What Happens
Inguinal hernias typically flatten or disappear when they are pushed gently back into place or when you lie down. Over time, hernias tend to increase in size as the abdominal muscle wall becomes weaker and more tissue bulges through.
If you can't push your hernia back into your belly, it is incarcerated. A hernia gets incarcerated when tissue moves into the sac of the hernia and fills it up. This is not necessarily an emergency.
But if a loop of the intestine is trapped very tightly in the hernia, the blood supply to that part of the intestine can be cut off (strangulated), causing tissue to die. In a man, if tissue is trapped, the testicle and its blood vessels can also be damaged. A strangulated hernia is a medical emergency that requires immediate surgery.
In adults, a hernia that can be pushed back into the abdomen can be surgically repaired at a convenient time. This is because incarceration is rare in adults. A hernia that cannot be pushed back can be repaired when surgery is convenient unless you have increased pain, redness of the overlying skin, fever, nausea and vomiting, or abdominal bloating. If any of these occur, the hernia may need to be fixed sooner.
Inguinal hernias can come back after surgical repair. But in women it is rare for inguinal hernias to recur.
Fertility is usually not affected by an inguinal hernia or hernia surgery. But in males there is a chance that surgery or an incarcerated hernia can cause injury to the vas deferens, the tube that carries sperm from the testicles to the urethra.1 It is not yet known how often or to what degree this affects a man's ability to father a child. In rare cases, surgery or an incarcerated hernia may injure the blood vessels that supply one or both testicles with blood, which may cause the affected testicle to shrink.
Hernias in children
Infants or children with an inguinal hernia need to have surgery as soon as possible because of the increased risk that a part of the intestine will become trapped and blood supply will be cut off, leading to tissue death.
Incarceration, when intestinal or abdominal tissue fills up the sac of a hernia, occurs in about 2 or 3 out of 10 infants younger than 6 months who have hernias. Most incarcerated hernias occur before the infant is 1 year old.1 Female infants face a higher risk of incarceration.
