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What Is a Femoral Hernia and How Is It Treated? My Diagnosis

I was worried when I was diagnosed with a femoral hernia. Luckily, this type of hernia can be easily fixed.

When you discover a painful lump in your lower abdomen or groin area (right around the hip crease), well, all sorts of bad thoughts can go through your mind. Painful lumps in the groin can never be a good thing, so I was worried when I got one. I was diagnosed with a femoral hernia. The good news is that it wasn't something worse and can be easily fixed!

What you'll learn from this article:

  • What is a femoral hernia, exactly, and where does it occur?
  • What are the causes?
  • What are the risks and is it preventable?
  • What happens next?
  • How do I keep a hernia from getting worse while waiting for treatment?
  • How long does it take to recover?
  • What are the chances of it coming back?
  • Where can I find pictures of femoral hernias?

A lot of the "medical information" you find online can be misleading, so I set out to gather useful, reliable information on femoral hernias to complement the stories of my own experience. I hope that you'll find this article to be helpful.

What Is a Hernia?

According to MedicineNet.com, a hernia is any protrusion of a tissue through the wall of the cavity in which it is normally contained.

Hernias are generally categorized according to body region—most commonly the abdomen or groin—and can be further specified depending on the specific location. For example, in the groin area, a hernia may be either inguinal (closer to the scrotum) or a femoral (closer to the thigh).

What Can Cause a Hernia?

It all comes down to pressure on a weak spot, usually as a result of excess strain from:

  • Heavy lifting
  • Constipation
  • Bladder obstruction
  • Chronic coughs

Obesity and pregnancy can increase your risk of getting a hernia. In my case, heavy lifting—or as I now call it, "doing something stupid"—caused the protrusion in my femoral wall.

Diagram of common locations for a hernia.

Diagram of common locations for a hernia.

What Type of Hernia Do You Have?

Depending on the location and severity of the protrusion, there are few different types of hernias:

Inguinal

According to The Doctor's Guide to Gastrointestinal Health, an inguinal hernia occurs in "the groin, the area between the abdomen and the thigh. Intestines push through a weak spot in the inguinal canal. This is a triangle-shaped opening (Hesselbach's triangle) between layers of abdominal muscles near the groin."

Femoral

A femoral hernia is also located in the groin area, but lower down—"at or very near the leg crease." In this case, the gap through which the intestines protrude is a triangular area that's bordered by the inguinal canal, the femoral vein, and the pelvic bone. They are one of the less common types of hernias—accounting for only 3% to 5%—and are more likely to develop in adults than in children, and in women rather than in men.

It is possible to have both hernias at the same time, but it can be difficult to clinically distinguish between the two kinds. However, "finding a painful lump or bulge on the hip crease adjacent to the pubic area suggests a femoral hernia." In layman's terms: if your hernia is well below the bikini line, it's most likely femoral.

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Reducible

If the protrusion can recede through the wall, either through pushing or passively when lying down, it is considered reducible. This is the most common type and usually less painful.

Irreducible

If the protrusion can't recede, it is considered irreducible. You may also hear that a hernia is incarcerated, meaning "trapped" or "imprisoned." An irreducible hernia usually comes with some pain and/or a feeling of illness.

Strangulated

If an irreducible hernia's blood supply is cut off, it is considered strangulated. Femoral hernias are the most likely to become strangulated because of the narrow canal the protrusion passes through. These are generally very painful and tender and are considered a medical emergency. The protruding tissue can die off and interfere with normal digestive function. Symptoms may include pain, nausea, vomiting, and a fever.

All hernias should have prompt medical attention, as they will not heal by themselves. While a reducible hernia is not generally considered an emergency situation, there is a chance that it may become irreducible. It is always best to see a doctor if you suspect you have a hernia.

Not All Lumps Are Hernias

It is normal to feel small lumps at the top of your inner thigh. They are likely lymph nodes that are slightly enlarged. Lymph nodes aren't generally painful unless you press excessively hard on them. If it is painful with even the slightest touch, it can be a hernia.

Signs You May Have a Hernia

According to The Doctor's Guide to Gastrointestinal Health, "People don't always know when they have a hernia. They may get a painful or painless lump that may change with position."

Harvard Health also notes that "some hernias can cause twinges of pain or a pulling sensation, but most do not cause pain. Hernias are usually easier to see with coughing or straining. They also tend to be more prominent with standing and often disappear with lying down. Most people discover their own hernias by noticing a bulge."

How I Discovered My Hernia

It started with a sharp pain in my groin when I was lifting my elderly dog to her feet. A few more weeks of this and I could feel a nagging discomfort in my hip crease. I also had what my doctor kindly called "bladder awareness." I was never sure if I had to go to the bathroom, or if I had emptied my bladder completely, and I had a general ache in my lower abdomen.

I didn't think anything of my symptoms until I found a lump in my hip crease, close to the groin area. Whenever I pushed on it, it would recede, and I would feel a sharp pain and a burning sensation. There was also a twinge everytime I coughed. This was when I decided to go see my doctor.

What to Expect When You See Your Doctor

Examination and Diagnosis of a Femoral Hernia

Your doctor and/or nurse will start by asking questions about your condition. It helps if you can think about your experiences ahead of time so you can clearly explain your condition. It's always a good idea to take notes of things to tell your medical team so you don't leave out anything that might be important or find yourself struggling to remember dates and details.

If this your first visit to this particular doctor, the nurse will likely get a general medical history to start. This will involve a series of questions about your family health history and your personal health, any pre-existing conditions or diseases, any surgeries that you've had, what medications you're taking, allergy information, and so on. Again, it will help if you're prepared to answer these questions. Carrying your prescription medications along with you is often recommended so there's no confusion about what you're taking, at what dose, how often.

Questions Your Doctor May Ask

These are the questions my doctor asked me to help diagnose my hernia. Your doctor may ask slightly different questions.

  • Where is the lump?
  • How long has it been there?
  • How did you discover it?
  • Has the lump changed in size or shape since you first noticed it?
  • Are you experiencing any pain, and if so, how would you describe it?
  • Did you have a bowel movement today?
  • Are there any changes in your bathroom habits? For example, are you getting up in the middle of the night to empty your bladder?
  • Any other health concerns?

This should give you a sense of what you should be prepared to answer. If you can write down this information and carry it with you to refresh your memory, that will help the doctor make the correct diagnosis more quickly and accurately.

Physical Examination

You will likely first be asked to lie down so the doctor can palpate your abdomen. They'll press firmly to check for tenderness any masses in your abdomen that shouldn't be there. Once they locate the lump, they may press on it quite hard to see if it can be pushed back into place. This may feel quite uncomfortable, but it can be an important diagnostic procedure. If it becomes too painful, let your doctor know.

If the lump goes away when you lie down or when the doctor presses on it, you may be asked to turn your head and cough. This is to check whether the lump will reappear.

It is also possible that you will be asked to stand up while the doctor keeps his hand pressed against the lump. This is to help the doctor determine the size and shape of the lump and confirm the diagnosis.

Tip: If you wear loose trousers or shorts, your doctor may be able to examine you properly without you needing to strip down altogether. This can be important if you're the shy type or if the doctor's examining room is too chilly!

Is It Necessary to Have Surgery on a Hernia?

Surgery to repair a hernia is a non-elective but non-emergency procedure. In other words, it has to happen, but it is not life-threatening. It may become an emergency if the hernia is strangulated.

For most of us, however, there will likely be a considerable waiting period before the repair surgery is scheduled. How long will you have to wait for surgery? That depends on your current health situation, where you live, and what surgical resources are available to serve your community.

Here in Canada, I had an appointment for a consultation with a surgeon within two months of the initial diagnosis. The surgery was scheduled within four weeks of that appointment. The total time, from diagnosis to surgery, was just over three months.

"If I Had a Hernia" - A Doctor's Viewpoint

"A hernia is simply a hole and the way we fix it surgically is we want to either close it shut with stitches (the problem with that is they often come back), or we put a plastic mesh on top or underneath."

–Dr. Daniel B. Jones, MD, FACS, of Beth Israel Deaconess Medical Center and Harvard Medical School

This quote is from an InsiderMedicine interview with Dr. Daniel B. Jones. I love how matter-of-fact he was about the condition—it was very comforting to hear those words before going into surgery! In this interview, Dr. Jones goes on to explain what a laparoscopic surgery is and why he prefers that method for hernia repairs.

The hip and groin regions are very complex. As you can see from this diagram of the right hip, there are many blood vessels and nerves running through the area.

The hip and groin regions are very complex. As you can see from this diagram of the right hip, there are many blood vessels and nerves running through the area.

Recovery From a Femoral Hernia Surgery

Within a few weeks, you'll probably feel a lot better and may forget to take it easy and avoid strenuous activities.

Don't rush it. There's still a risk of reinjuring yourself.

As my doctor explained to me when I took my concerns to him, the repair surgery for a femoral hernia takes place in an area with a lot of tiny nerves, and it will take a longer time for those nerves to heal. I found I was still getting some numbness, tingling, and a dull ache in the incision area for as long as a year after the operation.

Follow all post-surgery instructions very carefully. If you are given a prescription for pain-killers, don't try to act tough. Take the prescription. Pain can actually interfere with the body's ability to heal, so it makes sense to reduce the pain you'll feel in those first few days.

Ask for help with moving around and lifting things. After a short time, you will be given permission to lift smaller items (up to 10 pounds).

It helps not to worry too much. There will be bruising in the area of the surgery, but like with other bruises, an ice pack can help the healing. Don't panic if you feel a lump under the site of incision either. This is scar tissue, and it will gradually go away over the course of a few months to a couple of years.

Most importantly, don't rush to get back to normal before your body is ready!

An example of an abdominal hernia belt. It is similar to a back support or weightlifting belt and is meant to keep your gut in place.

An example of an abdominal hernia belt. It is similar to a back support or weightlifting belt and is meant to keep your gut in place.

Can a Hernia Belt Help With a Femoral Hernia?

A number of readers have asked about medical devices or garments, such as a truss or support garment, to hold a femoral hernia in place and reduce the pain or risk of further injury until you're able to schedule a surgery. I had to look into this, and it seems that the jury is still out on wearing a support garment.

Depending on your personal situation (i.e. your weight and size and the precise location of your hernia) and the design of the support garment, your doctor may suggest that you wear a truss or support brief on a short-term basis to help you manage the discomfort. However, some physicians and other medical professionals are firmly against the use of a truss.

There are a few obvious reasons why your doctor may not advise a truss, including the concern that:

  • A poorly fitting support garment may put pressure in the wrong area, doing no good and possibly making the hernia pain worse.
  • A patient may rely on a truss instead of getting their hernia repaired by surgery, particularly if they don't have health insurance or access to a public health care system.
  • Wearing a truss might encourage some patients to be less careful, leading to more strain, more damage to the abdominal wall, and possibly very serious complications such as strangulation.

Risk of strangulation is the most common concern:

emedicinehealth.com says:

"Trusses and surgical belts or bindings may be helpful in holding back the protrusion of selected hernias when surgery is not possible or must be delayed. However, they should never be used in the case of femoral hernias."

Patient UK says:

"In view of the high risk of strangulation, all femoral herniae should be repaired as an elective procedure, but as soon as possible. There is no place for a truss for a femoral hernia."

As always, follow the advice of your own doctor, who is familiar with the details of your particular medical situation.

Where to Find Pictures

Photos of hernias, and especially inguinal or femoral hernias, are generally not too family-friendly and may be unpleasant for the general public to view, although most people are undoubtedly curious. Images of femoral hernias will inevitably show more of the body than most want to see on top of the alarming hernia.

I was careful not to include graphic images in this article to avoid repelling readers who are just here to get the information. Instead, I've included links to sources where you can find the photos if your curiosity takes you there. If you're a visual person like me, you want to see what the painful lump actually looks like.

Real Photos

A few not-too-horrible femoral hernia pictures can be seen on SciencePhoto.com—they're a lot safer than what you'll find from a general Google search. There is a benefit in seeing a more realistic image of a physical condition you believe you may be suffering from and not just a drawing or diagram, although a medical illustration better illustrates what body parts are involved.

Remember, we're talking about the groin area, so it is difficult for pictures to avoid showing the patient's private parts. Most photographs also tend to show the extreme cases—very advanced or large hernias. If you're looking for surgical photos, you'll also see the inside of the body—there will be blood, scars, and bruises. With all of this in mind, I don't recommend doing a broad Google image search unless you have a strong stomach!

Medical Illustrations

The National Library of Medicine website, MedlinePlus, has an excellent diagram of a femoral hernia you can look at if you have trouble getting a clear picture of exactly where a femoral hernia is located and what's involved.

The diagram is one of the A.D.A.M. Medical Image Library illustrations, protected by copyright and licensed to Medline by A.D.A.M. Inc. It is similar to the same kind of medical illustrations you may have seen in a high school health or biology class. That means it will be less disturbing to look at than a photograph of a real person with a hernia.

Disclaimer

My experiences and the information given here are not intended as a substitute for professional medical advice. I am not a doctor. If you think you may have a hernia, please make an appointment to see your family physician.

This content is accurate and true to the best of the author’s knowledge and does not substitute for diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed health professional. Drugs, supplements, and natural remedies may have dangerous side effects. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.

Guestbook - Have you learned something new here today?

Kathy McGraw from California on September 13, 2014:

I am glad to have read this and that your surgery went well. This was a pretty comprehensive article and should answer just about any question someone has, and telling people to write down their questions to the Dr. is something I learned that is really helpful.

norma-holt on May 19, 2014:

Wonderful report and my thoughts are with you as I do hope all has come good. Well done.

macymace on April 30, 2014:

it helps me a lot,because i have a reducible hernia im 36 years of age, a wife and a mother of 3 children, i haved my hernia for almost 18 years now...

sha-ron on April 16, 2014:

I have learned so much from this lens. thanks

GuyB LM on March 30, 2014:

My grandma always used to say to me, "I hope you get a hernia." I never knew what that actually was until now. I can't believe she wanted me to go through this much pain-what a shrew!

Shinichi Mine from Tokyo, Japan on March 12, 2014:

I did learn something today. Fortunately I don't have and never have had hernia and hopefully never will. But if I do, I know what to do now.

seleen fouad on February 24, 2014:

Informative, I think I have a weak spot since I got pregnant twice, I should be careful, thank you

AnonymousC831 from Kentucky on February 24, 2014:

You have explained things so well here. I had a femoral hernia when I was a child. I can't remember what or how they explained things then, so I have always been curious/wondered about the femoral hernia. Great lens.

flycatcherrr (author) on February 03, 2014:

@joliannet: This may sound all silly & new-agey, but a positive mental attitude really does go along way in these things, @joliannet - chin up! For most of us, the hardest part is staying quiet afterwards & letting the healing happen, when we start to feel well enough to be bored and want to get up & doing. I'd wish you luck, but sure you won't need it. :)

joliannet on February 03, 2014:

@flycatcherrr: Thank you so very much for taking the time to respond to me. My surgery is tomorrow. I am so scared of the whole process, but reading about your experience is very helpful. It seems that the hernia is inguinal and not femoral. (It was so low I thought that it was femoral, but I suppose they are alike enough!) I was told that they will be doing a laparoscopic surgery. (Although on one of my papers it said 'poss. open...whatever that means!!) The idea of closing your eyes and waking up and it is all over sounds ideal. I am so glad that that was your experience.

flycatcherrr (author) on January 09, 2014:

@magaroo: Oh, you're most welcome! I wish I had known the same stuff, going in, so as not to worry so much - so I'd hoped that sharing my story would help to set others' minds more at ease. So glad to hear you found this helpful. :)

magaroo on January 08, 2014:

Thank you for sharing what to expect AFTER the surgery! My own surgery - I'm a 36 year old mother of two - was about 2 weeks ago, and how I wish my surgeon/nurse had spent more time discussing what to expect. In the midst of all the info-sharing, they forgot to mention that I shouldn't be freaked out by the arrival of "the healing ridge" (the name given to what was once your flat incision and is now a roll-of-quarters-under-the-skin-sized hard-ish ridge of an incision). Ick. But normal, and a great sign that your body is doing its healing job well. Also...the surprising exhausting for nearly a week following surgery. I later found out it was because so much of my body's resources were being diverted to the healing involved. Finally, I was very happy to hear that you also experienced what I have been feeling two weeks out...continued post-op aches beyond the incision site, numbness, and jolt-like twinges below my incision and in my inner thigh near the groin. LOTS of nerves in that area unfortunately. Honestly, the procedure itself is easy - the healing takes patience. Thank you for the reassurances!

flycatcherrr (author) on January 07, 2014:

@joliannet: @joliannet no need to be nervous! Compared to the wonders that medical science is called upon to do these days, a femoral hernia is not too scary. Day surgery - I don't know how long the operation itself took as I was asleep :) but a little time for paperwork ahead of time and a couple hours of snoozing in the recovery room afterwards, then the surgeon came in to talk with me about how it went and what to look out for, how to care for the incision, etc. I went to the hospital in the morning about 8:30 or something and was back home having a cup of tea by the middle of the afternoon. Going under the anaesthetic is not a big deal, just a mask to breath through and you go to sleep. I was chatting with the OR nurse and went to sleep in the middle of a sentence, just that quick. :) Afterwards, some people feel queasy and nauseous after going under a general anaesthetic but it usually passes off in a couple of hours. My advice to you would be to make a list of questions and be sure to ask your medical team about anything that's on your mind. Don't be shy to tell them that you're nervous - they will understand, and it will save you the trouble of trying to act all tough if you're feeling jittery. :)

joliannet on January 07, 2014:

Hello! Thank you so much for taking the time to share your experience. As you know well, it can be very scary to experience something like this, especially if you never have before. I really appreciate it!Would you mind sharing what your experience was like on the day of your surgery? What was it like getting the anesthesia? How long was your surgery?I have a femoral hernia, relatively large...about the size of an egg.I am meeting with the surgeon for the first time this afternoon.To be quite honest, I am terrified!Thank you so much, and I really look forward to hearing back from you!

joliannet on January 07, 2014:

Hello! Thank you so much for taking the time to provide this information! As you know, it can be very scary going into something like this, especially if you have never had surgery before. Your sharing is much appreciated!I have a femoral hernia. I have a first appointment with the surgeon this afternoon. I think this is to determine how soon I need the surgery and set up my next appointment. Would you mind sharing some of your experience from the day of your surgery? How was your experience with anesthesia? How long did the surgery take? I am terrified of the process!Thank you so much, I really look forward to hearing back from you.

Flora Crew from Evanston, Illinois on January 01, 2014:

I am still not sure whether mine is an inguinal or femoral but it is in that area. The doctors know about it but have not insisted on its being operated on. Thanks for the info.

anonymous on November 20, 2013:

and please remember: you don't have to bear the pain! that's what meds are for!

tonyleather on October 26, 2013:

Ouch! This lens is very informative, but still I hope it doesn't happen to me!

flycatcherrr (author) on October 20, 2013:

@steph56: Go to your family doctor (your primary care stop in Cdn healthcare system) and she'll do an exam and referral to a surgeon. if you don't have a family doctor, go to a walk-in clinic. This surgery does not requires a specialist, fortunately.

steph56 on October 20, 2013:

Anyone know of female hernia specialist in Maritime Canada? I am in excrutiating pain and my symptoms fit everything I've ever read about female hernia. I am in AGONY.

jake542 on October 20, 2013:

I find this a very interesting indeed and well thought out. I am in my 78th year, and I to have a femoral hernia. just how long it is to see a consultant, I am amazed. 6 weeks at least for a consultancy and four months if you lucky for surgery. I paid for a consultancy and was seen to in four days. They wanted nearly 3k for the operation.. It eased my mind. A 'symptomatic' operation. I honestly do have no idea what that is sadly I am having bad early morning nausea. Not very nice. Just do NOT know what to do.. It is to be a local operation. Give information given by U folks Ta

jake542 on October 20, 2013:

I am very impressed with this site indeed. I am 78, and diagnosed with a Femoral Hernia. Whilst not too painful, my problem is that every morning I wake up with nausea. It does fade during the day. It is so debilitating I had no idea the waiting time for a diagnosis, without the time to wait for an operation, is so long !!!!!!!! I did check to have it done in a private hospital, I found that it would cost nearly 3000 for day surgery.

anonymous on September 03, 2013:

@flycatcherrr: i am still trying to figure out what's going on. i've seen 2 gps, one of whom referred me to a surgeon who said he couldn't feel anything. and i've had 2 ultrasounds and 1 ct scan. next i am being sent for back and hip x-rays. no one seems to know what's up. apparently these hernias are VERY difficult to diagnose in some cases. I wonder why?

anonymous on September 03, 2013:

After 8 months of misdiagnosis my femoral hernia was discovered on the operating table! I had been told I had a lymph node that they needed to biopsy.... I had been in agony for months, nausea , painful legs, shortness of breath, swollen abdomen. It has been a horrible worrying year. So relieved when my lump turned out to be a hernia but as I'm not good with the taking it easy the recovery is a pain. I have no external bruising and my stitches have all but gone (10 days) but I still have lots of pain where the scar is, severe tingling in my upper thigh and a very tender abdomen , my 'fizzy' thigh is driving me crazy and the hard scar tissue is horrible - feels like someone has left a finger in there! This is first post that's described my recovery feelings - so thanks, has put my mind at ease.

flycatcherrr (author) on August 30, 2013:

@anonymous: My family doctor made the tentative diagnosis and referred me to the surgeon who confirmed it. No special tests needed - it was palpably clear that it was a femoral hernia.

anonymous on August 30, 2013:

@anonymous: just curious - how were you finally diagnosed?!

anonymous on August 23, 2013:

Thanks for the info...great to be able to hear from someone who actually went through this. I was diagnosed today with a femoral hernia after 3 doctors, 2 ultrasounds and a biopsy failed to figure it out. So glad I kept pressing on. I'm not looking forward to the surgery having never had any procedures outside childbirth before but this post definitely helped.

anonymous on August 12, 2013:

@anonymous: can you say more about your recovery renee? i'd really appreciate it!

anonymous on August 11, 2013:

Thanks for the post and the comments. I'm experiencing pain on my right side, pelvic hip area. I've had a pelvic ultra sound as well as other ultrasound sounds. Nothing was detected. After reading these posts I will schedule another appointment and ask the physican to look for the hernia. I am very active. I spin 4 days a week, jog, bootcamp and take not yoga classes. Yep maybe excessive but approaching 50 I feel great. The pain i am experiencing in my hip flairs io while i am mot active. i actually went to a piodiatris because of the leg pains and they booted my for my achielles. That's one problem. Now it's hip pain is getting worse it's radiating in my thigh and the muscle is flinching. Please share your experiencing and what method of detection is used to determine it's a hernia? Thanks for your feedback.

anonymous on August 09, 2013:

@maryseena: i agree! so helpful.

anonymous on August 09, 2013:

@anonymous: it's nice to know you had only local anesthesia; that's what i would prefer if it turns out that i need the same. hope you are well now.

anonymous on August 09, 2013:

@anonymous: Amy I feel a lot like you. No definite lump, but similar symptoms. LOTS of pain. :(

anonymous on August 09, 2013:

Can they miss a femoral hernia in a CT scan? How is it diagnosed?

anonymous on August 08, 2013:

Hi....I was diagnosed 4 years ago with a femoral hernia and to date it still has not been repaired...I am going to my regular gp on monday and have them refer me to another doctor as the one i am seeing says that the more weight i lose the more the symptoms will go away, he said the hernia will never go away but the symptoms will...which now from reading more on the subject worries me because all other people with femoral hernias that i have talked to have said that i need to have the surgery to repair it!