Why do people get hernias?
Hernias are a very common clinical finding among the population. A hernia can appear at any age and usually happens due to some weaknesses in the muscular walls that create the abdominal cavity. There are some theories about the physical composition of the abdominal wall layers which can be damaged. A history of trauma can also be obtained from different patients or a stab wound or a history of infection. There is no racial predisposition and obviously maintaining a good physical condition might make it less frequent. A history of heavy physical straining such as lifting can also be obtained from many patients.

When is is necessary to have my hernia repaired?
Once the clinical diagnosis of a hernia is made the advice given to any potential patient is to repair the defect. The reason is to prevent future complications such as incarceration or strangulation also it is easier to repair a hernia when it is smaller rather than when it is getting larger over time. Increased amount of pain is a very good indication that the hernia should be attended to sooner rather than later.

Why do people get recurrent hernias?
As in any other surgical procedure there is a risk of recurrence. Specifically when we talk about hernias the quoted recurrence rate is about 1½%. The exact reason for the recurrence is not always know but it can be due to tissue qualities, infection or bad technique. Recurrent hernias can be redone either through the same old incision or endoscopically.

How is a hernia diagnosed?
In most cases a hernia can be diagnosed on the basis of clinical findings. When the patient complains about specific pain in any of the hernia areas it is usually accompanied with a bulge or swelling that can indicate the presence of a hernia. On rare occasions when the diagnosis is difficult to make then a Cat Scan can be helpful.

How much pain should I expect after a hernia repair:
Pain after a hernia operation is a common occurrence. When a inguinal hernia is repaired a patient should expect to have two to three days of discomfort and pain. Obviously it is a subjective issue and every patient will experience a different level of pain. On rare occasions a nerve can be entrapped in the repair which can cause prolonged pain. This can be solved through different methods and one can discuss this possibility with the surgeon. Basically oral pain medications is all that the patient would need for the immediate pain control.

Since pain is a subjective measure there are some patients who will complain about pain, discomfort for a longer time. Because of the subjective nature of these complaints it might be difficult to give a satisfactory answer to those patients who have prolonged periods of discomfort. In the majority of these cases this amount of discomfort of funny feelings around the hernia repair site will disappear with time.

Are women getting Hernias as frequently as males?
Statistically speaking women get less hernias than their male counterparts but it is still affecting them. The basic clinical presentation is the same as for males and the advice to repair them once the diagnosis is made is as valid as for the males.

Are there new types of mesh available?
Over the last decade the plastic mesh that I use now for the repair were refined. Now the mesh is thinner and much more pliable and the pores are bigger allowing tissue to grow into the mesh and incorporate the mesh in the healing as well as strengthening process.

What is the difference between strangulation and incarceration?
These two definitions describe a situation in which the hernia content is bulging out through the hernia defect. It can stay out without any danger beside being painful and that describes an incarcerated hernia. In the case of strangulation there is a compromise to the blood supply which makes it an urgent situation requiring urgent treatment.

Should I use a hernia belt (hernia support) as treatment?
The basic answer is that this hernia belt only gives a temporary and subjective relief for the hernia. It should not be defined as a treatment because it does not take away the hernia and on the contrary can cause even more adhesions between the hernia content and the abdominal wall.

What other types of problems can mimic an inguinal hernia?
At times inflammation of the lymph nodes in the groin can cause swelling and pain typical of an inguinal hernia. There are some physical findings that upon examination can differentiate between the two and might use some other imaging modalities to differentiate between the two. An ultrasound of the groin can be very helpful to make the right diagnosis and if its not enough then a CT scan can help as well. Other clinical situations that can mimic inguinal hernia page are hip pain, arthritic changes or muscle strain. All of the above should be ruled out before the diagnosis of hernia is made.