I dont know if i have a hernia

Question

i have had pain near my groin and i went to doctors he said its either a hernia or a pulled muscle. if it gets bigger its prob a hernia. I started feeling the lump that i have. how should a hernia feel?

Answer 1

Hello,

A hernia is a pressure-bulge.  It happens either when the abdominal contents swell, (like you're very overweight, and have internal fatty bowels), or when the abdominal wall gets weakened.  The result is the same, the abdominal contents (bowels) start to bulge through the weakened abdominal wall.

The abdominal wall is constructed by God with a few weak points.  The groin is one of these: there are weak points where the sperm-cord first enters its exit-canal (in men), and also where the sperm-cord finally leaves its canal into the ball-sack.  These are technically called the internal inguinal ring, and the external inguinal ring.

The tummy-button is another relatively weak point in the abdominal wall, so is the hole where the food-pipe goes through the diaphragm.  But confining this to groin hernias,  I have looked for diagrams on the internet for the internal and external inguinal rings.

To anatomy experts: yes, I know I'm simplifying the anatomy slightly.  And God may or may not be responsible for the design defects.  :-)

An "indirect" inguinal hernia comes down through the sperm-canal. It starts at the internal ring (the beginning of the canal internally), -  which is marked on the skin-surface by  its being half-way between the outermost pelvic-bone lump and the p***s, - - and then it tracks down inside the canal, under the skin, to emerge finally at the external inguinal ring, (still under the skin).

A "direct" hernia, bulges its way straight out past the external ring, without having threaded its way down the sperm-canal first.

There's another less common type of groin hernia, a "femoral" hernia in the lower groin (or upper thigh), which bulges out through the "femoral ring" next to the femoral artery, (see diagram).

The hallmark of a small hernia is that when you lie down flat and relax, *there's no lump.*  However, when you lift your head off the pillow, or you cough, or otherwise strain like you were going to have your bowels moved,  -  -  the lump appears (bulges out) due to the internal abdominal pressure rising, and squeeezing out the abdominal contents, - - a bit like squeeezing toothpaste out of a tube, except it goes back again when you relax.

A *large* inguinal (groin) hernia does not go back when you relax, it's "out" all the time,  - - and its "root" or "neck" can get 'strangled' by the ring it's passing through.  This is dangerous because it cuts off the blood-supply, - -  that's called 'strangulation' of the hernia.

A hernia should be non-throbbing:  only lumps touching arterial blood-vessels, get a pulse or 'throb' in them. If you feel throbbing, you are feeling the femoral artery.

If a hernia is out all the time, it 'expands' when you cough, reflecting the pressure it's under.

You distinguish between a "direct" and an "indirect" inguinal hernia by relaxing fully, and then pressing over the 'internal ring' half-way up the groin.  Then coughing hard.......  

... The pressure on the internal ring should prevent an "indirect" inguinal hernia from coming out into the groin.  A "direct" hernia still comes out.

I hope this is of some help.  It's difficult to feel a small groin hernia without practice.  There's even confusion in the medical words used, - -  the 'internal' ring is also called the 'deep' ring or the 'abdominal' ring;  and the 'external' ring is also called the 'subcutaneous' ring or the 'superficial' ring.  

It's very difficult to visualize what is going on under the skin, hence I have located loads of diagrams, (see below).

Best wishes,

Belliger

Answer 2

If you have a lump that you can feel, it sounds very much like a hernia.  You need to go back to the dr., or a different one.  Hernias never get better, only worse, and need surgery to be repaired.  It is always better and safer to have the surgery sooner, rather than later.