A hernia occurs when a weakness in the abdominal muscle wall allows tissue—usually fat or bowel—to push through and create a lump or bulge.
Some hernias cause few symptoms, while others may lead to discomfort or complications if not treated.
Symptoms vary from person to person. You may experience:
- A visible or palpable lump
- A dragging or heavy sensation
- Discomfort or tenderness, especially with activity
- Pain that radiates to the groin or abdomen
- Occasional bowel-related symptoms
- A surgical emergency, with severe pain and collapse in the case of complications such as strangulation
Many people find that symptoms gradually limit their day-to-day activities as the hernia grows or becomes uncomfortable.
Hernias can develop in several areas:
Groin Hernias
- Inguinal hernia – the most common type
- Femoral hernia – less common, usually occurring in women
Abdominal Wall Hernias
- Umbilical or Paraumbilical hernia – around the “belly button”
- Ventral hernia – elsewhere in the front of the abdominal wall
- Incisional hernia – develops at the site of a previous surgical scar
Incisional hernias can occur shortly after surgery or many years later.
Most hernias are not dangerous, but they can become incarcerated, meaning the lump becomes stuck and cannot be pushed back in.
If the blood supply to the trapped tissue becomes compromised, this can lead to ischaemia (tissue death), creating a surgical emergency.
Signs of a complication may include:
- Sudden severe pain
- Redness or tenderness over the lump
- Nausea or vomiting
- A lump that will not push back in (reduce)
Such symptoms require urgent medical attention as bowel may be at risk and the situation could potentially become life-threatening.
Once a hernia has formed, surgery is the only effective treatment.
Hernia repair involves:
- Returning the hernia contents to the abdomen
- Reinforcing the muscle defect—usually with a light, soft surgical mesh
Mesh strengthens the repair by encouraging the body to form natural supporting scar tissue.
Techniques Available
The approach depends on the hernia location, size, your overall health, and preferences.
Options include:
- Open hernia repair
- Keyhole (laparoscopic) repair
- Specialist techniques for complex or recurrent hernias
The pros and cons of each method will be discussed with you in detail during your consultation.
Hernia repair is generally very safe. However, all operations carry some risks, including:
- Bleeding or infection
- Mesh infection is rare (<1%)
- Bruising or haematoma
- Recurrence (typically 2–5%, depending on hernia type / size and technique of repair)
- Injury to bowel (more relevant in large abdominal wall hernias or keyhole operations)
- Groin nerve pain (5% risk in inguinal hernia repair)
- Numbness over a small area of skin (sometimes unavoidable if a nerve must be divided to prevent chronic pain)
- Testicular complications in men (rare, 2% risk of reduced blood supply in large or recurrent hernias)
All risks will be discussed thoroughly so you can make a fully informed decision.
Most patients go home the same day.
What to Expect:
- Mild discomfort for a few days, managed with simple pain relief
- Normal household activities from the day of discharge
- Avoid lifting more than a light shopping bag for 4 weeks
- Avoid strenuous exercise for 4–6 weeks
- Most people return to work after 2 weeks
- Driving is usually safe after 4–5 days (check with your insurer)
For laparoscopic incisional hernia repairs, you may be advised to wear an abdominal binder for four weeks to support healing.
There has been significant media attention around surgical mesh, particularly in pelvic organ prolapse procedures. This is not the same as the mesh used for hernia repair.
Key Points:
- NICE (National Institute for Health and Care Excellence) does NOT apply restrictions to mesh used in hernia surgery.
- Mesh is used differently in hernia repair—lying flat between muscle layers rather than supporting organs.
- Mesh has been used safely for over 30 years, dramatically reducing recurrence rates and should be considered the gold standard to repair most groin hernias and other abdominal hernias larger than around 1cm in size.
- Serious mesh-related complications are uncommon in hernia repair. Mesh problems with prolapse surgery have been related to its use to “reposition” or sling organs, which has lead to erosion in some cases, which does not occur with hernia repair.
If you have concerns, we can discuss mesh and non-mesh options, and what is most appropriate for your individual situation.
