Your Hernia

About Your Hernia

If you have or think you might have a hernia, you're not alone; globally it is the 4th most common operation. Inguinal hernias, the most common kind, account for 2/3 of hernias overall. And about 80% of those are found in males. 

How Do I Know I Have a Hernia?

Think you might have a hernia? While some hernias have no symptoms (and are found during a routine physical), most inguinal hernias will have one or more of the following:

• What you may feel: a dull ache, feeling of weakness, heaviness, pressure, tingling, or a burning sensation in your abdomen, groin, or scrotum. It may get worse when you stand for long periods or strain your abdominal muscles, such as when you cough, lift heavy objects (like your children), play sports (even golf), or have a bowel movement. It may feel better with rest.
• What you may see: a soft bulge in the groin area or scrotum that you can push back in with gentle pressure or that gets smaller or disappears when you lie down. The bulge may get bigger over the course of the day or when you cough, bend, lift, or strain.*
• What you may notice: a sudden, sharp pain in the groin area or a sensation that something had 'torn.' Even if you have no other symptoms, you should see your doctor to check it out.

*If you have a bulge that cannot be pushed back inside, that is red, purple, or dark, or have pain with fever, chills, and/or vomiting, go to your hospital emergency room or call 911. Don't wait – this may indicate an emergency that can become life-threatening.

What Is a Hernia?

If you noticed a sudden pain in the groin or a sensation as if something had torn, you may be right. A hernia is a weakness or tear in the abdominal muscle wall, which normally holds the inner lining of the abdomen and internal organs in place (i.e. inside, where they belong). The weakness or tear allows the inner lining to protrude and form a pouch. The bulge you might see is usually a loop of intestine protruding through the tear in the muscle and into that pouch.

Contrary to popular myth (about lifting heavy objects), you didn't cause your hernia. Most people are born with a weakness in the muscle, which eventually gives way, or an opening that didn't close up (as it usually does) before birth.

Two Words About Embarrassment

Don't be. Because of a hernia's location, some people are embarrassed and avoid telling anyone or seeing the doctor. But there's only one way out: fix it. The sooner you do, the better you'll feel – physically and emotionally.

Why Men?

The area where inguinal hernias occur is the opening through which the testicles descend during fetal development. It usually closes up before birth except for a small space allowing the spermatic cord to pass to the scrotum. If it doesn't close properly, it can leave a natural weakness that can bulge or tear later on.

Will It Get Worse?

The short answer: Yes. A hernia will not go away by itself, and almost always gets worse the longer it's ignored. The tear gets bigger, and the bigger the tear, the bigger the surgery needed to fix it. What started as pressure or discomfort can turn into pain. The pain may not just be in the area of the hernia; it can radiate to your hip, back, leg – even to the genitals. As your hernia gets worse, many aspects of your life will get worse right along with it. Even if it isn't painful (yet), the sensation and pressure may cause you to avoid certain activities. Your job, your family, your weekends, and even your sex life can all suffer. 

A Hernia Can Become an Emergency

It's possible for the protruding loop of tissue and/or intestine to get stuck (obstructed) outside the abdominal muscle wall, unable to be pushed back inside. If the loop of intestine is tightly trapped, the blood supply can be cut off (strangulation). Without the blood supply, the trapped tissue will swell, die, and become infected. And that's an emergency – it can even be life-threatening.

Call 911 or Go Directly to Your Hospital Emergency Room If:

• The bulge of your hernia no longer goes back inside when you lie down or with gentle pressure
• You know you have a hernia and develop a fever, chills, nausea, or vomiting, have blood in your stool, or are unable to have a bowel movement or pass gas
• The bulge turns red, purple or dark
• You have rapidly increasing or severe pain in the abdomen or genital region

Now What?

The only way to repair a hernia is through surgery. The good news? Surgical techniques have come a long way since your (grand)father's hernia repair. New procedures and materials offer options that can decrease discomfort and speed recovery, so you can get back to your health – and your life – faster than you might think.

Step One:

Call your doctor or surgeon. He or she will diagnose your hernia: where it is, how big it is, and how soon you should have it repaired. And the more you know about surgical repair techniques, the better prepared you'll be to have an informed discussion – and make an informed decision – with your doctor.