Hernias are one of the most common problems encountered in my practice. A hernia is a weak place in the abdominal wall muscles, with fat or intestines protruding through from inside the abdomen. The most common type of hernia is an inguinal hernia. Other types include umbilical hernias (an “outie” belly button) or incisional hernias (in old surgical scars). An inguinal hernia is most often found in men, since men have a natural weak spot in the muscle wall in groin. A hernia can happen at any age, from newborn babies to ninety-year olds. Inguinal hernias happen in women, too, but not as often.

People with an inguinal hernia usually notice a lump in the groin, and usually complain of pain or soreness, particularly after standing for a long time or lifting something heavy.
Sometimes sitting for a long time makes it sore, too. The lump and pain usually go away when people relax or lie down. Small hernias usually hurt more, while larger hernias can have a noticeable lump but don’t cause much discomfort. I usually recommend that patients make plans to get the hernia repaired at their convenience, to avoid it getting larger or becoming an emergency. The operation is done as an outpatient, and office workers are usually back at work within a week. The operation can be done laparoscopically using a television camera to view the defect from inside the abdomen, or the traditional, open approach, which has a slightly longer (one day extra) recovery. Mesh is almost always used in the hernia repair, since mesh decreases the chance of recurrent hernia (even with mesh there is about a 3 to 5% chance of having a hernia come back). No, I don’t use the bad mesh the lawyers are advertising on TV. There is a small risk (less than 1%) of bleeding or mesh infection, which might require another operation to correct. About 3% of patients have postoperative pain lasting more than a month, and I usually treat this with a steroid injection in the office. Most patients resume full activity including sports in 4 to 6 weeks without limitations.

Ignoring a hernia can lead to an ER visit and emergency surgery with an unknown doctor in the middle of the night, so I recommend you let your primary physician check you if you think you might have a hernia!

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