Direct vs. indirect inguinal hernias
By Tom Seymour
Reviewed by Judith Marcin, MD
What is an inguinal hernia?
There are many different types of hernias. An inguinal hernia is when a bulge or protrusion of tissue occurs in the groin area. They occur within the inguinal canal and can extend into the scrotum in males.
The inguinal canal travels through the abdominal wall and is a passageway from the abdomen to the genitals. People have two inguinal canals, one on each side of the lower abdomen.
The abdomen is defined as the area between the chest and hips. The lower abdominal wall is the inguinal region, more commonly known as the groin.
Often what bulges is body fat or part of the small intestine, which comes through a weakened part of the lower abdominal wall.
Fast facts on direct vs. indirect inguinal hernias:
Here are some key points about hernias. More detail and supporting information is in the main article.
Symptoms of both include groin pain, which can be severe.
Direct inguinal hernias are often caused by age-related stress and weakened muscles in the inguinal canal.
Indirect inguinal hernias are caused by a persistent opening that does not close during fetal development.
The only way to repair an inguinal hernia is through surgery.
There are two types of inguinal hernias:
Direct: Develops over time due to straining and is caused by weakness in the abdominal muscles. Most common in adult males and rare in children.
Indirect: Caused by a defect in the abdominal wall that will typically have been present since birth. Most common in children, it affects up to 5 percent of newborns and up to 30 percent of premature babies. Often, it is discovered in the first year of life but can remain undetected until adulthood.
Inguinal hernias are up to 10 times more more common in men than women and one in four men will develop a hernia at some point in their life.
Abdominal X-ray: An X-ray machine is positioned over the abdominal area and a small amount of radiation is used to take a picture.
Computerized tomography (CT) scan: A person either drinks a solution, or a special dye, known as contrast medium, is injected into a vein. This helps to see blood vessels and blood flow on the X-ray.
Ultrasound: A device known as a transducer bounces painless sound waves off organs and body parts to build up an image.
Inguinal hernia surgery is the most common general surgical procedure in developing and industrialized countries, with around 2 in every 1,000 people undergoing the operation every year.
Surgery does not always have to be immediate, but if an inguinal hernia is discovered, it must be monitored closely by a doctor to see if the symptoms get worse. If the tissue of the hernia becomes trapped or incarcerated, then surgery will be more urgent.
The two main types of surgery are:
Open hernia repair: This is usually done under general anesthesia. A cut is made in the groin and the fat and intestines are moved back into the abdomen. Often, synthetic mesh will be placed over the weak area to prevent it reoccurring.
Laparoscopic hernia repair: Usually done under general anesthesia, small cuts are made and a laparoscope, a thin tube with a camera on the end, is inserted. Using the camera images as a guide, the repair procedure is done.
Most people recover more quickly from laparoscopic hernia repair than open hernia repair, but in both cases complications are rare.
Intense activity and heavy lifting are not recommended for several weeks and pain medication is often prescribed.
Hernias can reoccur after being repaired, so it is important for patients to follow their doctor's aftercare instructions and advice to reduce the risk of reoccurrence.
What is a spigelian hernia? Learn about spigelian hernias, a rare type of hernia that can cause painful symptoms and requires surgery. We also take a look at diagnosis and recovery. Read now
What is a strangulated hernia? A look at strangulated hernia, a condition where herniated tissue has its blood supply cut off. Find out about types, complications, and recovery. Read now
What's to know about epigastric hernia? An epigastric hernia is a bulge created by the bulging of body tissue through the surrounding muscle in the stomach area. This may not cause symptoms at all, but some cases are painful. Learn about the causes of an epigastric hernia, the symptoms, how it is diagnosed, and what to expect from surgery. Read now
All you need to know about hernia repair In this article, we look at the types of hernia repair (herniorrhaphy, hernioplasty), including when to see a doctor, and the risk factors involved. Read now
Foods to eat and avoid for a hiatal hernia Hiatal hernias occur when part of the stomach enters the chest cavity. Learn about which foods to eat and which to avoid with this condition. Read now
Seymour, Tom. "Direct vs. indirect inguinal hernias." Medical News Today. MediLexicon, Intl., 17 May. 2017. Web.
Seymour, T. (2017, May 17). "Direct vs. indirect inguinal hernias." Medical News Today. Retrieved from