Answer:

The most obvious sign of a groin (or inguinal) hernia is a lump or bulging where the upper thigh joins the abdomen. It may come with varying degrees of pain and is the result of intestines protruding through an area where the abdominal muscles are weakened. Often the bulging is noticed when coughing or bending.

Sometimes hernias do not require specific treatment because they can be easily reduced, or pushed back into place. If they are bothersome, a support, or "truss," strapped against the groin can offer temporary relief. However, this doesn't correct the problem or prevent complications.

In some cases, a bit of intestine becomes caught in the bulge and its blood flow can be squeezed off. This "strangulated" part of the intestine may begin to die and cause severe pain. A strangulated intestine is an emergency that can quickly lead to severe complications and requires immediate surgery.

If surgery is recommended for a hernia, it is likely to be one of two types: herniorrhaphy or hernioplasty. Herniorrhaphy, the oldest technique, involves making an incision, pushing the protrusion back into the abdomen, and then tightening the weakened muscle and supportive tissue with stitches. In hernioplasty, a mesh of artificial fiber is used to bridge the weakened muscles.

"There's a zillion different kinds of hernia repairs," says John Antolik, MD, a surgeon in private practice in Oregon City, Oregon. In the last few years, he says, there's been considerable interest in laparoscopic ("keyhole") hernia repair. In this procedure, a surgeon inserts a fiber-optic light and miniature video camera through incisions in the abdominal wall. Patients like it because it shortens recovery time and leaves less scar tissue than more "open" procedures.

The "keyhole" approach requires general anesthesia -- which comes with its own risks. If patients prefer a "spinal" or a local anesthetic, the "keyhole" approach is not an option. Patients who have been administered local anesthesia can get up right after surgery, says Antolik.

Hernia surgery, which takes from 45 to 90 minutes, is often performed in day surgery clinics. After surgery, patients can go home, eat, and move about as they like. Lifting more than 20 pounds, however, may be discouraged for six weeks.

Complications after surgery include reappearance of the hernia, which happens about 5% of the time, and infections, which may require removal of any mesh used and treatment with antibiotics.