Patient information · Minor surgery
Hernias
and the one situation that cannot wait
A hernia is a bulge where an internal structure pushes through a weakness in the abdominal wall. Most are uncomfortable rather than dangerous and many can be watched. But a hernia that becomes trapped is a surgical emergency, and knowing the difference is the point of this leaflet.
Call 999 or go to an emergency department if a hernia
- becomes suddenly painful, hard or tender
- cannot be pushed back in when it previously could
- turns red, purple or dusky
- comes with vomiting, and not passing wind or stool
- comes with fever, a racing heart or feeling very unwell
- is in a baby or child and cannot be reduced
A strangulated hernia has lost its blood supply and the trapped bowel dies within hours. This is a surgical emergency requiring an operation the same day, not a wait-and-see. In an emergency call 999, or go to the Royal London Hospital Emergency Department, Whitechapel Road, London E1 1FR.
The common types
- Inguinal — groin, by far the commonest, much more frequent in men. May extend into the scrotum.
- Femoral — upper thigh, more common in women, and far more likely to strangulate, so usually repaired promptly.
- Umbilical and paraumbilical — at or near the navel. Common in babies, where most close on their own by age four or five.
- Incisional — through the scar of a previous operation.
- Hiatus — stomach through the diaphragm. Causes reflux rather than a visible lump, and is managed differently.
What you may notice
- a bulge that appears on standing, coughing or straining and disappears on lying down
- a dragging or aching discomfort, worse at the end of the day
- in men, swelling extending into the scrotum
- occasionally no symptoms at all, found on examination
- Hernias do not heal by themselves in adults, and they gradually enlarge.
Do small hernias need repairing?
Not always. For a small, painless inguinal hernia in a man that reduces easily, watchful waiting is a reasonable option — the risk of strangulation is low. Most people do eventually come to surgery because symptoms increase. Femoral hernias are different and are repaired promptly because of the strangulation risk, as are hernias that are painful, enlarging or difficult to reduce.
Surgery
- Open repair through a small incision, usually with a mesh, under local, regional or general anaesthetic.
- Keyhole repair, often preferred for hernias on both sides or recurrent hernias, and generally with less post-operative pain.
- Most repairs are day cases.
- Recovery: light activity within days; driving when you can perform an emergency stop without hesitation, usually one to two weeks; heavy lifting and manual work typically after four to six weeks.
- Bruising and swelling in the groin or scrotum is common and settles over weeks.
- Risks include recurrence, and in a small proportion persistent groin pain.
Living with one before surgery
Helps
- Treating constipation and avoiding straining
- Treating a chronic cough, and stopping smoking
- Losing excess weight, which reduces pressure and makes repair easier
- Lifting with technique, and avoiding very heavy single lifts
- Knowing the strangulation warning signs
Not recommended
- Trusses and support belts as a long-term solution — they do not treat it and can cause complications
- Pushing hard to reduce a hernia that has become painful
- Ignoring a hernia that is enlarging or newly uncomfortable
- Heavy gym work while a hernia is symptomatic
- Assuming a groin lump is a hernia without examination
Why come to us. A groin lump needs examining, and not every one is a hernia — enlarged nodes, a hydrocele, a lipoma and a femoral aneurysm all present similarly. We examine you, perform ultrasound on site in the same visit where the diagnosis is uncertain, advise honestly on whether repair is needed now or can be watched, and arrange surgery through our CQC-registered partners without a wait. Seven days a week, no referral needed.
Examined and scanned in one visit
Ultrasound on site, honest advice on whether it needs repairing.
Tower Bridge Hospital London
97–99 Whitechapel Road, London E1 1DT
WhatsApp 07903 284 189
info@mhwclinic.co.uk
Open Mon–Sat, 9am–7pm (closed Sundays until September)
In an emergency
Call 999, or go to the Royal London Hospital Emergency Department, Whitechapel Road, London E1 1FR.
When we are closed and it is not an emergency
Call NHS 111 or visit 111.nhs.uk.