What is a Femoral Hernia?

A femoral hernia occurs when a part of the bowel or fatty acid pokes into the groin on top of the inner thigh. In this case, the hernia is pushed through a weak spot in the abdominal wall into the femoral canal. Therefore, this is called a femoral hernia.

Causes of Femoral Hernias

A femoral hernia may result from the following:

  • 1. Internal tissues get pushed through a weak muscular spot near the inner thigh or the groin.The cause of this femoral hernia is unknown as an individual may have structurally weak muscular wall by birth.
  • 2. Strain or excess pressure by lifting or pushing something heavy
  • 3. Persistent cough
  • 4. Difficulty in urination or passing stool
  • 5. Childbirth
  • 6. Obesity
  • 7. Accumulation of abdominal fluid
  • 8. Peritoneal dialysis as a kidney disease treatment

Symptoms of a femoral hernia

  • 1. Some of the most apparent symptoms include a lump on the groin or inner thigh region. The lump may be tender and painful, and they may disappear while lying down.
  • 2. Groin discomfort, especially while standing, straining, or lifting heavy objects
  • 3. Nausea
  • 4. Abdominal pain
  • 5. Vomiting
  • 6. Femoral hernias are presented differently in males and females. The main difference is that they occur more often in females and older ones because of the wider female pelvic region.

Treatment options for Femoral Hernias

According to the doctors, surgical interventions are the only final cure for femoral hernias.

It is an expert recommendation that femoral hernias need to be repaired at the time when it is diagnosed. It is advisable to prevent the increased risk of complications like incarceration or strangulation compared to the common inguinal hernia. According to the timing of interventions in treating femoral hernia, the complications like obstruction and strangulation present the emergency for surgery, and it should not be delayed in any terms.

Femoral hernias can also be treated by the “standard inguinal approach”, a minimally invasive treatment method that includes a robot-assisted or laparoscopic approach.

Regardless of treatment technique or method used for femoral hernia, key steps in repairing femoral hernia are:

  • 1. Dissection
  • 2. Reducing femoral hernia sac 
  • 3. Closing of the obliteration of the defect of placing a prosthetic mesh. 

In case of clinical concern for strangulation or incarceration, the hernia sac is opened, and its contents are examined to assess its viability. 

The lacunar ligament can be divided to facilitate reducing the hernial sac and its contents. Placing the prosthetic mesh must be avoided in the bowel, gross contamination, or enterotomy because of various concerns like bacterial infections.  Mesh infection is one of the serious complications, but it is rare. These complications get difficult to treat. It has been estimated that there is 2% to 4% surgical site infection in repairing femoral or inguinal hernias using elective procedures.

Femoral Hernia Complications

Risk factors include

  • 1. Recurrence of femoral hernia
  • 2. Coexisting infection
  • 3. Tobacco abuse
  • 4. Diabetes
  • 5. Obesity 
  • 6. Increased intra-abdominal pressure 
  • 7. Collagen tissue disorders
  • 8. Poor diet and nutrition 

According to the case studies, most hernias, including femoral hernia, recur within the first 2 years after the treatment. 

Discussing risks and benefits between patients and doctors that must happen pre-operatively includes the possible chronic pain following the femoral hernia surgery. It has been found that chronic pain might occur in approximately 15% of femoral hernia patients. The treatment of hernia and daily activities have also been affected in a subset of femoral hernia patients.

In many cases, post-herniorrhaphy pain is advised to be managed non-operatively using anti-inflammatory analgesics and suitable medications. Other complications arising post-operation are;

  • 1. Retention of urine 
  • 2. Infection at the surgical site
  • 3. Orchitis (inflammation of testicles)
  • 4. Seroma (accumulation of clear fluid in the body)

What complications may happen if  femoral hernia is not treated?

If a femoral hernia is left untreated, the obstructive or strangulated femoral hernia can cause life-threatening situations like 

Severe intestinal inflammation (necrotizing enterocolitis)

Sepsis (body’s immune response to infection)

Femoral hernias may occur at any stage of life or any age.

Therefore, it is important to get knowledge of warning signs of femoral hernias and to be aware.

Complications of leaving the femoral hernia untreated include:

  • 1. Obstruction (incarceration); wherein the portion of the intestine is stuck in the femoral canal. This causes nausea,stomach ache, and a painful lump of groin. 
  • 2. Strangulation; wherein portion of intestine gets trapped leading to cuts off in the blood supply.

Cost of Femoral Hernia

The cost of a hernia depends on the type of hernia a person is suffering from and the surgical procedure recommended by the doctors for the treatment of the surgery. The average cost to treat femoral hernia may be between 65,000 and 1,10,000. 

Frequently Asked Questions

What are the symptoms of a femoral hernia?

Different symptoms in the case of femoral hernias can be

  • 1. The appearance of painful lumps in the upper thigh portion or groin.
  • 2. Discomfort in the groin region and the situation gets worsened while lifting something or straining
  • 3. Abdominal ache
  • 4. Nausea
  • 5. Vomiting

The appearing lumps may disappear or can be pushed back. Intense Cough or strain eventually makes the hernial lumps appear.

How serious is a femoral hernia?

Among all types of hernias, femoral hernias are not considered life-threatening or serious medical conditions. Strangulation or obstruction may cause the femoral hernia to become life-threatening. Ultimately, they must be treated as an emergency surgical operation.

Do femoral hernias go away?

Femoral Hernias do not tend to go away independently without proper treatment or surgery. Compared to other hernias, femoral hernias pose a dangerous situation wherein a small intestine gets stuck into a weak abdominal area. The doctor or the surgeon may advise opting for surgery to cure a femoral hernia to avoid worsening medical emergencies.

Can a femoral hernia fix itself?

Among different types of hernias, the femoral hernia is associated with an increased risk of complications if the surgery has not opted for treatment. A portion of the bowel may get “trapped” in the cavity of the abdominal wall, eventually leading to obstructed bowel (blocked bowel) and peritonitis (that is, peritoneal inflammation lining).

Can a femoral hernia patient do exercise?

In case a person suffers from a hernia, especially a femoral hernia, certain heavy exercises, and intense activities must be avoided. Straining exertion exercises like weightlifting must be prevented.

How long is recovery from femoral hernia surgery?

According to the case studies, it has been found that full recovery requires 6 weeks or less to get rid of a femoral hernia entirely. Although in many cases, people may return to their daily activities, driving, work, and light activities within 2 weeks following femoral hernia surgery.

What kind of pain is a femoral hernia?

An intense pain in the upper thigh region or groin in femoral hernias may arise. This pain may also radiate in the entire leg and hip region. Painful lumps while exercises, coughing or straining and while lying down.

Can a femoral hernia cause bowel problems?

Yes, certain bowel complications may arise in the case of a femoral hernia. Obstruction or a portion of the bowel getting stuck into the femoral canal cause a painful lump in the upper thigh or the groin. Eventual obstruction of the bowel causes nausea and vomiting.

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