Femoral Hernia


What is a Femoral Hernia?

Hernias are named after the location in the body they occur. A femoral hernia is a bulge in the upper part of the thigh near the groin.

Other types of hernias include:

Hiatal Hernia: in the upper part of the stomach
Incisional Hernia: through a scar from a previous
abdominal surgery
Inguinal Hernia: a bulge in the groin area
Umbilical Hernia: around the belly-button

Do I Have a Femoral Hernia?

Symptoms may take weeks or months to appear. The diagnosis is often made from the patient’s symptoms and imaging tests that show the presence of a ventral hernia. Sometimes patients have no symptoms. Other times, symptoms include discomfort or pain in the area of the hernia, which might grow worse when you try to stand or lift heavy objects. You may see or feel a bulging or growth in the area that feels tender to the touch.

Do I Need to Treat My Femoral Hernia?

Treatment for a hernia requires surgical removal. Untreated hernias can grow into enlarged ventral hernias that become surgically difficult to remove. Swelling can lead to entrapment of the hernia contents. If not immediately addressed, this can lead to a reduced blood supply to the tissues involved, causing “strangulation.” Strangulation is typically accompanied by intense pain, and constitutes a medical emergency that requires immediate treatment to prevent tissue death (necrosis).

Risk Factors of a Femoral Hernia

Certain people are born with a defect, causing the abdominal wall to be unnaturally thin. They are at a greater risk for developing a ventral hernia.

Other Risk Factors for a Femoral Hernia Include:

  • Pregnancy
  • Obesity
  • History of previous hernias
  • Injuries to the bowel area
  • Family history of hernias
  • Constant lifting/pushing heavy objects

Causes of a Femoral Hernia

Most of the time, there is no clear cause of a hernia. Some hernias may be present at birth (congenital), but are not noticed until later in life.

Some factors that contribute to the development of a hernia include:

  • Chronic constipation
  • Chronic cough
  • Heavy lifting
  • Obesity
  • Straining to urinate because of an enlarged prostate

Femoral hernias tend to occur more often in women than in men.

Symptoms of a Femoral Hernia

You may see a bulge in the upper thigh just below the groin. Most femoral hernias cause no symptoms. There may be some groin discomfort that is worse when you stand, lift heavy objects, or strain. Sometimes, the first symptoms are sudden groin pain, abdominal pain, nausea, or vomiting. This may mean that the intestine within the hernia is blocked. This is an emergency.

Symptoms Include:

  • Mild discomfort in the abdominal area
  • Pain in the abdomen
  • Nausea
  • Vomiting
  • For a complete diagnosis, a doctor will perform a physical exam. He or she may need to look inside the body for confirmation.

Diagnostic Tests to Look for Signs of a Ventral Hernia May Include:

  • Ultrasound of the abdomen
  • Computed tomography (CT) scan
  • Magnetic resonance imaging (MRI)

Treatment of Femoral Hernia

Treatment depends on the symptoms present with the hernia.

If you feel sudden pain in your groin, a piece of intestine may be stuck in the hernia (called an incarcerated hernia). This needs treatment right away in a hospital emergency room, and you may need emergency surgery.

When you have chronic discomfort from a femoral hernia, talk to your health care provider about treatment choices.

  • Hernias often get larger with time, and they do not go away on their own.
  • Femoral hernias are more commonly incarcerate compared to other types of hernias.

Your surgeon may recommend femoral hernia repair surgery to avoid a possible medical emergency.

If You Do Not Have Surgery Right Away:

  • Increase your fiber intake and drink fluids to avoid constipation.
  • Lose weight if you are overweight.
  • See your health care provider if you have trouble urinating (men).
  • Use proper lifting techniques.

All femoral hernias need to be repaired, even if they do not cause any symptoms. If the hernia is not repaired, the intestine can get trapped in the hernia (called an incarcerated or strangulated hernia).

When a hernia is incarcerated or strangulated, blood supply to the intestines can be cut off. This can be life threatening. If this happens, you would need emergency surgery.

Options for Surgical Treatment Include:

  • Mesh placement surgery: a surgeon pushes tissue back into place and then sews in a wire mesh to keep it in place; this is considered safe and reliable
  • Laparoscopic removal: multiple small openings are made and the hernia is fixed using a small camera inside the body to direct the surgery
  • Robotic surgery: hernias can be removed using the most advanced, minimally invasive procedure with the daVinci robotic surgical system. The surgeon operates using only one incision through the bellybutton by controlling miniature, robotic assisted arms.
  • Open surgery (nonlaparoscopic): large opening is made so surgeon can enter the body to push the tissue back into place and then sew it

Benefits of Laparoscopic Removal Include:

  • A much smaller cut site (lowers chance of infection)
  • Reduced postoperative pain
  • Reduced hospital stay (generally able to leave day of or day after procedure)
  • Absence of large scar

Some Concerns of Open Surgery Include:

  • Longer stay in the hospital after surgery
  • Greater amount of pain
  • Medium to large scarring

Due to the amount of possible complications, we do not recommend open surgery as there are highly advanced laparoscopic alternatives that are faster, safer, and provide quicker recovery.

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