Groin hernia

Groin hernia presents as a lump in the groin. 

It occurs when the tissue, such as a part of intestine or fat, protrudes through a weak spot in the abdominal wall muscles. Such a bulge can be painful and can increase in size when the patient coughs, bends over or lifts heavy objects. Hence it is best noted in the standing posture. 

It can occur on both sides – not at the same time but may present sometime in the future on the other side.

However most hernia do not cause frank pain but will only cause discomfort or a dragging sensation in the groin. All hernia does not require surgery right away.

Causes and risk factors:

  • Increased pressure inside the abdomen
    • Straining during bowel movements
      • Chronic constipation
    • Strenuous activity or exercises
    • Pregnancy
    • Chronic cough
    • Chronic sneeze
  • Pre-existing weak spot in abdominal wall muscles
  • Congenital reasons
  • Male gender
  • Smoking
  • Previous inguinal hernia or hernia repair


  • Physical examination is all that is required to diagnose a hernia
  • Sometimes a CT scan or ultrasound may be required to rule out some other high-risk conditions that may be the cause for such a hernia

The possible differentials are:

  • Inguinal hernia
  • Femoral hernia 
  • Inguino-scrotal hernia
  • Sometimes hydrocele of testis, hydrocele of Canal of Nuck, encysted hydrocele of the cord, cord lipoma or inguinal lymph node can be mistaken for the groin hernia.


  • Management of groin hernia is surgery, if symptomatic
  • This can be done by conventional open technique or by laparoscopy (keyhole) or by robotic approaches
    • Lichtenstein’s open mesh repair can be done under general anesthesia or under spinal anesthesia
    • Laparoscopic mesh repair has to be done under general anesthesia
    • If the hernia recurs after laparoscopic repair, then we will offer open repair
    • Laparoscopic or keyhole or minimally invasive surgery will offer less discomfort, less scarring and a quicker return to activities – when compared to open surgery. However long-term results are comparable
    • Laparoscopic approach is preferred for those with hernia on both sides (bilateral)
    • We will discuss and decide which procedure best suits for the patient
  • Both approaches can be done as Day Surgery.

Most common reasons to recommend surgery for hernia:

  • Painful and symptomatic hernia
  • Irreducible hernia
    • When the contents of the hernia are trapped and unable to be reduced
  • Obstructed hernia
    • When the intestine within the hernia is blocked
    • This is a medical emergency and requires urgent surgery
  • Strangulated hernia
    • When the blood supply to the intestine or the tissue within the hernia is cut off due to entrapment
    • This is a medical emergency and requires urgent surgery
  • Recurrent hernia
  • Cosmetic reasons

Red flags: Consult us immediately if the patient notices…

  • Sudden pain with high intensity
  • A hernia that was usually reducible but it is now “not going back inside”
  • A hernia that turns red or purple or dark in color
  • Nausea or vomiting with abdominal bloatedness or distension
  • Unable to move bowels or pass gas for more than two days with abdominal bloatedness or distension

Road to recovery after surgery:

  • It only takes about 60-90 minutes for a hernia surgery
  • Patients can resume normal diet after recovery
  • Patients can resume normal daily activities after recovery, however we will recommend taking rest for a week atleast
  • Patients should refrain from strenuous exercises, swimming, or competitive sports, etc. for about 6-8 weeks
  • Most patients completely heal in 3-4 weeks.
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