Hernias

Patient Information Series

What is a hernia?

Hernias result when body tissue protrudes through a weakness usually in a muscle wall. The commonest occur in the groin of which there are two types – Inguinal and Femoral. Others can occur at or around the umbilicus (belly button), through weak scars (incisional hernia) or inside the abdomen.

What causes a hernia?

A hernia can be present at birth or soon after (congenital) or acquired later in life.

What are the symptoms.

Hernias usually present as a lump which may disappear on lying down (reducible). Sometimes they may become uncomfortable and irreducible.

How is the diagnosis made?

Usually by examination of the patient by a doctor. Some difficult ones may require special xrays and/or scans (ultrasound, CT or MRI ).

What is the treatment?

Hernias causing no symptoms especially in a person who is unfit for an operation can be left alone and watched.

A support (truss) can often be helpful.

Surgery may be necessary especially where the hernia is causing symptoms to prevent complications.

This involves removing the swelling and repairing the weakness in the abdominal wall.

Most inguinal hernias in the UK are repaired using a prosthetic material (mesh repair).

Surgery can either be by open operation or laparoscopy (keyhole method) using either local or general anaesthetic.

Most repairs are now performed as day-case surgery with the patient returning home the same day or at most staying a night in hospital or a pre-arranged hotel.

What are the complications of a hernia?

These are emergencies when they occur:

Obstruction – when the hernia becomes stuck and cannot be pushed back. This can lead to
Strangulation – the blood supply is cut off following obstruction leading to gangrene of the hernia contents.

What are the complications of operation?

Bleeding. This may form a swelling requiring a return to theatre for evacuation.
Wound infection.
Recurrence of the hernia.
Damage to the blood supply to the testis.
Chronic discomfort in the wound.