Could a hernia be causing my symptoms?
Do I need hernia surgery?
ABOUT MR STUTCHFIELD
How does a hernia develop?
A hernia happens when tissue from inside the abdomen pushes through a weak spot in the muscle wall. Most start small and grow slowly over time. Select each stage to see what happens.
The abdominal wall
The abdominal wall is made of layers of muscle and strong connective tissue that hold everything inside in place. Some areas are naturally weaker, such as the groin, the belly button and any previous surgical scar. Heavy lifting, straining, a persistent cough, the way the muscles layers line up, or simply getting older can stretch these areas until a gap opens.
Typical symptoms: often none at first. In the early stages some people notice an ache or dragging feeling, especially at the end of the day.
Understanding your diagnosis and treatment options
How a hernia is diagnosed, what hernia repair involves, and how to weigh surgery against leaving a hernia alone.
Most hernias are diagnosed by examination, and many people do not need a scan. A scan can help confirm the type and size of a hernia, find one that is difficult to feel, and plan the best repair. Ultrasound is commonly used for groin and abdominal wall hernias where the diagnosis may be uncertain. CT scans give detailed views of large, complex or hidden hernias. MRI may be used for groin or pelvic hernias that do not show on other scans, or to look for another cause of pain.
Examination and scans for hernias
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Ultrasound · groin and abdominal wall hernias
CT · large, complex or hidden hernias
MRI · groin pain with no clear cause
Hernia repair returns the tissue to its proper place and closes or reinforces the weak area in the abdominal wall. A hernia mesh is often used to strengthen the repair and reduce the chance of the hernia coming back. Hernia repair mesh is a thin, flexible medical material with a net-like appearance, similar to mosquito netting. Many hernias can be repaired by keyhole (laparoscopic) surgery, using small cuts and a camera, which can speed up recovery. Open surgery may be better for larger or complex hernias, or for hernias in certain locations. Large or recurrent hernias may need an abdominal wall reconstruction, a more extensive operation to restore the strength and shape of the abdominal wall.
Keyhole
or open, depending on your hernia
Mesh
often used to strengthen the repair
2 weeks
usual time off work
6–8 weeks
before heavy lifting
Hernia repair surgery
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Hernias are common and surgery is not recommended for everyone. Balancing the risks means weighing the chance of ongoing or worsening symptoms, and of complications from the hernia, against the risks of surgery. Hernias that cause no symptoms can generally be left alone, and if symptoms develop it is worth considering repair. Losing weight may improve symptoms, and for some people this means surgery can be avoided altogether. Femoral hernias are an exception: they are more likely to become trapped, so repair is usually recommended.
With surgery
Hernia repair is generally safe and usually relieves symptoms, but like all operations it carries risks. These include bleeding, infection, damage to nearby structures and the hernia coming back. Some people develop swelling from a fluid collection, and there is a risk of chronic (long-lasting) pain. There is also a chance of being worse after surgery than before.
Without surgery
A hernia does not heal on its own and may gradually get bigger and more uncomfortable. There is a risk of tissue becoming trapped or strangulated, which can be serious and needs emergency surgery. Some hernias cause a bowel blockage or limit daily activities.
Decisions are made on an individual basis after careful discussion
Balancing risks and benefits
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Frequently asked questions
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