Inguinal Hernias: The Most Common Hernia Is Also One of the Most Overlooked

Board-certified laparoscopic hernia surgeon specialist Dr. Ayotunde Adeyeri explains the subtle signs of a groin hernia, when they require treatment and why early evaluation matters.

By Ayotunde Adeyeri, MD, FASMBS
NJ Board-Certified Hernia and General Surgeon
Medical Director, Sterling Surgicare

As a hernia surgeon, I regularly meet patients who have lived with groin pressure, discomfort or a noticeable bulge for months before seeking medical attention.

Some assume they pulled a muscle. Others hope the problem will resolve on its own.

Often, the underlying condition is an inguinal hernia.

An inguinal hernia develops when abdominal tissue—sometimes fatty tissue or a portion of the intestine—pushes through a weakened area in the lower abdominal wall. It is the most common type of hernia and occurs considerably more often in men, although women can develop inguinal hernias as well.

While an inguinal hernia may initially cause few symptoms, it will not repair itself. Early evaluation allows us to confirm the diagnosis, discuss appropriate treatment and reduce the likelihood that an avoidable problem will become an emergency.

What Does an Inguinal Hernia Feel Like?

The most recognizable sign is a bulge on either side of the groin. It may become more noticeable when standing, coughing, bending, exercising or straining. The bulge may become smaller or disappear when you lie down.

Not every inguinal hernia is painful. Symptoms can be subtle and may include:

• Pressure, heaviness or weakness in the groin
• Aching or burning near the bulge
• Discomfort when lifting, coughing or bending
• Groin swelling that increases during the day
• Pain or swelling around the testicle in men

Groin pain can have several possible causes, so I do not recommend trying to diagnose a hernia yourself. A surgical examination—and, in some cases, imaging—can help distinguish an inguinal hernia from a muscle injury, enlarged lymph node or another medical condition.

Why Do Inguinal Hernias Develop?

Some people are born with an area of weakness in the abdominal wall. In other cases, muscle strength and connective tissue change over time.

Activities or conditions that repeatedly increase pressure inside the abdomen may contribute to a hernia becoming apparent. These can include chronic coughing, constipation and straining, pregnancy, excess body weight or frequent heavy lifting. Previous abdominal surgery, age and family history may also affect risk.

Heavy lifting does not necessarily create a hernia by itself. Frequently, it exposes a weakness that was already present.

Be seen in my office within 24-48 hours of your call to us!

A Common Scenario in My Office

“Michael,” a 54-year-old Monmouth County business owner, noticed a small groin bulge after moving furniture. The swelling disappeared overnight, so he assumed it was a pulled muscle.

During the next several months, however, the bulge returned whenever he exercised or worked around the house.

He also began experiencing a persistent feeling of heaviness and pulling in the groin, which became more noticeable after standing or being active throughout the day.

His examination was consistent with an inguinal hernia. After discussing the size of the hernia, his symptoms, overall health and treatment options, we developed an individualized surgical plan.

His experience illustrates an important point: recurring groin symptoms deserve a proper evaluation, even when the discomfort is manageable.

Does Every Inguinal Hernia Require Immediate Surgery?

Not necessarily. Some men with a small inguinal hernia and minimal symptoms may be candidates for careful observation. That decision should be made with a qualified surgeon after the hernia has been evaluated.

When a hernia causes pain, interferes with daily activity or becomes larger, surgical repair may be recommended. Surgery is the only way to physically repair the weakened area in the abdominal wall.

Depending on the individual case, inguinal hernia repair may be performed through an open incision or with a minimally invasive laparoscopic technique.

The appropriate approach depends on several factors, including the hernia’s location and size, whether it is present on one or both sides, previous operations and the patient’s overall health.

When recommending open or minimally invasive laparoscopic inguinal hernia repair, I consider whether the hernia is on one or both sides, its size and location, whether it is a first-time or recurrent hernia, the patient’s previous abdominal operations and overall health, and the demands of the patient’s work and daily activities.

These factors help me determine which surgical approach is most likely to provide a durable repair and an appropriate recovery for that individual.

911: When Is an Inguinal Hernia an Emergency?

Occasionally, tissue becomes trapped inside the hernia and cannot return to the abdomen. If its blood supply is compromised, the condition is known as a strangulated hernia and requires emergency treatment.

Seek immediate medical care for:

• Sudden or rapidly worsening groin or abdominal pain
• A firm, tender bulge that will not move back into place
• Nausea or vomiting
• Abdominal swelling
• Fever
• Red, purple or dark discoloration over the hernia

These symptoms should not wait for a routine office appointment.

Schedule an Inguinal Hernia Consultation in Central New Jersey

If you notice persistent groin pain, pressure, heaviness or swelling, I encourage you to schedule a surgical evaluation. I can determine whether an inguinal hernia is causing your symptoms and whether careful monitoring or surgical repair is the appropriate next step.

Sterling Surgicare offers prompt inguinal hernia consultations with me at our Holmdel and Old Bridge, New Jersey, offices.

New patients can generally be seen in-person by me within 24–48 hours.

Call 732-217-3897 or email our Practice Manager, Natasha, at natasha@sterlingsurgicare.com, to promptly meet with me and discuss your hernia symptoms and treatment options.