How an inguinal hernia (groin hernia) develops

Inguinal hernias (groin hernias) are one of the world's most common conditions. In Germany alone, more than new 250,000 inguinal hernias are operated on every year. Men in particular are affected by this condition, more so than women.

It is estimated that around 20% of men will experience an inguinal hernia at some point in their life. The ratio of cases in men to women is 9:1.
An inguinal hernia may be congenital or acquired.

The most common form of hernia is the congenital type (indirect inguinal hernia), with 49% of cases occurring on the right-hand side, 38% on the left-hand side and 13% occurring on both sides.

Congenital inguinal hernias develop as a result of incomplete development of the abdominal wall during foetal development.
 

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An acquired hernia (direct inguinal hernia) develops due to weakness of the abdominal muscles in the groin region.
This can sometimes be caused by a constitutional or degenerative connective tissue weakness (collagen metabolism defect), obesity, age and smoking. Another possible cause of direct inguinal hernias is increased pressure inside the abdomen, for example due to prostate enlargement, pregnancy or chronic bronchitis.
Inguinal hernias are less common among women due to the anatomy of their groin area.

Symptoms: inguinal hernias can cause a variety of symptoms. Commonly, there is a bulging in the groin region, which can vary greatly in size. This can be pressed back in (reduced) when standing, but sometimes only when lying down.

Pain often only occurs after exertion, but frequently also happens while sitting and after prolonged periods of standing. This pain is caused by pressure on the nerves in the inguinal canal or by irritation of the peritoneum (hernial sac). The pain feels like a dragging sensation, can be stitch-like or burning, and occasionally radiates towards the testicles and the inside of the thigh.

A hernia becomes complicated and life-threatening if part of the intestine gets trapped in the hernial sac (Incarceration). The symptoms of this are excruciating pain in the groin and abdomen, as well as feeling seriously ill. The bulge can no longer be reduced when lying down, it becomes hard and the skin in the area becomes reddened.
The symptoms of sports hernia (Sports hernia) are similar to those of an inguinal hernia, although the cause of the pain with this condition is primarily nerve compression. Characteristically, the pain can temporarily be improved with rest, however as soon as the groin is put under strain again, the same symptoms recur.
 

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