Did you know that 800,000 inguinal hernia repairs are performed in the United States each year? Inguinal hernias are one of the most common types of hernias and cause painful symptoms that can really impact your life.

What many people don’t know is that inguinal hernias can be direct or indirect. If you have a hernia, it’s important to understand the differences between a direct vs. indirect hernia and how they occur. This way, you’ll feel much more comfortable with your diagnosis and treatment options.

Keep reading this direct vs. indirect hernia guide to learn everything you need to know. 

Overview of Hernias

Hernias occur when an internal organ or another part of your body pushes through areas of tissues and muscles that usually hold them in place.

Most of the time, hernias are located in the abdomen but can also appear in the groin and upper thigh.

While hernias typically aren’t immediately life-threatening, they don’t resolve on their own. In many cases, you’ll need surgery to prevent future complications such as an intestinal obstruction.

Direct vs. Indirect Hernia

One of the most common types of hernia is an inguinal hernia. Inguinal hernias occur when a portion of your fat tissue or intestine bulges through the lower abdomen wall.

Inguinal hernias often contain portions of female reproductive organs, the scrotum, and parts of the small intestine.

Usually, inguinal hernias go through the inguinal canal in the groin area. Both males and females have an inguinal canal. In males, the testes descend through the inguinal canal before birth. In females, this canal is near the uterus.

Inguinal hernias can be either direct or indirect, depending on how they form and when they form.

What Is a Direct Hernia?

A direct hernia happens when a part of the abdominal muscles becomes weak. This allows a part of the intestines to push through the abdominal wall along the back of the inguinal canal.

Direct hernias are most common in adult males and typically result from heavy lifting. This puts extra pressure and strain on the abdominal muscles and causes them to weaken and even tear.

Other causes include previous abdominal surgeries, aging, and stress.  

Direct Hernia Symptoms

Often the first symptom you’ll notice is a prominent bulge in your groin area or pubic bone. You’ll also notice a dull ache in the area and pain when you cough, sneeze or laugh.

Additionally, direct hernias become more painful with prolonged exercise or standing.

Direct Hernia Complications

If any contents inside the hernia are trapped in the abdominal wall, it can cause a bowel obstruction. Bowel obstructions lead to severe pain, nausea,  and vomiting. Eventually, you won’t be able to pass gas or have a bowel movement.

Left untreated, this can prevent adequate blood supply from reaching your intestine. This is known as a strangulated hernia.

What Is an Indirect Hernia?

Indirect hernias are usually noticeable at birth and are more common in male infants. As opposed to direct hernias, indirect hernias result from abdominal tissue known as the inguinal ring failing to close up before birth.

As a result, the abdominal organs are pushed forward.

Even though indirect hernias are congenital, they don’t always appear during infancy or childhood. Adults can be diagnosed with an indirect hernia that appears later in life.

Indirect Hernia Symptoms

Like with a direct hernia, you’ll notice a bulge in your groin area or pubic bone. You’ll typically feel pressure or heaviness in your groin and pain with lifting, bending, or straining.

You also may notice a burning or pinching sensation that radiates from your pelvis down to your leg.

Indirect Hernia Complications

Over time, inguinal hernias tend to become larger and cause increased pain and swelling.

Indirect hernias can also become pinched and trapped, known as an incarnated hernia. They can also cause intestinal obstructions and block the blood supply to a portion of your intestines.

How Are Inguinal Hernias Treated?

Direct and indirect inguinal hernias don’t typically resolve on their own, so you’ll need to see an experienced surgeon for an evaluation. If your inguinal hernia is mild and not causing any symptoms, your doctor may advise you to wait and watch for a period of time before having surgery.

If your hernia is causing immediate symptoms, there are different surgery options for inguinal hernia repair that your surgeon will discuss with you.

Open Inguinal Herniorrhaphy

First, there is an open inguinal herniorrhaphy. Your surgeon will make a large incision over your abdomen and groin area during this surgery. They’ll repair your hernia by pushing it back into your abdomen, then strengthen the area with mesh.

Laparoscopic Inguinal Herniorrhaphy

The next option is a laparoscopic inguinal herniorrhaphy. With this procedure, your surgeon will make multiple small abdominal incisions and use a thin tube with a camera to see inside your abdomen.

Your surgeon inflates your abdomen with carbon dioxide so that they can see the weakness in your abdominal muscles. They’ll then place mesh to cover any weakness in the abdominal wall.

Robotic Hernia Surgery

Robotic hernia surgery is a newer technique that’s now available. Like laparoscopic surgery, your surgeon will use a laparoscope and make small incisions.

However, during robotic surgery, your surgeon sits at a console and uses robotic arms to operate the surgical tools. Using a robot provides your surgeon with 3D images of the inside of your abdomen, which allows for greater precision during surgery.

Robotic hernia surgery has many advantages, including less pain after surgery, quicker recovery times, and smaller scars.

Talk to a Surgeon About Hernia Repair Today

Now that you know the differences between a direct vs. indirect hernia, you’ll have an easier time understanding your diagnosis and hernia repair options.

If you’re looking for safe and quick hernia repair surgery, you won’t need to look any further than Surgco. Our surgeon, Dr. John Valentine, has been practicing in Hendersonville and Nashville since 2007.

We offer robotic-assisted hernia repair surgery and a warm and friendly office environment. We’ll give you the best possible care and be with you every step of the way as you heal.

Make sure you contact us today to schedule an appointment.