Inguinal Hernia Surgery in Singapore: Symptoms, Repair and Recovery
An inguinal hernia is a bulge in the groin where fat or a loop of bowel pushes through a weak spot in the lower abdominal wall. It is the most common type of hernia, especially in men. In adults it does not heal on its own, and repair with a mesh, by keyhole or open surgery, is the standard treatment.
What is an inguinal hernia?
The inguinal canal is a short passage through the lower abdominal wall, just above the groin crease. In men it carries the spermatic cord to the testis; in women, a small ligament to the womb. An inguinal hernia forms when fat or part of the bowel pushes into the canal through a weak spot.
There are two types, shown below. In adults both are treated the same way, and the type is often only confirmed during surgery. A lump just below the groin crease, at the top of the thigh, may instead be a femoral hernia.
Inguinal hernia symptoms
- A bulge in the groin that may disappear when you lie down
- Aching, heaviness or a dragging feeling, often worse at the end of the day
- Discomfort when coughing, lifting or straining
- Swelling around the testis in men, if the hernia extends into the scrotum
- Some hernias cause no symptoms and are found during a check-up
Who gets inguinal hernias?
They are far more common in men. The risk rises with age and is higher if you have had a hernia before or have family members who have had one. Anything that repeatedly raises pressure in the abdomen, such as a long-term cough or straining on the toilet, can make a weak spot give way. Read why hernias are so common in men and how symptoms can differ in women.
When is an inguinal hernia an emergency?
- The bulge becomes painful, tender or hard
- It will not go back in when you lie down or press gently
- You feel sick or vomit, or cannot pass wind or open your bowels
- The skin over the lump turns red or dark
These can be signs that the hernia is trapped (incarcerated) or its blood supply is cut off (strangulated). Go to the emergency department or call 995. Read more about which hernias are dangerous.
How an inguinal hernia is diagnosed
Examination
Most inguinal hernias are diagnosed by examining the groin while you stand and cough.
Ultrasound
Used if the diagnosis is not clear, for example a small hernia or groin pain without an obvious bulge. MRI is occasionally needed.
Ruling out other causes
Groin lumps and pain can have other causes, such as swollen lymph nodes or muscle strain, so it is worth having a lump checked.
Inguinal hernia surgery: keyhole or open repair?
In adults, inguinal hernias are repaired with a mesh, which lowers the chance of the hernia coming back compared with stitches alone. Both approaches below are standard; the right one depends on the hernia and on you.
Keyhole (laparoscopic) repair
Done under general anaesthesia through about three small cuts. The mesh is placed behind the muscle wall, covering the weak area from the inside. It is often recommended for hernias on both sides, hernias that have come back after open repair, and groin hernias in women. Read about keyhole hernia surgery.
Open repair
Done through one cut in the groin, with the mesh placed over the weak area. It can be done under local or spinal anaesthesia, which can suit people who should avoid a general anaesthetic. Compare open and keyhole repair.
Is watchful waiting an option?
For men with a small hernia that causes few or no symptoms, waiting and keeping an eye on it can be a reasonable choice, although many eventually choose surgery as symptoms develop. Groin hernias in women are usually repaired, because a femoral hernia, which is more likely to become trapped, can be hard to tell apart. Dr Kan Yuk Man will go through the options with you.
Recovery after inguinal hernia surgery
Going home
Planned repairs are often done as day surgery or with an overnight stay.
Getting back to normal
Most people return to everyday activities within about one to two weeks and can build up activity as comfort allows. Dr Kan will advise on work, driving, lifting and exercise.
Risks
Bruising, swelling and a fluid collection (seroma) are common and usually settle. Less often: infection, difficulty passing urine just after surgery, recurrence, or longer-lasting groin pain, which is usually mild.
See what to eat in our hernia surgery diet guide.
Inguinal hernia surgery cost in Singapore
The Ministry of Health fee benchmarks for inguinal or femoral hernia repair in private hospitals, including GST:
Fees towards the higher end are associated with larger hernias, complications and emergency surgery; repairs of a hernia that has come back are billed differently. Hospital charges are separate. MediSave and Integrated Shield Plans can be used where applicable. See our hernia treatment guide for more on costs.
Source: MOH fee benchmarks for surgical procedures.
Frequently asked questions
What patients most often ask about inguinal hernia surgery.
Can an inguinal hernia go away without surgery?
Not in adults. A hernia belt (truss) can hold the bulge in for a while, but it does not repair the weak spot and is not usually recommended as a long-term treatment.
Do I need surgery straight away?
Not always. Men with a small hernia that causes few or no symptoms can choose watchful waiting, although many go on to have surgery as symptoms develop. A hernia that becomes painful, hard or cannot be pushed back needs urgent care.
Is inguinal hernia surgery done under general anaesthesia?
Keyhole repair is done under general anaesthesia. Open repair can be done under general, spinal or local anaesthesia, which can suit people who should avoid a general anaesthetic.
Can hernias on both sides be repaired at the same time?
Yes. With keyhole surgery, hernias on both sides can usually be repaired in one operation through the same small cuts.
Will the hernia come back?
Recurrence is uncommon after mesh repair, but it can happen. Repairing the hernia with a mesh lowers the risk compared with stitches alone.
Can I use MediSave for hernia surgery?
Yes, eligible procedures can be partially covered by MediSave and Integrated Shield Plans, subject to policy terms.
Noticed a bulge in your groin?
Dr Kan Yuk Man, senior consultant surgeon, can examine you and explain whether keyhole or open repair suits you.
Disclaimer: This article is for general information only and is not a substitute for medical advice. Please consult a qualified doctor for advice specific to your situation.
Clinical guidance based on the international guidelines for groin hernia management (HerniaSurge Group, 2018).