How to tell if you have a femoral hernia

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In many cases, femoral hernias cause no symptoms. In more severe cases, people may experience:

• groin discomfort that may worsen when standing, lifting, or straining
• abdominal pain
• nausea
• vomiting

The most apparent symptom may be a lump on the upper inner thigh or groin. This may be tender or painful, and it may seem to disappear when the person is lying down.

Femoral hernias are unlikely to present differently in males and females. The main difference is that they occur more often in females, and particularly in those who are older, due to the wider structure of the female pelvis.

There are many types of hernias, and they occur in different parts of the body. The groin area has the lowermost part of the abdominal wall muscle, and groin hernias can develop when tissue pokes through this part of the muscle.

An inguinal hernia is a more common type of groin hernia. It involves either part of the intestines or fatty tissue protruding into the inguinal canal. This is a passage that connects the lower abdomen with the genitals.

Inguinal hernias occur more frequently in males than females, and femoral hernias occur more often in females. While femoral hernias are, overall, less common than inguinal hernias, they are often more serious.

Learn more about inguinal hernias.

A femoral hernia results from internal tissues pushing through a weak point in the muscle wall near the groin or inner thigh.

The exact cause may be unknown. A person may be born with a structurally weak muscle wall in the area. Femoral hernias can also result from straining or excess pressure due to:

• lifting or pushing heavy objects
• having a persistent, strong cough
• having difficulty passing urine or stool
• giving birth
• having obesity
• having ascites, a buildup of abdominal fluid
• receiving peritoneal dialysis, which is a treatment for kidney disease

Risk factors

A person may have a higher risk of a femoral hernia due to their:

• Sex: These hernias occur approximately 10 times more often in females than males because the female pelvis is wider than the male pelvis.
• Age: Femoral hernias are far more common in adults than children. If a child does develop one, it typically results from a medical condition.
• Family history: If a close family member has had a groin hernia, a person’s own risk increases.

Anyone who may have a femoral hernia should receive medical attention promptly. This is because there is a high risk of complications that can be serious.

A doctor examines the area, and they may also request imaging tests, such as ultrasound, CT, or MRI scans. These help them see the position of the internal tissues and differentiate between femoral and inguinal hernias.

If a femoral hernia becomes “incarcerated,” obstructed, or “strangulated,” it can cause additional symptoms and complications. A strangulated hernia is a life threatening situation that requires immediate medical care.

Incarcerated femoral hernia

Also known as an irreducible or trapped femoral hernia, this occurs when a hernia becomes trapped in the femoral canal and cannot move back into the abdomen.

Obstructed femoral hernia

This involves the hernia and a section of the intestine becoming entangled, and it can lead to a painful intestinal obstruction.

Strangulated femoral hernia

This arises when a hernia prevents blood from reaching the bowel. It is a medical emergency that can be fatal without treatment.

Strangulation is the most common serious complication of a femoral hernia, occurring in roughly 15–20% of cases. It tends to develop when the femoral canal is narrow, rigid, and unyielding.

Symptoms of this complication can include:

• sudden, worsening pain and extreme tenderness in the area
• fever
• nausea
• a rapid heart rate
• a change in skin color around the bulge
• vomiting

Without immediate surgery, a strangulated femoral hernia can cause the intestinal tissue to die and decay. This can result in a life threatening infection, and immediate treatment is necessary.

This procedure resolves the hernia and fixes the weak part of the muscle wall, keeping internal tissues from pushing through in the future. Moderate and severe hernias typically require surgery, due to the risk of strangulation.

There are two types of surgery for femoral hernia repair, and a doctor may recommend a type depending on the size of the hernia, the person’s age, their general health, and other factors.

Surgical hernia repair may be:

Open

This typically involves having a general anesthetic, meaning that the person is asleep for the procedure. However, in some simple cases, the team may give a local anesthetic. This makes the area numb, but the person stays awake.

The surgeon begins by making a small incision in the groin to access the hernia. They then move the bulging tissue back into the abdomen before repairing the femoral canal wall with strong stitches or a piece of mesh.

Laparoscopic

This surgery is minimally invasive, but the person receives a general anesthetic.

First, the surgeon makes several small incisions in the lower abdomen and inserts a thin, tube-like tool with a camera, called a laparoscope, into the incisions. They then move the bulging tissue back into the abdomen and repair the weakened area of the muscle with mesh.

Laparoscopic surgery is not suitable for everyone, such as people very large hernias. People who do receive this surgery tend to recover more quickly and have less scarring than those who receive open surgery.

Complications and risks of surgery

Surgery for a femoral hernia is typically safe, though any surgery carries some level of risk.

Complications, while uncommon, can include:

• bleeding or bruising at the incision sites
• blood clots
• difficulty passing urine
• injury to internal organs
• nerve damage around the incisions
• side effects of general anesthesia
• scarring
• temporary leg weakness
• wound infection

Older adults are more likely to experience complications than younger people.

People recovering from a femoral hernia repair can usually go home the same day or the day after.

While recovering, people typically need to:

• Take pain medication to alleviate discomfort.
• Limit their activities and movements for several weeks.
• Have a healthy diet to prevent constipation and straining.
• Take care of their wound.

Recovery can take 6 weeks or longer, but most people return to light activities after 2 weeks of resting.

Anyone who may have a femoral hernia should contact a doctor, who will decide whether treatment is necessary.

However, anyone with symptoms of a strangulated hernia should contact emergency services immediately. This may be lifesaving. These symptoms can include:

• sudden, worsening pain and extreme tenderness in the area
• fever
• nausea
• a rapid heart rate
• a change in skin color around the bulge
• vomiting

After a surgical femoral hernia repair, contact the doctor if any of the following develop:

• abdominal swelling
• chills
• difficult or painful urination
• a fever of 103°F (39°C) or higher
• intense pain that does not go away with medication
• persistent or heavy bleeding
• redness around the incision site that worsens with time
• severe nausea or vomiting
• shortness of breath

A femoral hernia is relatively uncommon, but the complications can be life threatening. For this reason, contact a doctor if a lump develops in the upper inner thigh or groin, especially if any associated discomfort worsens with straining.

Femoral hernia repair is a relatively straightforward surgery, with little risk, and most people make a quick recovery.