Inguinal hernia

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. Sometimes, wearing a supportive truss may help relieve symptoms, but check with your doctor first because it's important that the truss fits properly, and is being used appropriately. 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 minimally invasive hernia 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.

Minimally invasive hernia repair

In this procedure requiring general anesthesia, the surgeon operates through several small incisions in your abdomen. The surgeon may use laparoscopic or robotic instruments to repair your hernia. 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 small incisions to repair the hernia using synthetic mesh.

People who have a minimally invasive repair might have less discomfort and scarring after surgery and a quicker return to normal activities. Long-term results of laparoscopic and open hernia surgeries are comparable.

Minimally invasive hernia surgery 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 open hernia surgery. It also might be a good choice for people with hernias on both sides of the body (bilateral).

As with open surgery, it may be a few weeks before you can get back to your usual activity level.

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 the most likely cause of my symptoms?
• What tests do I need?
• What treatments are available and which one do you recommend for me?
• If I need surgery, what will my recovery be like?
• I have other health conditions. How can I best manage these conditions together?
• What can I do to prevent another hernia?

Don't hesitate to ask other questions you may have.

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.