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Inguinal hernia

Inguinal hernia is one of the most common surgical conditions, accounting for around 75% of all abdominal wall hernias. It is manifested by the protrusion of fat or an organ or part of it through a weakened area of the abdominal wall in the groin region.

This condition affects almost 27% of men and 3% of women during their lifetime, with an increasing prevalence with age.

Symptoms of inguinal hernia

The symptoms of an inguinal hernia vary depending on how it develops. Initially, a swelling or protrusion in the groin may appear, most noticeable when standing or during physical exertion such as coughing or lifting heavy objects. This swelling is often accompanied by a dull pain or a pulling sensation. In men, the protuberance may extend into the scrotum, causing local pain or swelling.

In complicated forms, a hernia may become incarcerated, meaning that the contents of the hernia can no longer return to the inside of the abdomen. This situation can develop into strangulation of the intestine, where the blood supply is interrupted, leading to acute pain, nausea, vomiting due to intestinal obstruction and changes in the colour of the protuberance (reddish, purplish). Strangulation is a medical emergency because there is a real risk of intestinal necrosis.

Causes of inguinal hernia

Inguinal hernias are caused by a weakness or opening in the abdominal wall, which may be present at birth (congenital hernia) or appear later (acquired hernia). Congenital hernias are often due to a lack of closure of the peritoneovaginal canal, a passage that normally closes during foetal development.

Acquired hernias, on the other hand, are often linked to a weakening of the tissues with age, intense physical effort or a prolonged increase in intra-abdominal pressure. Conditions such as chronic coughing, constipation or pregnancy can favour their appearance.

Inguinal hernia risk factors

Several factors increase the risk of developing an inguinal hernia. Men are significantly more at risk, with a risk 8 to 10 times higher than that of women. Heavy-duty workers are more at risk. Advanced age is another important factor, due to the progressive weakening of muscle tissue. People with a family history of hernia or suffering from connective tissue disorders are also at increased risk.

Premature babies and low-birth-weight infants are also more likely to develop a congenital hernia.

Diagnosing inguinal hernia

Diagnosis is based primarily on clinical examination. The doctor examines the groin for a protrusion, which can be accentuated by asking the patient to cough or stand. In some cases, an ultrasound scan is necessary to confirm the diagnosis, particularly if the hernia is not easily palpable. In children, the diagnosis may require careful observation during crying or exertion.

Treating inguinal hernia

The standard treatment is surgical repair. Two main techniques are used:
Open surgery (Lichtenstein technique): This involves making an incision in the groin to access the hernia and repair it by placing mesh to reinforce the abdominal wall.

Endoscopy and laparoscopy (TEP and TAPP): This minimally invasive technique uses small incisions and a camera to guide the repair. It reduces post-operative pain and allows a faster recovery.

In some cases, active surveillance may be proposed, particularly in asymptomatic patients. However, most hernias progress and eventually require surgery. Open surgery is performed in cases where laparoscopic surgery is not indicated.

Progression and possible complications

Recovery times after hernia surgery vary according to the technique used and the individual characteristics of the patient. In general, laparoscopic procedures allow a return to daily activities within a few days, whereas open surgery may require a longer period of rest. It is often recommended to avoid strenuous physical effort for at least 2 to 4 weeks, depending on the surgical technique, to allow optimal healing. Personalized instructions are usually provided by the medical team to optimize recovery and minimize the risk of complications.
If left untreated, an inguinal hernia has a high risk of worsening. Following hernia surgery, there may be chronic pain, which is exceptional but will require medical management.

Preventing inguinal hernia

Congenital defects that predispose to inguinal hernia cannot be prevented. However, it is possible to minimise excessive strain on abdominal muscles and tissues by adopting healthy habits. Maintaining a healthy weight, eating a high-fibre diet to avoid constipation, quitting smoking to reduce chronic coughing, and lifting properly by bending the knees. These measures can reduce the risk of developing or aggravating a hernia.

When should you contact the Doctor?

You should seek medical advice if you notice a protrusion or feel pain in the groin. If there are signs of strangulation (intense pain, nausea, vomiting, abnormal colour), you should seek urgent medical attention.

Care at Hôpital de La Tour

Hôpital de La Tour offers personalized care and uses advanced surgical techniques to minimize complications and promote rapid recovery.

FAQ on inguinal hernia

What is an inguinal hernia?
An inguinal hernia is a condition in which part of the fat or an abdominal organ, such as the intestine, protrudes through a weak point in the abdominal wall in the groin area. This protrusion may be visible and become more pronounced during exertion or when standing.

What are the symptoms of an inguinal hernia?
Pain or heaviness in the groin, accompanied by a visible protrusion, especially during exertion.

What are the treatments?
The main treatment is surgical, aimed at repairing the weak point in the abdominal wall. Two techniques are commonly used: open surgery (Lichtenstein technique) and laparoscopy. In some asymptomatic cases, active surveillance may be proposed, although most hernias progress and eventually require intervention.

Can hernias go away on their own?
No, inguinal hernias do not resolve spontaneously. If left untreated, it can worsen and lead to serious complications such as incarceration or strangulation, which are medical emergencies.

When should I consult a doctor?
It is important to consult a doctor if you notice a protrusion or feel pain in the groin, even if it is slight. Urgent surgery is necessary in the event of intense pain, nausea, vomiting or a change in the colour of the hernia.

Is inguinal hernia surgery risky?
Inguinal hernia surgery is considered safe. Modern techniques, in particular laparoscopy, reduce the risk of complications and allow a rapid recovery. However, as with any operation, rare complications such as infections or chronic pain are possible.

The number

More than 25,000 inguinal hernia operations are carried out every year in Switzerland, the majority of them on an outpatient basis

Did you know ?

Inguinal hernias are twice as common on the right as on the left, probably due to anatomical differences

Who should I see about these symptoms?

We recommend that you see the following health professional(s) :