Older man discussing health concerns
June 13, 2018 | by Clayton Hackerman MD

A hernia is a tear or weakness in the fascia of the abdominal wall. Fascia is the tough connective tissue which surrounds the abdominal wall, sometimes in layers between the wall and surrounding muscle or in the muscle. In some cases, because of this tear or defect, intestines or internal fat may protrude which might result in a visible bulge.

Types of Hernias

There are several types of abdominal wall hernias: inguinal (inner groin), femoral (outer groin), umbilical (belly button), and incisional (resulting from an incision). Laparoscopic technique is especially useful for most inguinal and some incisional hernias.

Inguinal Hernias Affect More Men

Inguinal hernias can be due to a congenital weakness or they may be acquired over time due to wear-and-tear injury from heavy manual labor, straining due to constipation or prostatic issues, and coughing secondary to smoking. Men are more prone to developing inguinal hernias since they have a natural opening in the groin muscles to allow blood vessels, nerves, and the spermatic duct to pass down into the scrotum.

Umbilical and Ventral Hernias Can Occur During Pregnancy

Umbilical and other types of ventral hernias can develop during pregnancy or can form due to increased abdominal pressure from weight gain, coughing, or straining.

Incisional hernias develop when a prior surgical wound did not heal completely and a gap remains in the fascia of the abdominal wall.

Hernia Signs and Symptoms

A hernia bulge can cause a chronic dull ache or a more severe sharp burning pain. Other common symptoms include:

  • Swelling or bulge in the groin or scrotum
  • Increased pain at the site of the bulge
  • Pain when lifting
  • Increase in the size of the bulge over time
  • A dull aching sensation
  • A sense of feeling full or signs of bowel obstruction, such as vomiting or constipation

When to Seek Medical Care for a Hernia

With the exception of some umbilical hernias found during infancy, hernias do not resolve on their own. Over time, a hernia can grow larger and more painful. Some hernias may predispose a person to certain complications which might require emergency surgery.

To learn more about hernia symptoms, treatment types, and recovery times, listen to the following interview with Dr. Steven Counter on KOMO news radio 1000.

Types of Hernia Surgery




Listen to Dr. Steven Counter discuss hernias on IRG Health Talk.

  • Open surgery, in which a cut is made into the body at the location of the hernia. The protruding tissue is set back in place and the weakened fascial wall is stitched back together. Often, a type of mesh is implanted in the area to provide extra support.
  • Laparoscopic surgery can be used in many types of hernia repair. Instead of a cut to the outside of the abdomen or groin, tiny incisions are made to allow for the insertion of surgical tools to complete the procedure.

Each type of surgery has its advantages and disadvantages. A consultation visit with a general surgeon will help determine the best approach.

To schedule a hernia consultation appointment, call the General Surgery department at 206.860.2302.

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