What is an inguinal hernia?
A hernia a weakness in the abdominal muscle at the groin. A hernia causes a lump in the groin that is sometimes painful.
There is a natural weakness in this area and patients can be born with a hernia. Hernias can develop at any age. Commonly they occur as a result of repeated heavy lifting or muscle weakening due to ageing. All hernias require surgical repair.
What causes an inguinal hernia?
Sometimes there is no cause for the hernia but mostly it is due to lifting and straining. Occasionally a single event causes the hernia but more commonly it is due to repeated lifting. Other causes include chronic cough and urinary outflow problems.
What are the symptoms and complications?
Hernias cause a lump in the groin area. This lump is sometimes painful. The lump may or may not disappear when you lie down.
The defect in the muscle allows the intraabdominal contents (bowel, fat etc) to enter the hernia. Eventually the hernia will get larger and cause more symptoms. Occasionally there are dangerous complications such as bowel obstruction and strangulation of the contents.
What are worrying symptoms?
- Increasing pain
If any of these occur urgent treatment is required.
What treatment is required?
Surgery is always required. Belts and harnesses do not work. The hernia will never get better without surgery.
How is the surgery performed?
The repair can be done via cut in the groin area as an open operation or with a series of small cuts in the abdomen as a laparoscopic (keyhole) operation. The choice depends on the size of the hernia and whether or not other operations have taken place already. Both operations involve reinforcing the defect in the abdominal wall with a plastic mesh that is permanent.
Which operation is better?
Both operations are safe and effective and have low recurrence and complication rates. Larger hernias, emergency operations and patients with previous surgery require open surgery. Laparoscopic surgery has a slightly faster recovery time but also a slightly higher recurrence rate.
What are the complications?
The complication rate is low (1-2%).
- Bleeding: The may be bruising at the wound that may extend to the scrotum in men.
- Pain: There is always pain after the operation, which lasts for a few weeks, Some patients develop chronic pain (more than 6 weeks) and this is due to nerve irritation. The problem can require long-term painkillers in a small minority of patients.
- Urinary problems especially if pre-existing problems
- Recurrence is uncommon
What can I expect after the operation?
Most surgery is performed as a day only or very short stay in hospital. You will be able to walk immediately and climb stairs. You will require painkillers that you will be given in hospital.
When can I resume normal activities?
There will be no lifting allowed for 2 weeks. You can carry your plate and cup but not much more. After the initial 2 weeks there will be a further period of 2 weeks of light duties (no more than 5kg). These restrictions are to allow time for the mesh to secure into the muscle.
If you work at a desk without any lifting you can return to work in around a week. You can drive once you are no longer requiring strong (prescription) medication. If your work does involve lifting but has no light duties you will need the full 4 weeks off. Each patient’s circumstances are different and certificates will be issued accordingly.
What is the follow up?
Dr Pathma-Nathan will see you in 2-3 weeks.