Femoral hernias: below/lateral to pubic tubercle. Inguinal: above/medial.

Femoral hernias should always be referred due to risk of strangulation. With inguinal, it depends. Incarceration (temporary or permanent) increases the risk a hernia will strangulate but does not necessarily mean it will. Painful incarceration, even temporary, needs to be taken seriously as a warning sign. A ‘click’ on reduction can mean that the hernia is getting ‘caught’ on the way back in and may mean one that’s becoming higher risk for incarceration, but isn’t terribly important.

The only activities that should be avoided after hernia surgery (either open or laparoscopic) are driving and contact sport. There are no hard-and-fast rules about either, but generally would estimate a week off driving (more if needed, obviously) and a few weeks off contact sport. Heavy lifting is fine from the start within reason (don’t enter a weight-lifting competition straight off!) and as long as comfortable. Getting back to full activity seems if anything to help healing.

OTC trusses are not worth getting – may cause more problems than they solve. Individually designed ones, from the surgical appliance officer in a hospital, can be more helpful but take several weeks and are not a substitute for surgery, so only worth using if a patient wishes to avoid surgery.

(From Pulse online learning module)


About Dr Sarah

I'm a GP with a husband and two young children.
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