What is Inguinal Hernia?

What is Inguinal Hernia?

Inguinal hernia is a type of hernia that develops due to a weak point in the inguinal canal. It can cause a lot of discomfort and interrupt the ability to perform basic activities. And surgery is the most plausible solution to repair the hernia. During the surgery, the weakness in the abdominal wall through which the abdominal content slips out into the inguinal canal is repaired.
Surgery is the ultimate treatment for an inguinal hernia as well as other types of hernias as they don’t resolve on its own. It can be performed electively or on an emergency basis depending on the severity of the condition. Elective hernia surgery is offered to the patients after considering the level of pain/discomfort, degree of disruption, as well as the overall health of the patient.
Emergency surgery is typically performed on patients who develop life-threatening complications, such as strangulation or incarceration.

How does inguinal hernia form?

Inguinal hernia, also known as groin hernia, forms when the abdominal tissues or organs push through a weak spot in the inguinal canal. This type of hernia typically occurs in males in which the opening between the testicles and abdomen is not closed properly. Normally, the opening closes shortly after the birth. But when the opening is partly open, it compromises the integrity of the muscle wall and creates a weak spot.
When the tissues start pushing against the weak spot, a bulge starts to form that may or may not cause any symptoms at first. But as the bulge continues to push the muscle wall and creates a hole, symptoms will start to appear.

Types of Inguinal Hernia

1. Direct Inguinal Hernia
2. Indirect Inguinal Hernia

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Causes of Inguinal Hernia

• Excess pressure on the abdominal muscle wall

Symptoms of Inguinal Hernia

• A bulge in the groin region

• Burning or aching in the bulge

• Occasional pain and discomfort in the groin

• Feeling pressure or weakness in the area

• Pain or swelling around the testicles (in males)

Diagnosis of Inguinal Hernia

Self-Diagnosis

An inguinal hernia starts with a small lump in the groin region. Even in the earlier stage, you will be able to feel the lump around the pubic bone. If you notice such a lump, note down or mark the location. Lie down and make a note of whether the lump disappears or becomes smaller. If so, it may be an inguinal hernia.
The best thing to do next is to consult a hernia specialist and get properly diagnosed.

Diagnosis By a Doctor

Tests

Severity of Inguinal Hernia

Inguinal hernia in the early stage can be managed by restricting the physical activities of the patient. As the condition progresses, it becomes severe and exhibits symptoms like-

• Difficulty in performing the basic activities, including walking and climbing stairs.
• Pain that comes and goes (sometimes stay for a long period)
• The hernia cannot be pushed back inside.

Symptomatic hernias are usually severe and it is always better to seek medical help to prevent them from advancing further.

Prevention of Inguinal Hernia

As inguinal hernia usually arises due to congenital weakness, it is difficult to prevent the condition from developing. However, if there are no congenital defects in the body, the following tips can be used to prevent an inguinal hernia from developing-

• Maintain a healthy weight through a balanced diet and exercise. Healthy food will provide ample nutrients to the body and exercise will strengthen the muscles. Thus, there will be lower chances of developing all kinds of hernia.
• Focus on the quality of food as well. Take a fiber-rich diet and drink plenty of water to prevent constipation as it is one of the primary causes of abdominal strain.
• Avoid performing strenuous activities that are beyond your limits, including lifting heavy objects or exercising longer than necessary.

Visit a doctor for a full-body checkup after every 6 months. Regular body checkups will make it easier for the doctor to identify if there is any health problem that you should worry about, including inguinal hernia.

When to consult an inguinal hernia doctor?

Normally, you should consult a hernia doctor as soon as you notice the bulge in the groin region. This will ensure that the condition doesn’t progress further. However, in most cases, people don’t pay much attention to the bulge and don’t take the necessary precautions as well. Due to this, the condition advances and ultimately require medical treatment.

If the following symptoms are present, you should promptly visit a doctor-

• Fever
• Nausea and vomiting
• Extreme pain
• Warm bulge and redness around the skin
• Inability to pass gas or stool

These symptoms indicate that the hernia is most probably strangulated and surgical repair is required immediately.

Questions to ask your doctor regarding Inguinal Hernia

• How many years of experience do you have?
• What is the best treatment method for inguinal hernia?
• Are there any alternative treatment options besides hernia surgery?
• Will a mesh be used for the repair?
• Are there any risks associated with the procedure?
• What is the success rate of open and laparoscopic inguinal hernia repair?
• How long will I need to recover completely?
• When can I go back to work?
• What are the chances that hernia will recur after surgery?

Inguinal Hernia - Treatment Options & Cost

Non-Surgical

If the hernia is not bothering the patient and there are no clear symptoms, the doctor will recommend watchful waiting. If required, the doctor may also suggest using a supportive truss to help the patient get relief from the symptoms.

Types of Inguinal Hernia Surgery

There are two types of hernia surgery-

Herniorrhaphy (Tissue Repair)

It is the standard procedure carried out to repair the inguinal hernia by returning the displaced organ to its original location. The hernia sac is removed and the sides of the muscle opening are stitched together to close the hole.

Hernioplasty (Mesh Repair)

In this type of hernia repair, the surgeon uses a mesh to close the muscle opening in the wall. In most cases, a synthetic mesh is used to cover the hole and act as reinforcement to strengthen the muscle wall.

The surgeon makes small cuts around the hole in the shape of the mesh and stitches the patch properly with the healthy tissues.

Inguinal Hernia Surgery Preparation

The preparation for inguinal hernia repair involves the following steps-

• You have to avoid eating or drinking anything at least 6-8 hours before the surgery.
• Give the list of medications that you take on a regular basis to the doctor so that he/she can adjust the medications accordingly. Some medicines can react with anesthetic agents and may cause reactions in the body. Thus, it is important that the medicines are checked and adjusted before the surgery if required.
• Avoid taking aspirin, blood thinners, or anti-inflammatory medications at least a week before the surgery.
• Get evaluated properly to eliminate the chances of any underlying medical condition that can impact the outcome of the surgery.
• Take a shower on the day of surgery and wear loose and comfortable clothes that don’t restrict your movement or rub against the body.
• Ask a friend or family member to accompany you on the day of surgery.

What to expect during the Inguinal Hernia surgery?

The steps involved in the surgery are explained below-

• An anesthetist will give you anesthesia (local, regional, or general depending on the technique used for the surgery). As the anesthesia takes effect, you won’t be able to feel any kind of pain or discomfort.
• Incisions will be made across the abdomen. If the open technique is being used, then a large incision will be made in the abdomen. If the laparoscopic technique is being used, then the surgeon will make 2-3 keyhole-sized incisions across the abdomen to insert the surgical equipment.
• The herniated organ or tissue is pushed back in the original location and the hole is closed with or without the help of the hernia mesh.
• Once the muscle wall is repaired, the stitches are closed with the help of stitches, staples, or surgical glue.
• You will be transferred to an observation room until the anesthesia wears off and then moved back to your ward where you’ll rest for the day.

After the Inguinal Hernia Surgery

Immediately after the inguinal hernia surgery, you will feel numb and have little or no sensation in the surgical site. IV fluids and pain medications will be given to you to manage the pain when the anesthesia wears off.

In many cases, when hernia surgery is done electively without any complication, the patient is discharged on the same day. However, in complex cases, the doctor may suggest hospitalization for more than 24 hours to ensure that there are no post-surgery complications.

During discharge, the doctor will also give you a recovery guide that will help you get back on your feet as soon as possible.

Inguinal Hernia Surgery Comparison - Before & After

Once the surgical repair is complete, you will get relief from the symptoms, including the bulge, pain, nausea, etc. The after-effects of hernia repair surgery will also resolve after some time and there won’t be any lingering symptoms of inguinal hernia.

Cost of Inguinal Hernia Repair

The cost of inguinal hernia repair varies across India based on the factors below-

• The choice of hospital
• Doctor’s fee
• The city you live in
• Risks and complications
• Diagnostic tests
• The technique used for treatment (open or laparoscopic)
• Type of mesh used (if any)
• Hospitalization expense
• Pre and post-surgery medications
• Follow-up consultations

Based on these factors, inguinal hernia surgery can cost you around Rs. 65,000 to Rs. 2,50,000 approximately. The exact cost will vary for each patient. So, it is important that you get an estimate for the treatment and also discuss the payment options.

Inguinal Hernia Insurance coverage

Inguinal hernia can lead to life-threatening complications which is why its treatment is necessary. Thus, the hernia treatment is covered under the insurance policy. You can pay for the entire treatment by using the insurance through cashless or reimbursement payment modes.

However, the amount of coverage you have in the purchased policy may vary. Hence, the amount you can claim may be limited and there is a possibility that the entire treatment cost may not be covered. Therefore, it is advised that before getting admitted to a hospital, you have a detailed discussion with the insurance provider and find out how much coverage you have for inguinal hernia treatment.

Inguinal Hernia Recovery rate

The recovery after inguinal hernia surgery depends on the technique used. When the laparoscopic technique is used for the repair, the complete recovery takes around 3-4 weeks. You will be able to resume normal activities like walking, climbing stairs, sitting, etc. within the first week, but the surgical wound would need longer for recovery.

In case open surgery is performed to repair the hernia, the recovery rate will be slow and you may need around 4-6 weeks to recover completely and return to your normal routine.