Inguinal hernia: symptoms and treatment

Written by: Professor Lee Dvorkin
Published:
Edited by: Conor Dunworth

Inguinal hernias are a common condition that can be extremely painful and require emergency surgery if not treated promptly. In his latest article, renowned colorectal surgeon Professor Lee Dvorkin gives a comprehensive explanation of this condition, including the symptoms and treatment options.

 

What are the first signs of a hernia?

The first sign or symptom of a hernia is a small bulge that appears in the groin which often appears when standing upright but may go away when lying down. As they get bigger, they may start to cause an ache or pain in the area. Small hernias are rarely a cause of severe groin pain.

 

How serious is a hernia?

Usually, a hernia is a problem because of how it looks and how it prevents patients from doing their usual activities or exercise. Over time, hernias can get bigger and cause more symptoms. Occasionally the hernia becomes strangulated. This means it becomes hard and painful and won’t go away. This is an emergency and requires urgent surgery.

 If the bowel has become trapped in the hernia patients can become very ill and surgery is even more urgent. Symptoms of this include a painful lump in the groin associated with abdominal pain and vomiting. Surgeons often recommend surgery in order to prevent this problem.

 

What can happen if an inguinal hernia doesn’t get treated?

If not treated a hernia can become larger and more symptomatic and with that, the chance of needing surgery becomes greater. For patients who are fit for treatment, surgeons would usually recommend surgery for all but the smallest of hernias.

 

How are they treated? Is surgery the only option?

For very small inguinal hernias that are not causing any symptoms, it may be reasonable to avoid surgery as the risk of strangulation is low, at about 3% over the next 2 years. If patients choose this option, they need to have the risks explained to them as 70% of these patients will need surgery at some point over the next 10 years.

For patients who are symptomatic, and those for whom the hernia is affecting their quality of life, surgery is usually recommended. 

The use of a hernia truss (or belt) can be helpful in some patients, especially those who are unfit for surgery, but its general use is controversial.

 

What’s involved in hernia surgery?

A groin hernia can be fixed by a variety of methods which the surgeon will discuss. This will usually (but not always) involve a general anaesthetic and the placement of a mesh to strengthen the area. These operations can be done by keyhole surgery under some circumstances but otherwise, there will be a small cut in the groin. The complication rate of hernia surgery is generally low and can often be done as a day case.


Professor Lee Dvorkin is a highly revered colorectal surgeon based in London, with over 25 years of experience. If you would like to book a consultation with Professor Dvorkin you can do so today via his Top Doctors profile.

By Professor Lee Dvorkin
Colorectal surgery

Professor Lee Dvorkin is a leading and well-respected consultant colorectal and general surgeon based in London.

Professor Dvorkin specialises in all aspects of benign and malignant bowel diseases including bowel cancer and inflammatory bowel disease. His clinical practice also includes the investigation and management of gastrointestinal problems, such as irritable bowel syndrome (IBS), inflammatory bowel disease, diverticular disease, abdominal pain and all common anal conditions (rectal bleeding, haemorrhoids, fissures and anal fistulae). He is formally accredited in colonoscopy and gastroscopy and undertakes laparoscopic (keyhole) surgery for gallstones, appendicitis, hernias and bowel cancer.
He practices privately at The Hospital of St John & St Elizabeth Hospital, The Wellington Hospital, The Hendon Hospital and The Cavell Hospital, while his NHS base is the North Middlesex University Hospital NHS Trust.
Professor Dvorkin holds an ​MBChB from the University of Leeds and the FRCS from the Royal College of Surgeons. He completed his basic surgical training in Wessex and after undertaking a period of research at The Royal London Hospital, was awarded his MD by the University of London. His research focused on pelvic floor disorders and has been presented both nationally and internationally. Professor Dvorkin continues with his surgical research and to publish numerous original works. 

Professor Dvorkin's higher surgical training took place in London and was completed in 2010. He then undertook an 12-month fellowship and a six-month laparoscopic colorectal fellowship at St Marks Hospital, which is internationally renowned for the treatment of bowel diseases.
He has held and continues to hold various senior academic and educational roles in the NHS and enjoys training the next generation of surgeons as director of an RCS Senior Clinical Fellowship programme. He is one of only a few colorectal surgeons in England to hold such a position, and he is also an honorary senior lecturer at University College Hospital. 

Professor Dvorkin is a member of various professional organisations including the Association of Coloproctology of Great Britain and Ireland (ACPGBI), the Royal College of Surgeons of England and the General Medical Council. 

View Profile

Overall assessment of their patients


  • Related procedures
  • Laser
    Laser scar therapy
    Surgical dermatology
    Hair transplant
    Scar revision
    Hyperhidrosis
    Facial surgery
    Chin surgery (mentoplasty)
    Breast augmentation with implants
    Breast fat transfer
    This website uses our own and third-party Cookies to compile information with the aim of improving our services, to show you advertising related to your preferences as well analysing your browsing habits. You can change your settings HERE.