A hernia occurs when an internal part of the body pushes through a gap or weak spot in the wall of the groin.
Why did I get a hernia?
Some people have groin hernias from birth, while others develop hernias later in life.
Groin hernias in adults usually appear due to a combination of factors such as increasing age, obesity, smoking, or due to increased pressure within the tummy, for example due to a long-term cough or sustained heavy lifting.
Most adult groin hernias occur in men.
What are the symptoms of a hernia?
You may notice a swelling or lump in the groin. Coughing or straining may make the lump appear. This swelling can often be pushed back in or disappears when you lie down. People with a hernia often report discomfort in the groin. Men may also report discomfort in the scrotum.
Some people get no symptoms from a groin hernia.
What are the options for managing hernias?
The options for managing your hernia include leaving the hernia alone or repairing the hernia with an operation.
What will happen if I leave my hernia alone?
If left alone, a hernia will either stay the same size or will get bigger and cause more symptoms. Most hernias will get bigger and cause more discomfort over time.
If left alone, there is a small chance that fat from inside the tummy or part of the intestine can poke through the hole in the abdominal wall and get stuck. This is very painful and the hernia becomes hard and cannot be pushed back in. This usually requires emergency surgery to fix. This is rare.
What does inguinal hernia repair surgery involve?
An inguinal hernia repair can be carried out as either open surgery or keyhole (laparoscopic) surgery. The type of surgery that you can have will depend on the size of your hernia, if you have had hernia surgery before, your preference and your overall health.
What is the difference between open surgery and keyhole surgery?
Open surgery: Your surgeon will make a cut in the groin over your hernia bulge. The hernia is placed back into the abdomen and the gap in the groin muscle is closed with stitches. A piece of material called a mesh is then stitched onto the wall of the groin to add strength to the repair.
Keyhole or laparoscopic surgery: Three or four small cuts are made on your tummy. A camera, and instruments are then passed through these cuts. The hernia is pulled back into the tummy and a mesh is placed over the hole in the groin.
I heard surgery might be done with a robot: what does this involve?
If you are having keyhole surgery, your operation may be performed using a surgical robot. This means that surgical instruments (normally held by a surgeon) will be held by a robotic device. Your surgeon will control the movement of these instruments from a console or computer next to the operating table.
This should not affect your recovery or the success of the operation. Your surgeon will tell you in advance if they plan to do your operation robotically.
What type of anaesthetic will I have?
An open operation is usually done under general anaesthetic (where you are asleep) but can sometimes be performed with a spinal anaesthetic (you are awake but can’t feel pain below the belly button) or local anaesthetic (you are awake but cannot feel pain in the groin). The type of anaesthetic you have will depend on your current health and your preference.
Keyhole surgery is carried out under general anaesthesia.
You will receive more information about your anaesthetic before your operation. You will be able to discuss your options with your anaesthetist.
Why do you use a mesh?
The mesh provides strength to the hernia repair and reduces the chance of the hernia coming back again in the future. There is a higher rate of hernia recurrence in people who have a hernia repair without mesh.
What is mesh made of?
This mesh is made of a soft, thin, flexible sheet of plastic. The mesh looks like a small square of mosquito net.
Will the mesh stay inside my body?
Yes. The mesh remains inside the body permanently. Your body will grow into the mesh and it will become part of the wall of your groin. You should not be aware of the mesh. You should not be able to feel the mesh after surgery.
Is it safe to use mesh?
Yes. Mesh has been used in groin hernia repair for over 30 years. Mesh is considered safe and effective in most patients. There is a small risk of mesh getting infected. If this happens, you may need another operation to remove the mesh. This is rare.
I’ve heard bad stories about mesh in the news. Is it safe?
Most of these news stories have been about using mesh in pelvic floor surgery in women. In some women, the mesh eroded into the vagina or rectum causing pain and infection. These operations have now mostly been stopped due to these issues.
The mesh in groin hernia surgery is placed in a different part of the body (between layers of the tummy wall). The mesh should not be in contact with any inside organs.
Are there any complications of hernia repair surgery?
Most patients do not have any complications. The following list describes the complications that can happen after repair of a hernia.
- Bleeding or bruising - After the operation bruising can develop under the cut, in the groin and upper thighs. This will usually get better in 4 to 6 weeks.
- Injury to structure in the abdomen or groin - During the procedure there can be injury to a blood vessel, the bowel or bladder. This usually noticed during surgery and is fixed at the same time. This is rare (occurs in 1 in 200 cases).
- Urinary retention – Some people may have difficulty passing urine immediately after surgery. This is more common in elderly people, and men with an enlarged prostate. If this occurs, you will have a tube called a catheter inserted into the bladder. The catheter will stay in place for several days or weeks until you are able to pass urine on your own.
- Infection of wound – This is rare. Your wound may be hot, red, swollen and painful. If this happens you should contact the hospital. You will need treatment with antibiotics.
- Infection of mesh- If the mesh becomes infected it can cause serious problems and it may need to be removed. This is very rare (occurs in less than 1 in 500 cases).
- Chronic pain in groin (1 in 20) – It is common to get some discomfort in the groin after surgery, but it should not cause any disability. A very small number of people (1 to 2 in 100) have severe pain that requires further treatment and may never go away completely.
- Numbness – It is common to get some numbness in the groin, thigh and scrotum (if you are male). In most cases sensation will gradually return. Rarely, the numbness may be permanent.
- Recurrence of hernia –A hernia may come back again in the future. This may need another operation. Hernia recurrence is rare (occurs in 1 in 200 cases)
- Blood clots in legs or lungs - This is rare. Your risk is higher if you are overweight, a smoker, in poor general health, have difficulty walking, or have had a previous blood clot.
If you are male:
- Injury to the spermatic cord – the hernia lies next to the blood vessels, nerves and sperm tube of the testicle. These structures can be injured during surgery. This is rare.
- Bruising in scrotum - Men may notice some swelling and bruising of the scrotum and penis after hernia surgery. If this occurs, it is advisable to wear supportive underwear. If the sweeling is very tense or painful then you should get in contact with the hospital.
- Reduction in size of testicle –After the operation you may notice that the testicle on the side of your operation is smaller. This is very rare (occurs in less than 1 in 100).
Can people die having hernia surgery?
Yes, but this is very, very rare. Overall, around one person out of 800 having hernia surgery will die. This is usually due to a post-operative complication. Your risk is higher if you are elderly or in poor health.
Extra procedures which may become necessary during the procedure
Repair of hernia on other side of groin
If you are having a keyhole surgery, your surgeon may look for a hernia on the opposite side. They may repair this during the same operation. This will be discussed with you before your operation.
Conversion to open operation
If you are having a keyhole surgery, your surgeon maybe unable to complete the operation with keyhole surgery. The operation may be completed through a cut on the tummy or in the groin. This is rare.
Is there anything I can do to improve my health before having surgery?
- Personalised advice to improve health and well being while waiting for surgery
- If you are a smoker, you should stop as far in advance of your surgery as possible (at least 6 weeks). More information.
Information about local smoking cessation services. - If you are overweight, you should try and lose weight, and get down to your target weight for your height. Information about weight loss services in the area.
After Your Hernia Repair Operation
When can I go home after my operation?
Most people will go home the same day as their operation. Most people will stay in hospital for a few hours after their operation. You can go home as soon as you feel comfortable.
Will I need to have somebody to look after me at home?
Yes. You will need a responsible adult to take you home and stay with you for the first 24 hours. Many people feel tired and have some discomfort after surgery. It is helpful to have someone available to help with cooking, chores and shopping until you are fully mobile.
What medications will I be sent home with?
Most patients will be sent home with painkillers, anti-sickness medication and laxatives. We will provide instruction on when and how to take these medications.
Will I have pain after my operation?
It is common to get some discomfort in and around the site of surgery. Any discomfort should gradually improve in the days and weeks after your operation. You should be able to manage any discomfort with the painkillers given to you by the hospital.
Can I eat and drink normally after the operation?
You can eat and drink normally after your operation. You may experience occasional sickness, bloating and loss of appetite in the first few days after surgery.
What activities can I do immediately after the operation?
It is important to keep mobile after surgery. You should avoid spending long periods of time sitting, lying down or not moving. You can return to normal activities as soon as you feel able. Do this gradually. If you feel sore or uncomfortable, stop and try again after several days.
It is important to avoid strenuous activity or heavy lifting for 6 weeks after your operation.
What do I do if I am struggling to open my bowels after the operation?
It is common to get constipated for the first few days after the operation. This is particularly common if you are taking strong painkillers such as codeine or tramadol. It is important to stay well hydrated and drink plenty of fluids. If you are taking strong painkillers, you should take a regular laxative alongside these. The hospital should send you home with a laxative called Macrogol. If not, laxatives are available at your local pharmacy.
What should I do with my wounds?
Most surgeons will cover the cut with a dressing. For the first couple of days, it is common to have slight blood leakage on to the dressing. The dressings are waterproof and you can shower with the dressings on.
If your wound is clean and dry after 4 days, you may have a shower with the dressings off (7 days for a bath). Extra dressings can be purchased online or at most chemists.
Some surgeons will cover wounds with a skin glue. The glue is waterproof so you can shower. Just keep the wounds clean.
How will I know if my wounds are healing properly?
Most wounds heal without problems. It is normal for a wound to feel hard and tender for several weeks. The scar will look red, and often remains red for many months.
You do not need to see a doctor or nurse visit unless you think there is a problem. You should get in contact with the hospital If your wounds became swollen, red, painful or smelly.
Will I need to have any stitches removed?
Most surgeons use skin stitches that do not require removal. We will tell you if you need stiches that need removal.
When will I be able to go back to work?
You can return to work as soon as you feel well enough. This will depend on how you are feeling and the type of work that you do. Most people need two to three weeks off work.
If you have a job that involves heavy lifting or strenuous activity, you should contact your employer and ask to return in a role that does not involve these activities. If this is not possible you may need six weeks off work.
Please ask us for a fit note (Statement of Fitness for Work) on the day of your operation.
When can I start to drive again?
You should usually avoid driving for at least seven to ten days after your operation. Some people may find it takes several weeks before they feel ready to drive.
Before driving you must be confident that you can control the car and respond quickly to any situation that may occur. You must be able to perform an emergency stop, safely. Please be aware that driving whilst unfit may invalidate your insurance.
When can I start doing sports or leisure activities?
You can start as soon as you are able but you should avoid heavy lifting and strenuous activities for 6 weeks.
Will I be given a hospital appointment after my operation?
Most people will make a straightforward recovery. We do not routinely see patients after a hernia operation.
If you are experiencing any of the following symptoms after your operation, please contact your surgical team
• If you develop a fever or chills
• Persistent vomiting or nausea
• Increasing abdominal pain or distension
• Increasing pain, redness, swelling or discharge of the wound
• Severe bruising
• If you have difficulty passing urine.
Contact information
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If your operation was at |
Call: 07990 528 061 |
| If your operation was at Heatherwood Hospital |
Call: 07770 730220 07826 921319 |
| If your operation was at Wexham Park Hospital or Heatherwood Hospital |
Call |
If you cannot get in contact, please call 111 |
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If you feel seriously unwell, call 999 or go
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Frimley Park Hospital 0300 613 6530
Heatherwood Hospital and Wexham Park Hospital 0300 615 3365