Types of Hernias Treated
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Inguinal hernia
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Umbilical hernia
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Incisional and ventral hernias
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Femoral hernia
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Hiatus hernia
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Ventral hernias
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Spigelian hernia
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Diaphragmatic hernias
What is a Hernia?
A hernia is a weakness in the muscle or connective tissue , commonly in the groin, through which fat (or sometimes bowel or other organs) protrude through.
It can be painful, or noticeable as a lump, or both.
Sometimes it can lead to further complications needing emergency surgical care, best avoided by repairing early.
Hernia Symptoms and Diagnosis in Men
In men, hernias most commonly present as a lump or bulge in the groin, which may come and go. This is often associated with a heavy, dragging, aching, or burning sensation, particularly with standing, lifting, coughing, or straining. Symptoms frequently worsen by the end of the day and improve when lying down. Importantly, up to one in three men have no symptoms when a hernia is first detected.
On examination, the bulge usually becomes more obvious when you cough or strain. Some hernias may extend into the scrotum, while others remain confined to the groin. Femoral hernias, although less common in men, can be harder to detect and carry a higher risk of complications. Umbilical and incisional hernias appear as a bulge at the belly button or a previous surgical scar.
Most hernias are diagnosed clinically. Ultrasound, CT, or MRI scans are used when the examination is unclear, symptoms are present without a visible lump, or another diagnosis needs to be excluded.
Management in Men: Monitoring vs Surgery
For men with no symptoms or only mild discomfort, careful monitoring (often called watchful waiting) is a safe and well-supported option. The risk of sudden complications such as incarceration or strangulation is low, and surgery can be safely performed later if symptoms progress.
However, many men eventually choose surgery due to worsening pain or reduced quality of life. Surgery is recommended if pain develops, daily activities become limited, or the hernia becomes hard, painful, or difficult to push back in. Femoral hernias in men are usually repaired once diagnosed due to their higher risk of complications.
Hernia Symptoms and Diagnosis in woMen
In women, groin hernias may present without a clear bulge. Symptoms may include intermittent or chronic groin pain, discomfort with activity, or vague lower abdominal symptoms. Because a lump may be absent or difficult to feel, diagnosis is often delayed.
Femoral hernias are more common in women and are associated with a higher risk of strangulation. As it can be difficult to distinguish femoral from inguinal hernias on examination alone, imaging is more frequently required. Umbilical and incisional hernias present similarly to men, with a visible bulge and activity-related discomfort.
Management in Women: Why Surgery Is Usually Recommended
For women, surgical repair is recommended for all groin hernias, even if symptoms are mild. This is because femoral hernias are more common and more dangerous. Delaying surgery increases the risk of emergency complications.
For umbilical and incisional hernias, surgery is generally advised when symptoms are present or the hernia is enlarging. In selected cases with small, easily reducible hernias and higher surgical risk, careful monitoring may be considered.
Mesh, Hernia repairs and SAFETY
Mesh repair is the standard of care for both open and laparoscopic inguinal hernia surgery and is supported by strong international evidence showing significantly lower recurrence rates compared with non-mesh (tissue) repair. Modern mesh techniques reduce the risk of hernia recurrence by 30–75%, making them the preferred option for both primary and recurrent hernias.
In open mesh hernia repair, recurrence rates are very low (typically under 2%), and complications such as infection, seroma, or haematoma are uncommon. Long-term outcomes show no increased risk of chronic pain or numbness, with most patients reporting improved comfort and quality of life. Mesh infection is rare, and contemporary surgical meshes have an excellent safety profile.
In laparoscopic inguinal hernia repair (TAPP or TEP), mesh is placed behind the abdominal wall in the pre-peritoneal space. Recurrence rates are comparable to open repair, with the added benefits of less ongoing pain, smaller incisions, and a faster return to normal activities, often by about one week. Serious mesh-related complications are rare when surgery is performed by an experienced hernia surgeon.
References
How Hernias Are Repaired – Minimally Invasive Surgery
Most adult hernias do not resolve on their own, and surgery is often recommended to prevent worsening symptoms or complications. Fortunately, hernia repair is usually straightforward and, in many cases, can be performed using minimally invasive (laparoscopic or robotic) techniques.
Minimally invasive hernia surgery involves small incisions and the use of a camera and specialised instruments to repair the hernia from inside the abdomen. Compared with traditional open surgery, laparoscopic hernia repair typically results in less postoperative pain, smaller scars, and a faster return to work and normal activities. For many patients, this means getting back to exercise, work, and family life sooner.
In most modern hernia repairs, surgical mesh is used to strengthen the abdominal wall and significantly reduce the risk of the hernia returning. Mesh repair is supported by strong evidence and is considered the standard of care for many types of hernias, including inguinal hernias.
It is completely normal to have concerns about surgery. At UGIcare, we take time to discuss the benefits, risks, and alternatives of hernia surgery in clear, practical terms. Together, we will decide on the most appropriate approach for your condition, lifestyle, and goals.
