Inguinal hernia in women, is it common?

An inguinal hernia presents as a bulge or lump caused by a hernia sac. Hernias are caused by a weakening of the inner wall of the abdominal muscles which causes a tear in the abdominal wall, causing the contents of the abdomen (mostly viscera) to bulge outwards and manifest as a lump in the patient.

Inguinal hernias are hernias that appear in the groin due to a weakening of the wall of the groin muscle. In other cases, inguinal hernias can be congenital, that is, they can appear from birth due to a genetic predisposition. In this case, it is more common in boys than in girls.

If the patient has a lump in the groin area, she should see a specialist in general surgery and digestive system surgery as soon as possible, as he or she will be the one to confirm the diagnosis.

Inguinal hernias are easy to detect, as a physical examination is enough for the specialist, as it is perceived as a bulge, as we have already mentioned.

It is also possible that the doctor may want to check that it is indeed an inguinal hernia by having the patient perform certain actions to confirm it, such as coughing, urinating, lifting weights or making other types of effort. It is normal for the patient to feel pain when performing these actions, which is a clear symptom of an inguinal hernia.

As aforementioned, an inguinal hernia in women may be caused by a weakening of the inguinal canal and subsequent weakening of the abdominal wall during the formation of the foetus in the mother's womb, although hernia protrusion may also be due to significant physical exertion that increases pressure on the abdominal tissue and muscles. 

Some of the factors that can increase pressure in the abdomen and may lead to hernia include:

• Lifting heavy objects.
• Chronic coughing.
• Chronic constipation: straining during bowel movements.
• Nausea and vomiting.
• Being overweight.
• Weakening of the abdominal wall due to age.

Inguinal hernias can be of two types: acute or chronic.

• Acute inguinal hernias are those that appear suddenly due to physical exertion or a previous operation on the abdominal wall.
• Chronic inguinal hernias are those that develop over time, as weakness in the woman's abdominal wall also develops. In these cases, there is no specific cause for their appearance, but rather the weakening of the abdominal wall itself is the cause.

Finally, as we have said throughout the text, inguinal hernias are more frequent in men than in women due to their anatomy, although we cannot rule out the possibility that they may also occur in women in some cases.

As we have also pointed out, inguinal hernias in women can easily be confused with femoral or inguino-crural hernias, because both are located almost in the same area. Femoral hernias are much more common in women than inguinal hernias.

In any case, it is necessary to see a specialist as soon as possible to determine the type of hernia.

It must be said that inguinal hernias occur more frequently in men than in women, but why? The explanation is simple and is as follows:

In the case of male foetuses, when they develop inside the mother's womb and as they grow and mature, their testicles begin to develop in the abdomen and shortly afterwards move to the scrotum. The passageway through which they move from the abdomen to the scrotum is called the "inguinal canal".

Once the testicles have reached the scrotum, the inguinal canal closes, preventing the testicles from moving back into the abdomen. However, there may be occasions when the inguinal canal does not close completely, which can cause a portion of the intestine to move into the inguinal canal, causing the hernia.

On the other hand, in the case of women, the weakening of the inguinal canal can also occur, since they also have it.

However, as we will discuss later, inguinal hernia in women can sometimes be confused with inguino-crural or femoral hernia, which is much more common in women.

Femoral hernia: more common in women. Differences with inguinal hernia

It is very easy to confuse an inguinal hernia with a femoral or inguino-crural hernia, as the area where both are located is almost the same. In the case of a femoral hernia, the hole is located just below the groyne, where the leg begins, whereas an inguinal hernia is located in the region closer to the pubis.

This condition, as mentioned above, is more common in women than inguinal hernia due to the anatomical predisposition of women.

Femoral hernia, unlike inguinal hernia, is in all cases acquired, since no congenital origins have been demonstrated for its formation. However, its acquired origin is, as in the case of inguinal hernia, due to weakening of the abdominal wall and abdominal strain on the part of the patient.

One of the causes of femoral hernia in women is multiple pregnancies, as women who have had several children in their lifetime are more prone to weakening of the abdominal wall.

At this point it should be noted that the diagnosis of the hernia by an experienced specialist in general surgery and digestive system is vital, since it is he who will correctly distinguish the type of hernia. 

The diagnosis by the specialist must be made as soon as possible, as the later the diagnosis is made, the more likely the patient is to suffer incarceration and strangulation of the hernia, especially in the case of a femoral hernia. 

This would require emergency surgery, as part of the intestine becomes trapped in the hernia and tissue necrosis or death can occur, which can be dangerous for the patient.

The only way to repair a hernia, whatever type it may be, is surgery.

The patient should see a specialist as soon as possible for the reasons explained above. Moreover, if it is not treated as soon as possible, the hernia may increase in size and hinder the success of the treatment and, therefore, increase the number of complications that may put the patient's life at risk.

There are three ways to repair inguinal hernia or any other type of hernia.

Inguinal hernia repair in women by herniorrhaphy

This surgery consists of suturing the hernia defect, i.e. closing the defect in the abdominal wall with sutures, which prevents the abdominal contents from protruding again.

This type of intervention is being performed less and less often, as hernioplasty offers a series of advantages to the patient. In any case, it will be the specialist who will recommend one type of intervention or another to the patient.

Inguinal hernia repair in women using open hernioplasty

In this case, the specialist repairs the hernia by placing a surgical mesh of synthetic material where the hernia defect is located. This mesh acts as an abdominal wall just where the hernia is defective, preventing the abdominal cavity from protruding outwards again.

Hernioplasty is the most commonly used technique today, as it is the technique that gives the hernia the least chance of protruding outwards again.

Inguinal hernia repair in women by laparoscopic hernioplasty

In this surgical technique, the main difference with open hernioplasty is that a surgical instrument called a laparoscope is used and that it is not necessary to make large incisions in the area to repair the hernia. In addition, patient recovery times and postoperative pain are shorter with this technique.

The laparoscope is an instrument that has a tiny camera at one end and, by introducing it through a small incision in the area of the patient's hernia, it is possible to see inside the cavity and allow the surgeon to operate the area with greater precision.

Through small incisions in the area, the surgeon can operate correctly and without complications. Once the defect has been repaired, a surgical mesh is also placed to prevent the hernia from protruding again. Finally, the small incisions are sutured.

The length of the surgery will always depend on the type of technique used, although open hernioplasty normally lasts 30-40 minutes and laparoscopic hernioplasty lasts 90-120 minutes.

The length of time will always depend on the severity and size of the hernia.