A hernia can be simply described as a bulge or an out-pouching of body contents into an area outside their normal positions. They can happen anywhere in the body although the trunk is the most commonly involved region. Our center, Chennai Hernia Center has experts well versed in the diagnosis and treatment of all types of hernias.
What is a femoral hernia?
A femoral hernia is the third most common type of hernia (after inguinal and incisional hernias), in which the bulge occurs at a region known as the femoral canal. The femoral canal is located on the upper thigh, very close to the groin. The hernias too are seen here.
Femoral hernias are more often found in women than men and have a preponderance to occur on the right side. The female predisposition to femoral hernias has been attributed to their wider hip structures, and a further correlation with multiple pregnancies is likely because the femoral canal is affected by the increased intra abdominal pressures in these women, leading to an expansion of the canal, allowing the bowel to herniate.
Femoral Hernia is commonly seen in:
Though men may suffer from femoral hernia, women are more prone to it as their wider than the male pelvis.
Femoral hernias are far more common in adults than in children. In cases of children, the hernia typically results from a medical condition, like a connective tissue disorder.
People with a close family member who has a groin hernia can be prone to a femoral hernia
Primary Causes of Femoral Hernia
The exact cause of femoral hernia is unknown in most cases. One can be born with a weak area in the femoral canal or develop certain weak spots over time.
Straining can play a major role in the weakening of the muscle.
Over straining can be caused due to following reasons:
Difficulty in urination as a result of an enlarged prostate
Types of Femoral Hernia
Incarcerated femoral hernia This type of femoral hernia occurs when a hernia gets trapped in the femoral canal, and cannot move back into the abdomen.
Obstructed femoral hernia An obstructed femoral hernia occurs when a hernia and a section of the intestine become entangled and can lead to a painful intestinal obstruction.
Strangulated Femoral Hernia When a hernia prevents blood from reaching the bowel, it results in a strangulated femoral hernia. It requires immediate medical attention as strangulated femoral hernia can be fatal without treatment.
Sudden, severe pain and extreme tenderness around a hernia
Increased heart rate
Red skin around the bulge
A strangulated femoral hernia can cause the intestinal tissue to die and decay and cause a life-threatening infection if it is not treated via surgery immediately.
Diagnosis of a Femoral Hernia
Patients who speculate they have a femoral hernia should visit their doctor immediately as there is a high risk of complications that can be serious.
A surgeon will be required to examine the bulge and confirm that it is a hernia before suggesting surgery. He/she would gently press the area and possibly ask for imaging tests to see the internal tissues.
What are the signs and symptoms of femoral hernias? Is it dangerous?
Like most hernias, the first symptom is that of a lump in the region. This lump might be pushed back or reduced if pressed on. After a while, there might be a dragging pain in the region.
Sometimes, if a hernia gets stuck through the weakness and is not able to be pushed back inside, this leads to a complication called an incarcerated hernia. Unfortunately, this is very common in femoral hernias due to the rigidity of the femoral canal borders. Furthermore, if on incarceration, the blood supply to the bowel loop that has herniated also gets cut off, it becomes an even bigger complication called a strangulated hernia. Strangulated hernias may lose their blood supply, die, and decay inside the hernia cavity, leading to a host of problems.
Key Signs and Symptoms of Femoral Hernia
A typical sign of a femoral hernia in a patient is a painful lump in the groin or inner thigh and groin discomfort.
The severity of the symptoms can be high when the femoral hernia starts obstructing a patient’s intestine and is known as strangulation. (It is a medical emergency, and the patient must get immediate medical assistance in this situation).
Severe symptoms of a femoral hernia are severe stomach pain, sudden groin pain, nausea, and vomiting.
The patient experiencing a strangulated hernia may have all or some of the following symptoms:
If untreated, these complications have a very high chance of causing death, and therefore, when a strangulated hernia sets in, the first thing is to get EMERGENCY surgery (no waiting around; get an ambulance and go to the hospital, where they will immediately operate).
As mentioned earlier, these complications are much more common in femoral hernias, and unfortunately, up to 30% of femoral hernia cases present as an emergency for operation. This is why doctors immediately suggest surgical management of the femoral hernia when first diagnosed. Although it can seem pre-emptive and suspicious to the patient, it is necessary to avoid an emergency. Scheduling a surgery on diagnosis, with both patient factors and doctor availability taking into consideration (aka ELECTIVE surgery) is the safest bet while doing an operation. It allows us to plan for the operation, gives the patient time to prepare (for example, if they are on medicines like blood thinners or insulin, they can discuss with their other doctors and taper and stop those doses as required for surgery). Obviously, during emergency surgery, it might be difficult to account for all these factors, either because of lack of time, knowledge, or resources.
What happens if I don’t want to get surgery?
Although certain measures can be taken to mitigate the symptoms of a hernia like using a truss and lifestyle modifications, hernias NEED to be operated on. This is especially true for femoral hernias because they are at higher risk of incarceration and strangulation than other hernias. At our center, we will try to answer all your concerns about surgery and alleviate your fears regarding the same. We understand the prospect of surgery is scary and can seem sudden, but we hope that this article can help shed some light on why it is necessary. For more information, please feel free to contact us or schedule an appointment at Chennai Hernia Center, Specialists in Hernia Surgery.
What surgery will be done for me?
After performing appropriate work-ups like some blood tests and ultrasound, we will start discussing your options for surgery. Broadly, there are 2 main types of surgery:
Here the surgeon puts a single large cut (incision) over the hernia and the contents protruding out are gently pushed in. The defect through which the hernia came out is strengthened using a mesh. Dr ( Major ) R S Rengan has been a pioneer in the use of Hernia Mesh systems which can help reinforce the area and restore integrity and strength at the defect.
Laparoscopic (keyhole) surgery:
Here instead of the single large incision, three small incisions are made and a tube containing a camera is pushed through one of the openings so that the surgeon gets to see inside the abdomen through the screen placed nearby. Although laparoscopy has advantages of quicker recovery, less blood loss, and scarring, etc, not all cases can be operated on this way. Complex cases or larger hernias are some examples of ineligibility. However, recently, it is this form of surgery that is being more commonly performed.
Chennai Hernia Centre
Chennai Hernia Centre is an initiative by our Chief Surgeon Dr ( Major ) R S Rengan to create a hernia focussed clinic to ensure high standards of care without compromising on affordability in the field of hernia surgery.