A physical exam is usually all that's needed to diagnose an inguinal hernia. Your doctor will check for a bulge in the groin area. Because standing and coughing can make a hernia more prominent, you'll likely be asked to stand and cough or strain.
If the diagnosis isn't readily apparent, your doctor might order an imaging test, such as an abdominal ultrasound, CT scan or MRI.
If your hernia is small and isn't bothering you, your doctor might recommend watchful waiting. In children, the doctor might try applying manual pressure to reduce the bulge before considering surgery.
Enlarging or painful hernias usually require surgery to relieve discomfort and prevent serious complications.
There are two general types of hernia operations — open hernia repair and laparoscopic repair.
Open hernia repair
In this procedure, which might be done with local anesthesia and sedation or general anesthesia, the surgeon makes an incision in your groin and pushes the protruding tissue back into your abdomen. The surgeon then sews the weakened area, often reinforcing it with a synthetic mesh (hernioplasty). The opening is then closed with stitches, staples or surgical glue.
After the surgery, you'll be encouraged to move about as soon as possible, but it might be several weeks before you're able to resume normal activities.
In this minimally invasive procedure, which requires general anesthesia, the surgeon operates through several small incisions in your abdomen. Gas is used to inflate your abdomen to make the internal organs easier to see.
A small tube equipped with a tiny camera (laparoscope) is inserted into one incision. Guided by the camera, the surgeon inserts tiny instruments through other incisions to repair the hernia using synthetic mesh.
People who have laparoscopic repair might have less discomfort and scarring after surgery and a quicker return to normal activities. However, some studies indicate that hernia recurrence is more likely with laparoscopic repair than with open surgery.
Laparoscopy allows the surgeon to avoid scar tissue from an earlier hernia repair, so it might be a good choice for people whose hernias recur after traditional hernia surgery. It also might be a good choice for people with hernias on both sides of the body (bilateral).
Some studies indicate that a laparoscopic repair can increase the risk of complications and of recurrence. Having the procedure performed by a surgeon with extensive experience in laparoscopic hernia repairs can reduce the risks.
Preparing for your appointment
You'll likely start by seeing your primary care provider. Here's some information to help you get ready for your appointment.
What you can do
Make a list of:
- Your symptoms, including when they started and how they may have changed or worsened over time
- Key personal information, including recent life changes and family medical history
- All medications, vitamins or supplements you take, including doses
- Questions to ask your doctor
Take a family member or friend along, if possible, to help you remember the information you get.
For an inguinal hernia, some basic questions to ask your doctor include:
- What's likely causing my symptoms?
- What other possible causes are there?
- What tests do I need?
- Is my condition likely temporary or chronic?
- What's the best course of action?
- What are alternatives to the approach you're suggesting?
- If I need surgery, what will my recovery be like?
- I have these other health conditions. How can I best manage them together?
- What can I do to prevent a recurrence of this problem?
Don't hesitate to ask other questions.
What to expect from your doctor
Your doctor is likely to ask you several questions, such as:
- When did your symptoms begin?
- Have your symptoms stayed the same or gotten worse?
- Do you have pain in your abdomen or groin? Does anything make the pain feel worse or better?
- What physical activity do you perform on your job? What other physical activities do you regularly engage in?
- Do you have a history of constipation?
- Have you had a previous inguinal hernia?
- Do you or did you smoke? If so, how much?
What you can do in the meantime
Get emergency medical care if you develop nausea, vomiting or fever or if your hernia bulge turns red, purple or dark.