An inguinal hernia is an abnormal opening in the abdominal wall, more common in men, and usually following the spermatic cord and testicular vessels from the abdomen to the scrotum. 

An inguinal hernia is not necessarily dangerous, however it will not improve on its own and will tend to get larger over time.  Complications related to an inguinal hernia such as a loop of bowel becoming trapped can be life-threatening and require emergency surgery.  If the hernia is becoming painful and or enlarging, then surgery is generally recommended.  This is a very common operation for general surgeons.

• A bulge in the groin that can become larger on standing, straining or going to the toilet.  Often goes away on lying down or with gentle pressure applied ; 
• Groin pain that can be worse of coughing, straining or lifting something heavy ; 
• Occasionally swelling of the scrotum when the hernia becomes large enough ; 
• A heavy or dragging sensation over the groin.

Physical examination is the best way to detect all abdominal wall hernias, and a referral can therefore be made to us without any imaging. If a hernia is not clinically apparent, imaging such as an ultrasound, CT or MRI may be requested by your surgeon prior to surgery.

Groin hernias can be repaired with an open or minimally invasive keyhole approach. They are generally always repaired using a mesh to reduce the risk of recurrence. Most small hernias are day-surgery cases, however patients with larger hernias or on blood thinning medication will usually stay in hospital overnight.

Keyhole hernia repairs are now done very commonly, and are usually the preferred option unless contraindicated.  They are associated with less post operative pain and a shorter return to normal activities.

There is a small risk <5% of early or late recurrence of hernia.  There is also a risk of post-operative pain, which can become chronic pain.  This is why it is generally not advisable to operate on small asymptomatic hernias that have been found incidentally.  

With open repairs, the ilio-inguinal nerve is sometimes divided, which can cause numbness over the mons pubis, labia majora, scrotum or upper thigh.

Dissolvable sutures are used to close skin.  In general, these do not require removal. You can shower with the dressings on after 48hours.  If the outer opsite dressings become soiled or fall off, there is surgical steristrip tape underneath that will usually stay on.  It is a good idea to keep the skin incisions covered for a minimum of 5-7 days.  We will usually remove the dressings for you on your post-operative clinic review.  A small amount of dried blood on the dressings are not of clinical concern.  

Please avoid strenuous activities for 4 weeks following surgery and avoid heavy lifting [>5kg] or straining for 6 weeks.  Try to avoid constipation by staying hydrated and including regular fruit and vegetables in your diet.  If constipation is an issue for you, you might also consider taking over the counter laxatives such as Movicol, Coloxyl and Senna or lactulose during your recovery period.