A hernia occurs when an internal part of the body (e.g. an organ or tissue) pushes through a weakness in the muscle or surrounding tissue wall from where it normally resides, most notably resulting in a visible bulge. This can occur in various parts of the body, with the most common site being the groin.
This increased pressure and/or weakened muscle or tissue wall may be caused by:
Hernias typically require surgery to treat, which involves pushing the displaced organ or tissue back into place and reinforcing the weakened area of the muscle or tissue wall.
While signs and symptoms vary depending on the type, location and severity of the hernia, common ones include:
Making up around 9 in 10 of all hernias, inguinal hernias occur when a part of the intestines or fatty tissue pushes through into the groin area near the inner thigh. This primarily affects men and is often linked to ageing and repeated strain on the abdominal area.
Similar to inguinal hernias, femoral hernias occur when fatty tissue or part of the intestine pushes through into the groin or the top of the inner thigh. This often affects older women.
This occurs when fatty tissue or part of the intestines protrude through the abdominal wall near the belly button. This is more common among infants, but can sometimes happen to adults as well.
This may occur after an abdominal or pelvic operation when tissue or part of the intestine protrudes through the site of the incision or scar.
Medical attention should be promptly sought – even if symptoms are initially mild – because hernias can often worsen over time. There also lies a risk of complications, such as a strangulated hernia and a bowel obstruction.
A strangulated hernia occurs when blood supply to a part of an organ or tissue trapped in the hernia has become cut off; and a bowel obstruction occurs when a part of the intestine entered the hernia and became blocked as it is trapped and tightly pinched in place.
You should see a hernia doctor if you suspect you have a hernia, even if it isn’t bothering you much yet. That said, you should seek urgent medical care immediately if you have a hernia and you develop any of the following serious symptoms:
These may be indicative of a strangulated hernia or a bowel obstruction, which are medical emergencies that require immediate hernia treatment.
While hernias do not go away on their own, and only surgery can definitively repair a hernia; surgery may not be needed immediately, and some may never even need one at all.
However, the only way to know for sure is to consult a hernia doctor who can assess your condition and determine if the non-surgical route may be suitable for you.
You may be suitable for conservative treatment if:
The hernia is asymptomatic
Other possible causes of raised intra-abdominal pressure have been ruled out (e.g., tumours, enlarged prostate, chronic cough from lung disease and smoking, constipation)
Conservative treatment options may include:
Using a binder or hernia truss: Supportive undergarments to keep the protruding tissue in place and to reduce discomfort caused by the hernia.
Controlled weight loss: To reduce pressure on the displaced part of the organ or tissue
Hernias usually do not resolve on their own, and require surgery to treat. There are three main types of hernia surgery in Singapore that may be performed:
In an open hernia surgery, a single cut is made over the hernia, with the average incision being about 6 to 8cm long. The hernia surgeon then pushes the herniated tissue back to its rightful place, and a mesh is placed on the weakened abdominal wall (where the hernia bulged through), so as to strengthen the area.
If the hernia has already become strangulated, however, and part of the intestines has been damaged, the affected segment may need to be removed and the remaining ends of the healthy intestines joined together.
This method of repair is the same as an open surgery, except tiny incisions are used (instead of a longer cut) to allow the insertion of small surgical tools to complete the procedure.
In laparoscopic hernia repair, a laparoscope (a tiny camera and light source) is inserted into the abdomen to visualise the hernia in real-time on a monitor. The hernia surgeon then uses this as a guide for his or her movements, which involves removing the hernia sac, placing the herniated organ back in place, and placing a mesh over the defect to strengthen the area.
In the hands of an experienced hernia surgeon, a hernia surgery is considered a very safe and effective procedure.