Inguinal & Umbilical Hernia | Southern Alberta Surgical Center

Inguinal Hernia

Visible bulge: The most common symptom is a bulge or swelling in the groin area, which may become more noticeable when coughing, bending over, or lifting heavy objects.
Pain or discomfort: This can be mild to severe, especially during physical activity or when straining. The pain may worsen after standing or during certain movements.
Heaviness or pressure: Some individuals may experience a sensation of fullness or pressure in the groin.
Incarceration or strangulation: In more severe cases, the hernia can become incarcerated (trapped), causing a blockage, or strangulated (blood supply cut off), leading to severe pain, nausea, vomiting, and a hard, swollen lump. This is a medical emergency requiring immediate attention. Patients are recommended to attend the Emergency Room if this occurs.

Increased abdominal pressure: Anything that increases pressure within the abdomen can contribute to an inguinal hernia. This includes:
- Heavy lifting or strenuous physical activity
- Chronic coughing (e.g., from smoking or lung disease)
- Obesity: Excess weight puts pressure on the abdominal muscles.
- Pregnancy: Increased pressure during pregnancy, especially if there is multiple pregnancies or excess weight gain.
- Straining during bowel movements or urination due to constipation or prostate problems.
Congenital factors: Some people are born with a weakness in the abdominal wall or inguinal canal that can lead to the development of an inguinal hernia, often becoming noticeable during childhood or adulthood.

Watchful waiting: If the hernia is small, asymptomatic, and not causing problems, doctors may recommend simply monitoring it over time. However, hernias typically do not go away on their own, and surgery may eventually be necessary.
Surgical repair: Surgery is the most effective treatment for an inguinal hernia, particularly if it is causing pain, enlarging, or has the potential for complications. The two main types of surgery are:
- Open surgery: A single incision is made to access the hernia, the protruding tissue is pushed back into place, and the abdominal wall is repaired with sutures and mesh.
- Laparoscopic surgery: A minimally invasive procedure where small incisions are made, and the hernia is repaired using specialized tools a camera, and mesh.

Visible bulge: A soft bulge or lump near the belly button, especially noticeable when coughing, or straining (such as during lifting or bowel movements).
Pain or discomfort: The hernia itself may not cause pain, but if it becomes large or is irritated, it may cause discomfort or tenderness around the area.
Size of the bulge: The size of the bulge can vary and may become more pronounced when standing or straining, and it may reduce when lying down.
Incarceration or strangulation: In rare and more severe cases, the hernia can become incarcerated (trapped), or strangulated (cut off from blood supply), which can cause sudden pain, nausea, vomiting, and a firm, tender lump. This is a medical emergency and we recommend patients to attend the Emergency Department.

In adults: Umbilical hernias are caused by increased pressure within the abdomen, which can push through a weakness in the abdominal muscles near the belly button. Factors that increase the risk in adults include:
- Obesity: Excess body weight puts added pressure on the abdominal wall.
- Pregnancy: The pressure of a growing baby in the abdomen can cause a hernia, especially in women who have had multiple pregnancies.
- Chronic coughing: Conditions like chronic obstructive pulmonary disease (COPD) or smoking can increase intra-abdominal pressure, contributing to hernia formation.
- Straining during bowel movements or urination: Conditions that cause chronic constipation or difficulty urinating may increase the risk.

Observation: If the hernia is small and/or not causing any symptoms of pain, bowel obstruction, or limitations to ones daily activities or quality of life a recommendation to monitor these may be given.
Surgical repair: If the hernia is painful, or causes other complications, surgery is often necessary. The two main surgical options are:
- Open surgery: A single incision is made near the belly button, and the protruding tissue is pushed back into place, followed by stitching the abdominal wall +/- mesh.
- Laparoscopic surgery: A minimally invasive technique where small incisions are made, and the hernia is repaired using a camera and surgical instruments, often with the use of mesh to reinforce the area.