Do you experience any of these symptoms?
• Swelling or a lump in your groin?
• Weakness, pressure or a feeling of heaviness in your groin?
• A dull ache or pain in your groin when you cough, bend over or
lift something heavy?
If so, you might have a hernia.
“Even if the symptoms don’t seem like a big deal, you shouldn’t
ignore them. That small bulge that doesn’t hurt now will only get
larger and become increasingly painful over time. It can even become life-threatening,”
Dr. Kyle Marthaller of Boulder Valley Surgical Associates warned during a free health lecture
held at the Boulder Jewish Community Center.
It’s best to see your doctor if you have a bulge or any groin-area
discomfort you can’t explain.
Inguinal Hernia: The Most Common Type
A hernia occurs when an internal organ or tissue bulges through a weakened
spot in a muscle wall.
“Although there are many different kinds of hernias, about 75 percent
of them occur in the inguinal region – the groin area,” explained
Dr. Marthaller. “With an inguinal hernia, it’s usually a part
of the intestine that pushes through a weakness in the lower abdominal
Groin-region inguinal hernias most often happen in men. “In fact,
over the course of a lifetime, the chance of a man getting this type of
hernia is 25 percent, while for a woman it’s about 5 percent,”
said Dr. Marthaller.
Inguinal hernias become a medical emergency if the intestine becomes trapped
in the abdominal wall and blood flow to the intestine becomes blocked.
Dr. Marthaller said this loss of blood flow is called strangulation and
requires emergency surgery.
Femoral Hernia: Dangerous and More Common in Women
A femoral hernia also occurs in the groin. However, women are more likely
than men to suffer from them. Although uncommon, they can be very dangerous.
According to Dr. Marthaller, most femoral hernias do not cause bulge. “Often
you feel very little. Maybe a vague pelvic discomfort. This is why they
tend to be so dangerous – there are often no symptoms until they
strangulate and come to light as emergencies.”
Symptoms of strangulation from a femoral hernia include severe belly pain,
fever, nausea or vomiting. If you have these symptoms, seek medical help
When to Have a Hernia Surgically Repaired
If you’ve been told by a health care provider that you have a hernia,
you could be wondering whether to have surgery right away or wait.
Your doctor might suggest just keeping an eye on it as long as the hernia
is small and not causing problems. While watchful waiting is safe, Dr.
Marthaller typically recommends surgical repair sooner rather than later.
“A hernia will not seal or fix itself. Over time, a small hernia
will start to become larger, because of exercising, lifting or physical
activity,” he said. “The earlier the repair, the more surgical
options you’ll have, the lower the risk of strangulation, and the
easier the surgery will be.”
Dr. Marthaller also pointed out that by repairing your hernia early on,
you can get back to your normal exercise routine, instead of putting limits
on your activities from the condition.
Surgical Options: The Pros and Cons
Dr. Marthaller went on to review the pros and cons of each type of hernia repair:
Traditional open repair
This is the oldest, most traditional method for repair. Today’s
techniques typically are tension-free, meaning they entail using a mesh
implant to cover and reinforce the weak muscle area.
Pros: Can be done under local anesthesia and sedation. This is sometimes the
best option for those in poor health and who should not be given general
Cons: Requires a large incision — typically 3 to 6 inches — that
tends to have a longer and more painful recovery than other options.
Laparoscopic hernia repair
Laparoscopic surgery involves inserting special instruments through tiny
incisions in the abdomen.
Pros: Incisions are smaller, which means less discomfort after surgery, little
to no scarring, and a quicker return to normal activity. Unlike an open
repair, the surgeon can place a larger piece of mesh behind the hernia
opening instead of in front of it. This has the mechanical advantage of
using the muscle wall to support the mesh for a more durable repair.
Cons: Always done under general anesthesia. The surgeon secures the mesh in
place with tacks, which might increase post-operative pain.
Robotic hernia repair
da Vinci robotic surgery for hernia repair uses the same principles of laparoscopic repair: small
incisions for a shorter recovery and the placement of a larger mesh for
a more durable repair.
Pros: Allows the surgeon to position the mesh with sutures, offering the advantage
of less post-operative pain, which reduces the need for pain medication.
Cons: Requires general anesthesia.
When asked which repair is best, Dr. Marthaller replied, “All offer
excellent outcomes, but not every technique is right for every patient.
We look at the technique that will provide the strongest repair while
minimizing risks and discomfort and the quickest return to normal activities.”
To schedule an appointment with
Dr. Kyle Marthaller, call Boulder Valley Surgical Associates
at (303) 443-2123.
Click here to view PowerPoint slides from Dr. Marthaller’s lecture on “Hernia
Symptoms You Shouldn’t Ignore.”
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