A thigh hernia is a hernia of the intestines. It occurs below the inguinal ligament and is noticeable with pain that does not necessarily indicate the injured region. For example, the symptoms may initially affect the thigh. A thigh hernia always requires surgical treatment.
What is thigh hernia?
In the context of a thigh hernia, there is an outpouching of a hernia sac through a site in the tissue. Especially when there is increased pressure, the thigh hernia can not only be felt in the abdomen, but often seen as well. The hernia itself is composed of various elements. These include a hernial orifice, hernial sac, and the hernial contents. A femoral hernia is manifested by a hernial orifice, which has a maximum size of one centimeter. It can be located under the inguinal ligament. Because parts of the intestine may be located in the hernia sac, a thigh hernia always requires surgery. Otherwise, the intestine may become trapped between the structures, which would result in further discomfort. Overall, women are more often affected by a thigh hernia than men. In 40 percent of the patients, trapped intestinal segments can already be found during the establishment of the diagnosis. In addition to a thigh hernia, another hernia may occur at the same time. Such a phenomenon occurs in about 50 percent of all patients. In this case, not only a thigh hernia is present, but also an inguinal hernia.
Causes
The cause of a thigh hernia may be found in a weak area of tissue within the abdominal wall. The abdominal wall is stabilized by various structures, such as fascia and aponeuroses. However, the inguinal region is not universally and evenly supported. Instead, some areas have a lack of aponeuroses and muscles. Thus, these are naturally more susceptible to herniation and can be understood as a natural weak point. One such hernia site is present in the back of the inguinal ligament in the setting of a thigh hernia. In case of increasing pressure with a concomitant weak connective tissue, thigh hernia may eventually occur. According to experts, some factors exist that favor the development of such a phenomenon. These include, for example, more frequent pregnancies, an existing overweight as well as a collagen weakness, which develops with advancing age. Some other diseases are manifested by collagen weakness, such as Marfan syndrome. After groin surgery, certain applied procedures may also increase the likelihood.
Symptoms, complaints, and signs
A thigh hernia does not always cause discomfort. When a patient suffers from pain, it often cannot be directly attributed to a thigh hernia; instead, it radiates into the thigh, for example. Swelling may be particularly noticeable during heavy exertion. If the hernia sac is already incarcerated, pain may occur that is limited to the groin, the abdomen, as well as the inner thighs. Such discomfort often results from the fact that the affected structures are exposed to movement. Especially in women, it cannot be excluded that also the ovaries lose their position due to the thigh hernia. A thigh hernia is basically acquired. In most cases women are affected. In men, the complaints occur especially after surgery in the groin area.
Diagnosis and course of the disease
Swelling in the area of the power below the inguinal ligament should always be clarified by a physician. Such an appearance may indicate a thigh hernia. Before the physical examination, a detailed discussion with the doctor takes place. Here, information should be provided about the period of symptoms, previous surgeries, and any concomitant diseases. Whether a thigh hernia is present can usually be determined during a palpation examination. This is done both while the patient is sitting and standing. As soon as the patient tenses and presses the structures, the hernia sac can be felt. If the patient is overweight, palpation sometimes proves difficult. In this case, an ultrasound examination can be of further help.
Complications
First and foremost, those affected by this disease suffer from severe pain.The pain occurs in the area of the thigh and can also radiate into the entire leg. This also leads to severe movement restrictions and also to limitations in everyday life. Unfortunately, in many cases there is a delay in treatment because the disease does not show any characteristic symptoms. Due to the permanent pain, the child’s development may possibly also be impaired, resulting in complaints in the patient’s adulthood. Other complaints usually do not occur. Due to pain at rest, there may be difficulty sleeping at night, possibly causing irritability and psychological discomfort in the patient. Treatment of thigh hernia is usually performed with the help of surgical intervention. There are no particular complications. The discomfort is relieved and the disease is completely defeated. In most cases, the patient does not suffer from further restrictions in movement after the operation. The patient’s life expectancy is also not negatively affected by the femoral hernia. If treatment does not occur, it is possible that the tissue of the intestine may also be injured.
When should you go to the doctor?
Initially, a thigh hernia often progresses without clear symptoms. A visit to the doctor is recommended when the typical pain in the groin area occurs. The discomfort is usually noticeable during physical exertion and can radiate into the thigh. Affected individuals should have their symptoms examined by their family doctor. If the pain quickly becomes more severe or is accompanied by other symptoms, a doctor is best consulted directly. If risk factors such as increased age, connective tissue weakness or pregnancy are present, the doctor must be consulted. Severe obesity as well as chronic cough can also trigger a thigh hernia due to persistent pressure on the viscera. Those who belong to the risk groups must pay attention to any signs of illness and, if in doubt, talk to their family doctor. A thigh hernia is treated by the general practitioner, an internist or a gastroenterologist. Depending on the symptoms, other specialists may be consulted. If the thigh hernia is diagnosed early and operated on, the symptoms should have subsided after a few weeks. Close consultation with the physician during follow-up care will help clarify any accompanying symptoms. Children who show signs of a femoral fracture must be taken to a pediatrician. If the symptoms are severe and intensify rapidly, the emergency medical services should be consulted.
Treatment and therapy
Because the organs do not regress on their own, surgery must always be performed for a thigh hernia. Otherwise, there would be a risk that the intestine would be trapped in the hernial orifice and the tissue would be injured. A differentiation can be made between various surgical methods. On the one hand, an open surgery can be performed, on the other hand, a minimally invasive one can be performed with the help of the keyhole technique. In the latter method, the surgical intervention is performed through only a small incision of the tissue. In open surgery, the physician opens the hernia sac. The procedure can start either in the groin area or in the area of the thigh. After the hernia sac is removed, the other structures are pushed into their original positions and the hernia orifice and wound are then closed. Isolated surgery is performed without opening the inguinal canal. Instead, the incision is made near the inguinal ligament. After the structures are pushed back, the hernial orifice is closed with the help of a suture. A closed surgical procedure is considered to be particularly gentle. However, it can only be used under certain conditions. The physician makes small incisions through which he inserts his surgical instruments. A laparoscope helps to maintain orientation. In order to stabilize the hernial orifice of the femoral hernia, it is recommended to use a mesh made of plastic.
Prevention
There is limited prevention of a femoral hernia. Ultimately, decreased collagen is part of a natural sign of aging. However, repeated births and obesity appear to increase the risk. Accordingly, excess pounds should be shed and attention paid to a healthy diet.
Follow-up
After hernia surgery, patients can usually leave the hospital after one to seven days.The suture material is removed after four to ten days. Showering is already possible within two days, bathing and direct sunlight on the scars should be avoided for about two weeks. The exception is large scar hernias, where wearing an abdominal bandage is recommended for three months. Patients should take it easy on themselves for about two to three weeks after the operation. During this time, they should refrain from efforts that exceed the simple activities of daily living, such as personal hygiene and housework. This is followed by a slow increase in physical exertion. Depending on the type of activity, work can be resumed after about three weeks, and the first sporting activities can be undertaken after four weeks. Weights of more than ten kilograms can only be lifted safely after six weeks. Wound pain can be expected for up to 14 days after the operation, which can be treated well with painkillers. If the discomfort lasts longer, a doctor should be consulted. During the healing phase, overexertion in the groin area should be avoided, such as when pressing too hard during bowel movements. The use of mild laxatives is recommended for relief.
What you can do yourself
In case of a thigh hernia, the affected person basically needs medical help and support. Self-help options are not sufficient to achieve relief or recovery. The patient should maintain close cooperation with the attending physician. Since a surgical intervention is necessary, strengthening the body’s own defense system helps in a fast and good healing. To support the wound healing process to the best of our ability, a balanced and healthy diet is important. The organism needs a stable immune system to defend itself against possible pathogens or germs. A sufficient supply of oxygen and exercise also strengthen the body. In order to enable the organism to regenerate optimally, sufficient breaks and adherence to good sleep hygiene are advisable. Overexertion, physical strain or stress should be avoided or reduced. Since complications can arise in the course of the disease that are associated with restrictions in the range of movement, incorrect posture and one-sided physical stresses should be corrected early on in everyday life. To this end, independent attention should be paid to movement patterns and rigid postures should only be adopted for short periods. Muscle complaints or tension can be reduced by balancing movements. Physiotherapeutic exercises are recommended if the discomfort is alleviated. In addition, adequate heat and massage help prevent muscular irregularities.