Hernia

Most of people know they have hernia problem but they are unable to figure out the type of hernia. They do not know the difference between femoral and inguinal hernia or direct or indirect hernia. Sometimes, hernia goes away on their own but sometimes they need immediate medical attention. Let us know the difference between the two most common types of hernia.  

What is an inguinal hernia?

An inguinal hernia occurs in the abdomen near the groin area. It occurs when intestinal tissues protrude through a weak muscle in the abdomen. It is at the base of the abdomen. The protrusion along the groin area may increase in size when you cough or stand up.

Inguinal hernia

The symptoms of an inguinal hernia include:

  • Pain while coughing, exercising or moving
  • Sensation in the groin
  • Burning sensation
  • Swelling of the scrotum in men

The causes of inguinal hernia can be extra pressure on this area of the body. Some other factors can be:

  • Heredity
  • Premature birth
  • Obesity
  • Chronic cough
  • Chronic constipation
  • Being male
Causes of inguinal hernia

Inguinal hernia can be direct or indirect. An indirect hernia happens in premature births before the inguinal canal becomes closed off. This can happen at any time during your life and mostly happens in male. While direct hernia occurs in adults as they age. An incarcerated inguinal hernia occurs when tissues get stuck in the groin and cannot be reduced. Also, when intestine in an incarcerated hernia has its blood flow cut off, it is known as strangulation.

Treatment of inguinal hernia

If the inguinal hernia is small and is not bothering you much, the doctor may suggest you wear a truss. It may help relieve symptoms but talk to the doctor and make sure that you wear the correct size. If the hernia is large and causes pain and discomfort, you may need surgery. There are two types of surgeries – open repair and laparoscopic repair.

In the open surgery, the surgeon makes an incision in the groin and pushes the protruding tissues into the abdomen again. Then the weak area is sewed often reinforcing it with a synthetic mesh. The recovery may take some time.

Laparoscopic surgery for inguinal hernia is a minimally invasive surgery that requires general anesthesia. The surgeon makes two to three small incisions in the abdomen. The surgeon inflates the abdomen using carbon dioxide to get a clear view of the internal organs. A thin tube-like instrument called laparoscope with a camera fixed on top of it is used to perform the surgery along with other surgical tools. There is less discomfort and scarring after the surgery. The recovery is faster in the case of laparoscopic surgery.

Also Read: What to expect under Hernia Surgery?

What is a femoral hernia?

Your muscles are strong enough to keep your organs and intestine intact. Sometimes, your intra-abdominal tissues get back through the weak spot in the muscle when there is a strain on them. If a portion of the muscle gets back through the femoral canal, it is known as a femoral hernia. It is a bulge near the groin or thigh. The femoral canal contains a femoral artery, smaller veins, and nerves. Femorocele is another name for a femoral hernia.

Femoral hernia

This is more common in women than in men. Most femoral hernias do not cause symptoms. However, they may lead to severe problems if the hernia blocks the blood flow to your intestines which is known as strangulation. It is a medical emergency and needs immediate surgery.

What causes the femoral hernia?

There are chances that an individual is born with a weak area of the femoral canal or it may get weak over time. The primary cause of femoral hernia can be straining. Furthermore,  straining maybe because of the following factors:

  • Chronic constipation
  • Heavy lifting
  • Being obese
  • Childbirth
  • Difficulty urinating due to an enlarged prostate

Signs and symptoms of femoral hernia

The small-sized hernia may not give any symptoms and do not give any bulge. Whereas large hernias may be noticeable and cause pain and discomfort. The bulging may become worse and can cause pain when you stand up, sit or strain in any way. It may cause hip pain as it is located close to the hip bone.

Some severe symptoms may include obstructing the intestines, which is a serious condition called strangulation. Again, it is a medical emergency. Other symptoms may be:

  • Severe stomach pain
  • Groin pain
  • Nausea
  • Vomiting

The diagnosis of femoral hernia is done by conducting an ultrasound of the abdomen and the groin area.

Ultrasound

Treatment of femoral hernia

Femoral hernia between medium to large needs surgery, especially if they are causing pain and discomfort. The surgery is under general anesthesia. It is either done through open surgery or laparoscopic surgery. In open surgery, the surgeon makes a long incision at the defect area. The recovery takes longer in comparison to laparoscopic surgery.

In the laparoscopic surgery, the surgeon makes two to three small incisions that minimises the blood loss. There are advantages of laparoscopic surgery for femoral hernia are: 

  • Less pain after surgery
  • No scarring
  • Short hospital stay
  • Short recovery time
  • negligible post-surgery complications

Difference between inguinal and femoral hernia

Inguinal hernia Femoral hernia
It is more common in male It is more common in female
Passes through the inguinal canal It passes through the femoral canal
It is above the crease of the groin This is below the crease of the groin
Can reduce completely It cannot reduce completely
The neck of the sac is above and in the middle of the pubic tubercle The neck of the sac is below and lateral the pubic tubercle
This is less common to be strangulated It has a higher risk of strangulation
It may be treated without surgery Femoral hernia must be treated surgically
Cough impulse usually present Many do not have cough impulse
The sac mainly contains bowel The sac mainly contains omentum

Also Read: Difference between a direct and indirect hernia

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