A hernia occurs when an internal part of the body pushes through a weakness in the muscle or surrounding tissue wall.
Your muscles are usually strong and tight enough to keep your intestines and organs in place, but a hernia can develop if there are any weak spots.
What is a femoral hernia?
A femoral hernia is an uncommon type of hernia. It’s estimated that only about 1 in every 20 groin hernias are femoral hernias, and the rest are inguinal hernias.
Femoral hernias sometimes appear as a painful lump in the inner upper part of the thigh or groin. The lump can often be pushed back in or disappears when you lie down. Coughing or straining may make the lump appear.
For information on other types of hernia, see:
What causes a femoral hernia?
A femoral hernia usually occurs when fatty tissue or a part of your bowel pokes through into your groin at the top of your inner thigh.
It pushes through a weak spot in the surrounding muscle wall (abdominal wall) into an area called the femoral canal.
Unlike inguinal hernias, femoral hernias occur far more frequently in women, particularly older women. This is because of the wider shape of the female pelvis. Femoral hernias are rare in children.
Femoral hernias can sometimes appear suddenly because of strain on the abdomen, such as:
- straining on the toilet if you have constipation
- carrying and pushing heavy loads
They’ve also been linked to obesity and having a persistent, heavy cough.
When is surgery needed?
Femoral hernias can be repaired using surgery to push the bulge back into place and strengthen the weakness in the abdominal wall.
Unlike some other types of hernia, treatment of femoral hernias is almost always recommended straight away because there’s a higher risk of complications developing in these cases.
Complications that can develop as a result of a femoral hernia include:
- obstruction – where a section of the bowel becomes stuck in the femoral canal, causing nausea, vomiting and stomach pain, as well as a painful lump in the groin
- strangulation – where a section of bowel becomes trapped and its blood supply is cut off; this requires emergency surgery within hours to release the trapped tissue and restore its blood supply, so it doesn’t die
Surgery gets rid of the hernia and prevents any serious complications, although there’s a chance of it returning after the operation.
What happens during surgery?
There are two ways a femoral hernia repair can be performed:
- open surgery – where one cut is made to allow the surgeon to push the lump back into the abdomen
- laparoscopy (keyhole) surgery – a less invasive, but more difficult, technique where several smaller cuts are made, allowing the surgeon to use various special instruments to repair the hernia
There are advantages and disadvantages to both methods. The type of surgery you have depends on which method suits you and your surgeon’s experience.
You should be able to go home the same day or the day after surgery. It’s important to follow the hospital’s instructions on how to look after yourself. This includes eating a good diet to avoid constipation, caring for the wound and not straining yourself too soon.
Most people make a full recovery from femoral hernia repair within six weeks, although many people can return to driving, work and light activities within two weeks.
Read more about:
Are there any risks from the operation?
Femoral hernia repair is a routine operation with very few risks, although around 1% of hernias return after the operation.
Other uncommon complications of femoral hernia repair include:
- developing a lump under the wound
- difficulty passing urine
- injury or narrowing of the femoral vein (which passes through the femoral canal)
- injury to the bowel
- temporary weakness of the leg
- injury to the nerves, causing pain or numbness in the groin area
Complications are more likely if you’re over 50 or have another illness, such as heart disease or breathing problems.
How femoral hernia repair is carried out
Recovering from femoral hernia repair
You should be able to go home on the day of, or the day after, your operation. Get an adult to take you home in a car or taxi and follow any instructions you’re given by the hospital.
After the operation, your groin will feel sore and uncomfortable. You’ll be given painkillers to help relieve this discomfort.
Looking after yourself
An adult must stay with you for the first 24 hours after your operation, in case you experience any problems.
If you’re still in pain after going home, continue taking painkillers as advised by the hospital. Applying gentle pressure to your wound using your hand or a small pillow can make coughing, sneezing and moving between sitting and standing more comfortable.
Make sure you follow the instructions your nurse gave you about caring for your wound, hygiene and bathing.
Straining on the toilet because of constipation can cause pain around your wound. You can reduce your risk of constipation by drinking lots of fluids and eating plenty of vegetables, fruit and high-fibre foods, such as brown rice, wholemeal bread and pasta. A mild, over-the-counter laxative may also help.
If the operation was carried out under a general anaesthetic (which puts you to sleep during your operation), your co-ordination and reasoning may be affected for a short time. Avoid drinking alcohol, operating machinery or signing legal documents for at least 48 hours after any operation involving general anaesthetic.
Over time, you can gradually return to your normal activities as soon as you’re able to do them without feeling any pain.
Most people are able to do light activities, such as shopping, after one or two weeks. You should also be able to return to work after two or three weeks, although you may need more time off if your job involves manual labour.
Gentle exercise, such as walking, can help the healing process, but you should avoid heavy lifting and strenuous activities for about four to six weeks.
You may find sex painful or uncomfortable at first, but it’s usually fine to have sex when you feel like it.
Speak to the medical professional in charge of your care for advice about when you can drive. It’s usually advisable to avoid driving until you are able to perform an emergency stop without feeling any pain or discomfort (you can practise this without starting your car).
It will usually be one or two weeks before you reach this point after having keyhole surgery, although it may take longer after open surgery.
It’s usually recommended that you contact your car insurance company before starting driving again.
When to call a doctor
Call your surgeon if you develop any of the following symptoms:
- persistent fever over 38C (100.4F)
- increased swelling or pain in your abdomen
- pain that is not relieved by painkillers
- persistent nausea or vomiting
- persistent coughing or shortness of breath
- increasing redness surrounding your incisions
- difficulty passing urine