A hernia occurs when an internal organ/intestines pushes through a weakness in the abdominal muscle wall.

A hernia can develop if there are any weak spots.

What is an inguinal hernia?

An inguinal hernia is the most common type of hernia. It can appear as a swelling or lump in your groin, or as an enlarged scrotum (the pouch containing the testicles). The swelling may be painful.
The lump often appears when you're lifting something and disappears when you lie down.

There are other types of hernia: femoral hernia, Spiegel hernia, umbilical hernia depending on the location of the weakness on the abdominal wall

What causes an inguinal hernia?

> An inguinal hernia usually occurs when a part of your bowel, such as the intestine, pokes through into your groin.
> It pushes through a weak spot in the surrounding muscle wall (the abdominal wall) into an area called the inguinal canal.

Inguinal hernias occur mainly in men. Most are thought to result from ageing, although they can occur at any age. This is because as you get older, the muscles surrounding your abdomen (tummy) can become weaker.

Inguinal hernias can sometimes appear suddenly after putting pressure on the abdomen, such as straining on the toilet if you have constipation or carrying and pushing heavy loads. They have also been linked to having a persistent, heavy cough.

When is surgery needed?

Inguinal hernias can be repaired using surgery to push the bulge back into place and repair the weakness in the abdominal wall with a mesh.
If you have a hernia that causes pain, severe or persistent symptoms, or other serious complications operation is required.

Serious Complications that can develop and need emergency repair include:

> Obstruction – where a section of the bowel becomes stuck in the inguinal canal, causing nausea, vomiting and stomach pain, as well as a painful lump in the groin

> Strangulation – where a section of bowel becomes trapped and its blood supply is cut off; this requires emergency surgery within hours to release the trapped tissue and restore its blood supply, so it doesn't die

Surgery gets rid of the hernia to prevent any serious complications, but there's a chance it could return after the operation.

What is done during an inguinal hernia repair?

Open surgery – where one cut is made to allow the surgeon to push the lump back into the abdomen
Laparoscopic (keyhole) surgery – a less invasive technique where several smaller cuts are made, allowing the surgeon to use various special instruments to repair the hernia

There are advantages and disadvantages to both methods. Discuss with Mr Damas which surgery is better for you.

Patients usually go home the same day or the day after surgery. It's important to follow the surgeon instructions on how to look after yourself. This includes eating a good diet to avoid constipation, caring for the wound and not straining yourself too soon.

Most people make a full recovery from inguinal hernia repair within six weeks, although many people can return to driving, work and light activities within two weeks.

What are the risks from the operation?

An inguinal hernia repair is a routine operation with very few risks. However, up to 10% of hernias come back at some point after surgery. Around 2-4% of hernias return within three years and need reintervention.

Other potential risks of inguinal hernia repair include:

> Blood or fluid building up in the space left by the hernia (this usually gets better without treatment)
> Painful swelling and bruising of the testicles or base of the penis (in men)
> Pain and numbness in the groin area caused by a nerve being damaged or trapped during surgery
> Damage to the blood supply to the testicle
> Damage to the vas deferens – the tube that carries sperm to the testicles

Complications are more likely if you're aged over 50, smoke or have another illness, such as heart disease or breathing problems.