What is a groin hernia?

A groin hernia occurs when tissue or part of the intestine bulge through a weak point in the abdominal wall and into the groin.

The two main types of groin hernia are inguinal hernias and femoral hernias.

Inguinal hernias represent about 75 percent of abdominal wall hernias. They may be present at birth or develop later in life. About 90 percent of inguinal hernias occur in men.
Femoral hernias represent roughly 3 percent of all hernias, and over 90 percent occur in women.

In both inguinal and femoral hernias, surgery is often recommended to avoid potential complications such as strangulation, which is when a portion of the bowel becomes trapped, cutting off its blood supply.

Because of the increased risk of complications, physicians typically recommended that femoral hernias are fixed quickly (although typically not on an emergency basis). Inguinal hernias, on the other hand, should be fixed electively if they are symptomatic. If they are not symptomatic, they can be observed after a discussion with your doctor.

illustration of inguinal hernia

illustration of femoral hernia

What are the risk factors for groin hernias?

Heavy lifting or other strenuous activities may contribute to a groin hernia developing, though most patients with a groin hernia have no prior risk factors.

What are the signs and symptoms of groin hernias?

In most cases, patients with an inguinal hernia present with a bulge in the groin or swelling of the scrotum. They may also experience pain when:

Coughing
Sneezing
Lifting heavy objects
Standing for long periods of time

Patients with a femoral hernia often present with a small bulge where the inner thigh meets the groin.

How are groin hernias diagnosed?

Your doctor will review your medical and surgical history and then carefully examine the affected area. He or she may also request that you stand and cough in order to detect a bulge which would signify a hernia.

A diagnosis of a groin hernia may be confirmed via imaging tests such as:

Ultrasounds
Computed tomography (CT) scans
Magnetic resonance imaging (MRI) scans

In addition, these tests may help your doctor pinpoint where the hernia is located and decide on the best treatment option.

What are treatment options for groin hernias?

Treatment options include:

Observation: In some milder cases, your doctor will recommend observing the hernia over time before taking more action.
Elective surgical repair: Some groin hernias cause excessive pain or discomfort, which may lead your surgeon to recommend elective (non-emergency) surgical repair.
Emergency surgical repair: Urgent or emergent surgery may be needed in the rare cases in which a groin hernia threatens to strangle a portion of the intestine.

Surgical repair of a groin hernia involves closing the weakness in the abdominal wall and reinforcing it, sometimes with synthetic mesh material. The method used depends on your hernia's size and location, your general health and your expected level of future physical activity.

What are the different types of groin hernia surgery?

The surgeons at the Brigham and Women's Hospital Hernia Program are highly experienced in the full range of surgeries for groin hernias, including:

Open hernia repair: This involves making an incision over the hernia site and pushing the bulging tissue or organ back in place. The surgeon then closes the hole with sutures or with a combination of sutures and plastic mesh.
Laparoscopic hernia repair: This is a minimally invasive procedure in which small incisions, a tiny video camera, special surgical tools and a piece of plastic mesh are used to repair the hernia.
Robotic hernia repair: This procedure is similar to laparoscopic repair. In this case, however, your surgeon uses robot-assisted technology to guide the movements of the surgical tools precisely.

As part of their role at a major academic medical center, our surgeons keep up to date on and incorporate into their practice the latest advancements in hernia surgery. In some instances, our surgeons are performing research that guides hernia care across the country and the world.

How do you make an appointment?

To learn more about the Hernia Program’s multidisciplinary approach to patient care or to schedule an appointment with one of our specialists, please call 617-525-9726. Our providers see patients at the following locations: