Overview

There is much information, and disinformation, about hernias available.  I have tried to clarify and simplify as much as possible, and answer most of the common questions. The things you might really want to know are :-

What is a hernia ?

How do I know if I have one ?

Diagnosing the hernia

How are hernias treated ?

Is surgery the only option ?

What operation should I have ?

What about after surgery ?

 

What is a hernia

An abdominal hernia is a hole or defect in the ‘abdominal wall’ through which your insides can protrude. You would normally see a swelling under the skin, and usually it will go away when you press on it or lie down.

Usually hernias are described by where the hole is in the abdominal wall* –  read more

How do I know if I have one ?

When the hernia is ‘out’, (so you can see or feel the swelling), you may feel discomfort , but severe pain is unusual (but see strangulation).

With inguinal (groin) hernias  there is sometimes a sensation of discomfort in the testicle or a burning feeling into the top of the thigh.

With other abdominal hernias there is sometimes abdominal pain

Diagnosing the hernia

I believe there always has to be a swelling to make the diagnosis.   Without a swelling the diagnosis of hernia is unlikely.  The swelling should be visible when you stand or cough.

How can you be sure about the diagnosis ?

The diagnosis can be confirmed by an experienced surgeon, and usually no further tests are necessary. Special tests – read more

What happens if I do nothing, if I just leave it?

The hernia will gradually enlarge in size, become more uncomfortable and more of a nuisance. Sometimes (rarely) a piece of bowel becomes trapped in the hernia. This is called strangulation. It is a dangerous situation and requires an emergency operation. It is one of the reasons that it is usually better to deal with the hernia early.

How are hernias repaired?

The modern way of repairing hernias is to use a mesh or gauze to cover the hole, rather than sewing the edges of the hole together as used to be done.  The mesh has to be inserted in the correct way, sometimes actually beneath the edges of the defect, and this is where the skill and experience of the surgeon is important.

Open or laparoscopic (keyhole) surgery

These are the two ways of inserting the mesh.  Both are good when carried out by an experienced surgeon

How do I know which operation is best for me?

Discuss this with your surgeon. He should present the options and explain the ‘pros and cons’.  Both open local anaesthetic repair and laparoscopic (keyhole) repairs  are specialised techniques, not carried out by all surgeons.

I have had some problems with my heart in the past and I am worried about having a general anaesthetic.

Many hernias can be repaired using local anaesthetic.  This means that the area of the hernia is made numb with an injection of local anaesthetic (such as you would have at the dentist).  After the first small injection you feel nothing and you remain awake while the hernia is repaired. [ and please note – local anaesthetic is not an injection in the back]