intestine reaches the scrotum (the pouch that protects testicles

“Hernia is usually apparent when you are in a standing position or when you cough and strain the groin region. It may flatten out when you lie down,” says Prof Wong Wai Keong, Head and Senior Consultant, Department of General Surgery, Singapore General Hospital (SGH), a member of the SingHealth group.

In male babies, the testicles form within the abdomen and move through the inguinal (groin) canal into the scrotum. The inguinal canal typically closes soon after birth. In cases where it doesn’t close properly, a weakness develops which can lead to inguinal hernia years later.

This pre-existing weakness is one cause of inguinal hernia. Other causes and risk factors of inguinal hernia include:

  • Strenuous physical activity, particularly heavy lifting
  • Persistent coughing or sneezing
  • Excessive straining during bowel movements and while urinating
  • Obesity
  • Weakness in the abdominal muscles due to ageing

Diagnosis and treatment of inguinal hernia

Hernia never goes away on its own. If your hernia is small, you may be able to push the protruding organ back into place yourself and not require any treatment. Your doctor may simply put you under observation. You will require treatment if your hernia symptoms persist and bother you.

Inguinal hernia treatment involves surgery which is of two types: open hernia surgery (herniorrhaphy) and minimally invasive laparoscopic surgery. Both procedures are safe and effective, though there is a small risk of a future recurrence of hernia.

Open hernia surgery: The surgeon makes an incision over the hernia and pushes the protruding intestine back into place. The torn muscle or ligament is repaired and a synthetic mesh is provided to support it. This procedure is usually carried out under regional or general anaesthesia. You will be able to resume your normal activities after 4-6 weeks.

Laparoscopic surgery: The surgeon makes three small incisions in your abdomen in this procedure carried out under general anaesthesia. A small tube equipped with a tiny camera (laparoscope) is inserted into one incision and tiny instruments to repair the hernia are inserted into the other incisions.

There is less discomfort, pain and scarring and the recovery period is shorter with laparoscopic surgery.

“Laparoscopic surgery is more suitable if you have bilateral inguinal hernias, which is hernia on both sides. It may not be suitable if you have had previous pelvic surgery or can’t tolerate general anaesthesia,” says Prof Wong.

While most patients are able to resume normal activities after hernia surgery, some patients may develop complications such as chronic groin pain. Chronic groin pain can develop 3-6 months after hernia surgery.

Hernia which is not treated appropriately can grow large and painful and put pressure on surrounding tissue. Large hernias can lead to complications such as obstruction or strangulation of the bowels.

In men, large hernias can protrude into the scrotum causing pain and swelling in the testicles. These complications of inguinal hernia cannot be treated with laparoscopy and require open hernia surgery.

Read on to learn about the difference between inguinal hernia and sports hernia, and how to prevent hernia when weight-lifting.