Femoral Hernia Repair

Overview

A femoral hernia happens when fatty tissue or part of the bowel pushes through a weak spot in the groin into a narrow passage called the femoral canal. This passage sits just below the groin crease, near the top of the thigh. A femoral hernia repair is an operation to put the tissue back and close the weak spot.

Femoral hernias are uncommon compared with other groin hernias. They are more common in women and in older adults. Because they can become serious, doctors usually advise repair rather than waiting.

Anyone can get a femoral hernia, but they are most often seen in women, especially older women. They can also affect men and children, though this is less common.

Symptoms

Common symptoms

• A small lump or swelling in the groin or upper thigh, often below the groin crease
• Aching or discomfort in the groin, made worse by standing, coughing, or lifting
• A lump that may disappear when you lie down or can be gently pushed back
• A heavy or dragging feeling in the groin

Symptoms in children

• Femoral hernias are rare in children.
• A child may have a small swelling in the groin or upper thigh.
• A child may be fussy or uncomfortable with the swelling.
• Seek urgent advice if a child has a hard, painful groin lump or vomiting.

Symptoms in older adults

• Older adults may have vague groin or thigh discomfort and may not notice a lump.
• The risk of a hernia becoming trapped is higher, so new groin symptoms should be checked promptly.
• A lump may be more difficult to see if you have a larger body shape.

Causes

Main causes

• Weakness in the lower abdominal wall near the groin
• Increased pressure inside the abdomen, which can push tissue through the weak spot

Risk factors

• Being female, especially after menopause
• Older age
• Long-term cough
• Constipation and straining on the toilet
• Heavy lifting or repeated strain
• Being overweight
• Pregnancy
• Fluid buildup in the abdomen, called ascites

When to see a doctor

See a doctor urgently if:

• A groin lump that is painful, firm, or cannot be pushed back
• Vomiting, belly pain, or bloating with a groin lump
• A hernia that suddenly changes or feels tender
• Redness, warmth, or dark skin over a groin lump

Book a routine appointment if:

• A soft lump in the groin or upper thigh
• Aching or discomfort in the groin when standing, coughing, or lifting
• A known hernia that is bothering you more than usual
• Any new groin symptoms that worry you

Diagnosis

A doctor usually diagnoses a femoral hernia by asking about your symptoms and examining your groin. They may feel for the lump while you stand and lie down, and may ask you to cough.

Tests that may be done

• Physical examination of the groin and abdomen
• Ultrasound scan, which uses sound waves to make pictures inside the body
• CT scan in some cases, especially if complications are suspected
• Blood tests if you are unwell or emergency surgery is being considered

What to expect at your appointment

You may be referred to a surgical team. If you have signs of a trapped hernia, such as severe pain, vomiting, or a hard lump, you should go to your local emergency department straight away.

Treatment

Surgery is the only reliable treatment for a femoral hernia. A planned repair is usually recommended because of the risk that the hernia could become trapped. Your surgical team will explain the best option for you.

Self-care at home

• No home remedy can close a femoral hernia.
• Avoid heavy lifting and straining while you wait to see your doctor.
• Treat constipation by drinking enough fluid and eating fiber-rich foods.
• If you smoke, ask for help to stop.
• Do not try to force a painful lump back; seek urgent advice instead.
• Do not use a truss or corset unless a healthcare professional advises it.

Medical treatments

Surgery can be done as an open operation or as keyhole surgery, also called laparoscopic surgery. The surgeon puts the tissue back in place and closes the weak spot, sometimes using a mesh patch to strengthen the area. Your care team may give medicines around surgery to prevent infection and manage pain. There is no medicine that fixes a femoral hernia.

When is surgery considered?

Doctors usually recommend planned surgery soon after diagnosis, even if symptoms are mild, because a femoral hernia can become trapped. Emergency surgery is needed if the hernia is trapped or the blood supply is cut off.

Living with this condition

Before surgery, avoid heavy lifting and straining. After surgery, follow your care team's advice about wound care, activity, and returning to work. Some groin aching is common at first and usually improves over time.

Lifestyle tips

• Keep active in gentle ways, such as short walks, unless your care team says otherwise.
• Avoid constipation by eating fiber and drinking enough fluid.
• Lift safely and avoid sudden heavy strain.
• Stop smoking if you can, as it helps healing and reduces coughing.
• Keep to a healthy weight if this is right for you.

Diet and exercise

Eat regular meals with fiber from fruits, vegetables, beans, and whole grains, and drink enough water to keep stools soft. Gentle exercise helps circulation and recovery. Ask your surgical team when it is safe to return to gym workouts, heavy lifting, or strenuous sports.

Mental health and emotional wellbeing

It is normal to feel anxious about surgery or about a hernia becoming trapped. Talk to your doctor about your worries. If you feel you cannot cope or have thoughts of harming yourself, contact your local emergency number or a crisis support service right away.

Prevention

You cannot always prevent a femoral hernia, especially if you have a natural weakness in the groin. You can lower strain on your abdomen by avoiding constipation, not smoking, lifting safely, and keeping to a healthy weight.

Vaccines

There is no vaccine for femoral hernia.

Screening programmes

There is no routine screening programme for femoral hernia. See your doctor if you notice a groin lump or new groin pain.

Complications

If left untreated

• The hernia can become stuck, called an incarcerated hernia.
• The blood supply can be cut off, called a strangulated hernia.
• The bowel can become blocked, causing vomiting, belly pain, and bloating.
• Emergency surgery may be needed if the hernia is trapped.

Long-term outlook

Most people recover well after a planned femoral hernia repair. Many return to normal activities within a few weeks, but your timeline depends on your health, the type of surgery, and your job. Ask your care team what to expect for you.

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