These are relatively common hernias that may occur in both sexes, although they are more common in males. Inguinal hernias may occur at any age, and may even occur in infants. Together with femoral hernias (which are more common in females) they form the group known as groin hernias. Inguinal hernias are classified as indirect or direct, depending on where they anatomically originate. This distinction is difficult or impossible to make prior to surgery, and is of little importance, since the approach for repair of either is the same. Occasionally there may even be components of both indirect and direct herniation present at the same hernia site.
Not uncommonly, inguinal hernias are associated with little or no pain, and may be found incidentally at the time of a work or school physical exam. Subtle complaints of a heaviness or fullness in the groin area may be noted, particularly after prolonged standing. Resting or sleeping tends to relieve the discomfort. A smooth bulge or swelling may be visible and/or palpable, just at or above the groin crease, medially. As with most hernias, inguinal hernias frequently will enlarge slowly over time. It is commonly assumed that inguinal/groin hernias are associated with vigorous activities, including heavy lifting and possibly sports–hence the often heard, but inaccurate term, “sports hernia”. There is actually little fact to support this belief—ie. both construction workers and accountants are at matched risk for developing an inguinal hernia!
Inguinal hernia repair now almost always involves implantation of some type of patch material. The notable exception is in infants and young children. The development of the tension-free repair principle, utilizing mesh to patch and reinforce the defect, provides for a more durable repair with a low recurrence risk, and significantly less post-operative pain, compared to the historical sutured repair. Application of laparoscopic technology, together with lightweight anatomically contoured mesh, allows these principles to be employed through three small tubes, or ports. Even less post-operative pain, and a prompt return to full unrestricted activity, is the result.