Understanding Inguinal Hernias and Hernia Surgery

May 5, 2026

Inguinal hernias, which account for approximately 75% of all abdominal wall hernias and affect 700,000-800,000 individuals each year, are a common but often misunderstood condition, leaving many patients unsure about when symptoms require medical attention or surgery. To better understand inguinal hernias and when surgery may be recommended, Rachel Gordon, MD, General & Colorectal Surgeon at Episcopal Health Services (EHS) has answered key questions: what inguinal hernias are, why they develop, how they are diagnosed, and what patients can expect before and after surgery.

What is an inguinal hernia?

Inguinal hernias differ from other hernias, such as hiatal hernias, primarily by location. An inguinal hernia occurs in the groin area, where tissue, most often a portion of the intestine, pushes through a weakened area of the abdominal wall. This creates a visible or palpable bulge that may come and go and often causes discomfort or pain. Inguinal hernias are the most common type of groin hernia and occur more frequently in men due to natural anatomical differences related to testicular descent, which creates an area of weakness in the abdominal wall.

What are the symptoms?

Common symptoms include:

• A bulge in the groin
• Groin discomfort or pain, even when the bulge is not visible
• Pain that may radiate to the inner thigh or scrotum

More serious symptoms, such as severe pain, bloating, nausea or vomiting or inability to pass gas, may signal an emergency situation that requires immediate care.

What are common risk factors?

Risk factors for inguinal hernias include being male, heavy lifting or physical labor, chronic coughing, obesity, constipation with straining, weightlifting, and smoking.

How are inguinal hernias diagnosed?

Most inguinal hernias are diagnosed through a physical exam, often with the patient standing and coughing to make the hernia more noticeable. Imaging tests are not usually needed but may be ordered in certain cases.

When is surgery needed?

If a hernia is not causing discomfort, your doctor may recommend monitoring it over time rather than treating it right away. However, Dr. Gordon notes that about 80% of people will develop symptoms within a year and ultimately choose surgery.

Surgery is highly recommended if:

• Symptoms worsen
• The hernia becomes painful
• The hernia becomes stuck and cannot be pushed back in
• There are signs of bowel obstruction or compromised blood flow

What does hernia surgery entail?

Hernia repair is performed using one of two main approaches:

• Open Surgery: A small incision is made over the hernia, the tissue is placed back where it belongs, and a surgical mesh is used to reinforce the weakened area.
• Laparoscopic Surgery: Small incisions and specialized instruments are used to repair the hernia from inside the abdomen or abdominal wall, also using mesh.

The approach depends on the size of the hernia, patient factors, and surgeon preference.

Is surgical mesh safe?

Surgical mesh is a standard and essential tool used in modern hernia repair. It significantly lowers the risk of hernia recurrence. While all surgeries carry risks such as bleeding or infection, complications related to mesh are rare. Dr. Gordon emphasizes that the meshes used today are safe and widely accepted in surgical practice.

What can I expect during recovery after surgery?

Most patients recover quickly and return to normal daily activities almost immediately, with important restrictions on heavy lifting for 4–6 weeks. Temporary bruising, swelling, fluid buildup, or numbness in the groin or inner thigh are common and usually resolve over time.
Can inguinal hernias be effectively treated with positive results?

Inguinal hernias are common and highly treatable. With proper diagnosis, timely surgery when needed, and careful recovery, most patients experience excellent outcomes and a low risk of recurrence. If you notice a groin bulge, persistent discomfort, or have concerns about a possible hernia, speak with your healthcare provider. Early evaluation can help prevent complications and ensure the right treatment at the right time.

To learn more about hernia care and surgical services at EHS call 718-EHS-DOCS (347-3627) to schedule an appointment with a provider.