If a hernia is stopping you walking, cycling or playing with the grandchildren, then it’s time to do something about it, says Tony Miles, consultant colorectal surgeon at The Montefiore Hospital, in Hove
One in three men are likely to suffer with an inguinal hernia at some point in their lives. It is the most common type of hernia and is a hole in the abdominal wall through which fatty tissue or part of the bowel pokes through. It can cause discomfort even before it begins to protrude and form a lump in the groin area.
Causes: Sustained heavy lifting or a persistent cough can cause the hernia, but it is age-related and more common in men aged over 45 years. In most cases, inguinal hernias are relatively harmless, however they can cause considerable pain and discomfort, especially when they push their way out into the groin. Once the hernia is outside the body there may be a halcyon period of no pain, but they will become bigger and more uncomfortable with time. There was a trend in the past not to repair hernias and for some men they can manage without surgical intervention, especially if they are elderly and live a sedentary life. There is special underwear you can buy to provide support but wearing a truss to stop the lump coming out of the hole is thought to have no benefit.
When to seek help: Hernias will not repair themselves so if is limiting your normal activities such as walking or cycling or playing a sport you love, then make an appointment with your doctor who will refer you to a specialist. Many of my hernia patients finally come to see me when they have had to stop playing golf.
Surgery: Depending on your health and your preference, you will be offered either open surgery, in which a small incision is made in the groin area, or keyhole (laparoscopic) surgery. Both involve a mesh placed over the hole and stitched or glued into place. The mesh acts as a scaffold and your own tissue will grow around it to reinforce the weakened area. The operation takes around 60 minutes and is done under general anaesthetic. You shouldn’t need to stay overnight in hospital and will be walking the first day. You can go back to work after a week – I’ve known patients back on the driving range within seven days.
Keep active: It is important to keep active and not to wrap yourself in cotton wool. The mesh is very strong and will not break. If you over-do it, you’re likely to feel pain long before you do any damage.
Failure rates of inguinal hernia repairs are very low, so if in the unlikely event your hernia does reoccur, it is likely to be a fault in the operative technique. Choose a surgeon who specialises in hernia repair and is a member of the British Hernia Society to ensure the best outcome.
Mr Miles holds clinics at The Montefiore Hospital on Mondays. For more details, visit www.themontefiorehospital.co.uk, or call 01273 828148.