What is a groin hernia?
An inguinal hernia passes through a weakness in the groin canal and may extend into the scrotum. A femoral hernia appears slightly lower, near the upper thigh. Femoral hernias are less common but are more likely to become trapped, particularly in women.
The lump may enlarge on standing or coughing and cause dragging, burning or pressure. Examination is needed because lymph nodes, a hydrocele and other swellings can look similar.
What are the symptoms of a groin hernia?
Some groin hernias cause no pain at all. Common symptoms are:
- A bulge in the groin or scrotum that grows on standing or coughing and gets smaller when lying down
- A dragging, aching or burning feeling in the groin, often worse by the evening
- In women, a lump just below the groin crease near the upper thigh, which may be a femoral hernia
- A bulge that becomes painful, firm or cannot be pushed back, which needs emergency care
How is a groin hernia diagnosed?
Most groin hernias are diagnosed by examining you while standing and coughing. Ultrasound helps when the lump is uncertain; CT or MRI is reserved for selected hidden, recurrent or complex hernias. The surgeon also checks the opposite groin, previous scars, urinary symptoms, chronic cough and fitness for anaesthesia.
When does a groin hernia need surgery?
Planned repair is usually recommended for pain, activity restriction, enlargement, a suspected femoral hernia or a groin hernia in a non-pregnant woman. A groin hernia does not heal by itself and can trap bowel, so repair is usually advised once it is diagnosed.
Mesh reinforcement lowers recurrence for most adults. A tissue repair without mesh is suitable only in selected circumstances and requires the right expertise.
How is a groin hernia repaired, and what are the risks?
Open repair treats the hernia through a groin incision and may be possible without general anaesthesia. Laparoscopic or robotic repair works from behind the abdominal wall and can be useful for hernias on both sides or after a previous open repair. A recurrent hernia is usually approached through a tissue plane that has not already been used.
Risks include bruising, fluid collection, urinary retention, infection, injury to vessels or bowel, testicular complications, chronic groin pain, numbness and recurrence. The safest approach depends on the hernia and the patient.
Recovery after groin hernia repair
Walking and comfortable light activity are encouraged early. Use pain relief as prescribed and avoid constipation. Return to work, driving and lifting depends on comfort, the operation and your job.
Seek review for increasing swelling or redness, fever, persistent vomiting, inability to pass urine, severe pain or a recurrent lump. A small postoperative ridge or fluid collection can be normal but should be checked if it is enlarging.
When to seek urgent care
Go to an emergency department if a groin lump becomes suddenly painful, firm or impossible to push back, especially with vomiting, abdominal swelling, fever or inability to pass stool or gas. These signs may mean trapped or strangulated bowel.