A bulge or swelling appears near the crease of the groin or upper thigh. This lump may become more noticeable when standing, coughing, or straining.
Femoral Hernia
A femoral hernia occurs when tissue pushes through a weak spot in the groin or upper thigh, near the femoral canal. This type of hernia appears as a small, sometimes painful lump in the groin area and is more common in women than men. Femoral hernias can cause discomfort during daily activities and, if left untreated, may lead to serious complications requiring prompt medical attention.
Symptoms of Femoral Hernia
Common signs and symptoms of a femoral hernia may include:
Lump in the groin or thigh
Pain or discomfort
Some patients experience aching, heaviness, or discomfort in the groin area, especially when bending, lifting, or during physical activity.
Digestive issues
In some cases, patients may experience nausea, vomiting, or constipation if the hernia affects the bowel.
Tenderness around the lump
The area around the hernia may feel tender to touch, and this tenderness might increase with physical activity or pressure.
Causes and Risk Factors
Several factors can increase the likelihood of developing a femoral hernia:
Increased abdominal pressure
Chronic coughing, straining during bowel movements, heavy lifting, or pregnancy can put pressure on abdominal tissues and contribute to hernia development.
Age and gender
Femoral hernias are significantly more common in women, particularly older women. The anatomical differences in the femoral canal between men and women contribute to this higher prevalence.
Previous surgery
Prior operations in the lower abdomen or groin area may weaken muscles, increasing the risk of hernia formation.
Chronic constipation
Regular straining during bowel movements can increase pressure on the abdominal wall, potentially leading to hernia development.
Types of Femoral Hernia
Femoral hernias are typically classified based on their severity and presentation:
- Reducible femoral hernia: The protruding tissue can be gently pushed back into place or returns on its own when lying down. These hernias still require medical attention.
- Irreducible (incarcerated) femoral hernia: The herniated tissue becomes trapped outside the abdominal cavity and cannot be pushed back in. This requires prompt medical attention.
- Strangulated femoral hernia: The blood supply to the trapped tissue is cut off, causing tissue death. This is a medical emergency requiring immediate surgical intervention.
Diagnostic Methods
A colorectal and general surgeon will typically use several approaches to diagnose a femoral hernia accurately:
Physical examination
The surgeon will ask you to stand and cough while examining the groin area. This helps identify the hernia bulge and distinguish it from other types of hernias or conditions.
Ultrasound imaging
This non-invasive scan uses sound waves to create images of the soft tissues, helping to confirm the presence of a hernia and determine its exact location and contents.
CT scan
For complex cases or when complications are suspected, a computed tomography scan may be used to provide detailed images of the hernia and surrounding structures.
MRI scan
In some cases, magnetic resonance imaging might be used to obtain highly detailed images, particularly when other diagnostic methods have not provided clear results.
Surgical Treatment for Femoral Hernia
Surgery is the definitive treatment for femoral hernias due to the risk of complications:
Open hernia repair
This traditional approach involves making an incision near the hernia to access and repair the weakened area. The surgeon will push the protruding tissue back and strengthen the muscle wall, sometimes using mesh for reinforcement.
Laparoscopic (keyhole) repair
Using small incisions and a camera, the surgeon repairs the hernia from inside the abdomen. This minimally invasive technique typically results in less pain and faster recovery for suitable candidates.
Mesh reinforcement
During either open or laparoscopic repair, a piece of surgical mesh may be placed to strengthen the weakened area. This helps prevent the hernia from recurring by providing additional support.
Robotic-Assisted Repair
Robotic systems improve surgical accuracy with 3D visualisation and specialised instruments. The surgeon operates robotic arms from a console, following the same steps as traditional laparoscopic repair but with enhanced control. This approach is particularly beneficial for complex or recurrent hernia cases.
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Prevention and Management
While not all femoral hernias can be prevented, certain measures may reduce the risk or help manage existing hernias. Maintaining a healthy weight is important to reduce intra-abdominal pressure that may contribute to hernia formation. For individuals with asymptomatic or early-stage femoral hernias, clinical monitoring under a specialist surgeon can help assess the risk of progression and determine optimal timing for intervention.
Managing underlying causes—such as chronic coughing, constipation, or prostate issues—can also minimise strain on the abdominal wall. Until surgical repair is performed, patients are advised to avoid heavy lifting or strenuous activities that may worsen the condition.
Frequently Asked Questions
How urgent is femoral hernia treatment?
Femoral hernias have a higher risk of becoming strangulated compared to other hernia types, making them relatively urgent to address. Most surgeons recommend repair soon after diagnosis, even for small or minimally symptomatic hernias.
What is recovery like after femoral hernia surgery?
Most patients can return home the same day or after one night in hospital. Recovery typically takes 2-4 weeks, with a gradual return to normal activities. Heavy lifting and strenuous exercise should be avoided for at least 4-6 weeks.
Can femoral hernias come back after surgery?
Recurrence is possible but relatively uncommon with modern surgical techniques. Using mesh reinforcement during repair significantly reduces the risk of the hernia returning.
When should I seek emergency care for my hernia?
Seek immediate medical attention if you experience severe or rapidly worsening pain, nausea, vomiting, fever, or if the hernia becomes hard, tender, or discolored. These may be signs of a strangulated hernia, which requires emergency surgery.
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