Chronic Groin Pain
Many patients with chronic groin pain may be suffering from an undiagnosed sports hernia injury, even though they weren’t injured during an athletic endeavor. Twisting and lifting such as occurs when unloading a truck or working on an assembly line is a common mechanism of injury. Even severe vomiting or slipping on ice can cause real groin injuries of this type. Not uncommonly, these patients have been told they did not have hernias or have had a hernia repair that did not relieve their pain. CT Hernia surgeons are regional experts in diagnosing and treating many types of chronic groin pain including occult sports hernias.
In spite of modern techniques and expertise, all hernia repairs, unfortunately, have a recurrence rate. For groin or inguinal hernias and small umbilical or ventral hernias this rate is very low on the order of 1-2%. CTHC surgeons tailor an appropriate approach that is optimized for a durable repair.
Repairing hernias that have recurred requires an advanced skillset that CT Hernia surgeons possess. Prior operations often mean more scarring and adhesions especially where much has been previously employed due to the inherent complexity of recurrent hernia repair. The CT Hernia Center has become a regular referral resource for these types of cases. Your surgeon will guide you through each phase of care and offer the reassurance that comes with experience and expertise.
A sports hernia is a weakening of the muscles and tendons in a thin portion of the lower abdominal wall, resulting in groin pain that tends to intensify with physical activity. It is common in recreational and competitive athletes, both male and female, as well as workers with physically demanding jobs.
Learn more about Sports Hernias here
Symptoms of a hernia include a bulge or swelling in the abdomen or groin area, which can also cause discomfort or pain. Your symptoms depend on the size and location of your hernia. Common symptoms include:
- A bulge in the groin, abdomen, thigh, or genitals. The bulge may get bigger when you stand and go away when you lie down.
- Discomfort or pain that is worse at the end of the day or after standing for long periods.
- Pain during lifting, coughing, sneezing, or physical activities.
- A feeling of weakness or pressure in the groin.
- Discomfort or pain during urination or bowel movements.
Types of hernias
There are different types of hernias. The most common ones are described below:
Inguinal (Groin) Hernia
These are common in both men and women and appear as a bulge in the area of the groin. Groin pain along with a lump in the same area usually indicates an inguinal hernia. However, it is more common in men and the bulge may extend down to the scrotum. Men risk damage to their testicles if a hernia becomes strangulated. There are two types of inguinal hernias: indirect and direct. They form at or near a tunnel between the abdomen and the groin called the inguinal canal. Since these hernias form in the same area, your surgeon may not be able to determine which type you have prior to surgery. Regardless, your surgeon will be able to identify and repair either type during surgery. Your surgeon will talk to you about the best method to repair your inguinal hernia. A mesh device is used to make a tension-free repair. Over time, new tissue grows into the mesh. This will strengthen the repair and help prevent the hernia from recurring.
Another area of natural weakness where a hernia can occur is in the area of the navel (belly button). This is called an umbilical hernia and appears as a bulge at the navel. It occurs when the muscle around the navel doesn’t close completely. The weakness in the abdominal wall can develop at birth or later in life. It is common in male and female adults and children. This type of hernia is often present at birth. Or, it can be caused by abdominal pressure from pregnancy, frequent coughing, being overweight, or other factors. Umbilical hernias were previously treated using a traditional suture repair. Now, a mesh device is used to make a tension-free repair, which is more comfortable after surgery and less likely to result in a recurrence.
A ventral hernia occurs when part of the contents of the abdomen (bowel or intestine) stick out through a weakened part of the abdominal wall. This can result from previous surgery, heavy lifting, chronic coughing, severe vomiting, obesity, pregnancy, or diabetes. If the hernia occurs at or near where an old surgical scar was, then it is called an incisional hernia. However, ventral incisional hernias are often just referred to as ventral hernias. Any prior surgery of the abdomen can produce an incisional hernia. Whenever surgery of the abdomen is performed, an incision (cut) is made in the abdominal wall and later sutured (sewn) together. Over time, a hernia tends to develop in these weakened areas. It can be caused by infection or the operation itself whether it is a large abdominal surgery or a small incision as with an appendectomy. While these can occur at the incision, they are more commonly seen along a straight line running vertically (up and down) from the breastbone straight down to the pubic bone. Incisional hernias in this area are among the most frustrating and difficult hernias to treat. To prevent the hernia from returning, a tension-free repair method using mesh (synthetic material) is used. The most common symptom of an incisional hernia is a bulge or knot that forms beneath the skin near a scar.
A femoral hernia may be seen as a painful lump or bulge in the upper part of the thigh near the groin. Femoral hernias tend to occur more often in women than in men. Most femoral hernias cause no symptoms. There may be some groin discomfort that becomes worse when you stand, lift heavy objects, or strain. Surgery will relieve discomfort. Also, if the hernia is not treated, there is a risk of tissue getting stuck or trapped in the weak area (called incarceration). Sometimes, the first symptoms are abdominal pain, nausea, and vomiting. This may mean that the intestine is blocked, which is an emergency since the tissue may die off if it remains incarcerated for too long.