Causes Of Femoral Hernia
In most cases the cause of femoral hernia are unknown. You may be born with a weakened area of the femoral canal, or the area may become weak over time.
Straining can contribute to the weakening of the muscle walls which include childbirth, chronic coughing, constipation and obesity.
Symptoms of Femoral Hernia
A femoral hernia will appear as a small swelling, very low down your body, next to the groin or near the top of your thigh.
Often femoral hernias cause very little pain or other symptoms, so it is important to visit your GP if you suspect you have a hernia.
If left untreated, a femoral hernia could strangulate, where your bowel becomes trapped in the hernia and its blood supply is cut off. If strangulation occurs, the lump will become hard and tender, you will experience severe local and abdominal pain, nausea and vomiting.
The reason so many femoral hernias are discovered as emergencies is probably that the femoral canal, through which the hernia appears, is narrow with most of its entrance is rigid and unyielding.
It is important to see your GP to confirm the diagnosis even if the hernia causes no pain. Your GP will then refer you to a specialist hernia surgeon.
Treatment For Femoral Hernia
Femoral hernias should be repaired early and not left until they become a problem. The aim of surgery is to close off the femoral canal. Before ‘mesh’ was introduced this was done with stitches – stitching the front and back of the opening together. The problem is that there is not much give here – you are trying to sew two rigid structures to each other.
Suture: This is probably still the standard method, certainly in the UK. There is quite a lot of pain and the recurrence rate can be high, but accurate or reliable figures are just not available.
Mesh cone or plug: This preference of London Hernia consultant Mr Martin Kurzer is to place a soft mesh cone plug in the femoral canal. This sits in the femoral canal where it remains, stopping anything going through. This can be done with local anesthetic through a short cosmetically placed incision just above the groin crease.
‘Keyhole’: The procedure can also be performed laparoscopically, covering the entrance to the femoral canal with mesh. The success rate will depend on who does the operation.
Many hernias do not hurt so the temptation is to leave them and get on with life. But failing to get medical advice can be damaging and is not recommended. If left the hernia will grow and discomfort and pain, even if negligible to start with, will intensify.