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Groin Pain vs. Hernia

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Dear Dr. Levister: I have pain in my groin. Does that mean I have a hernia? C.E.

Dear C.E.: Groin pain is a frequent disability commonly seen in footballers, golfers and other sports players and athletes. In certain muscle strains and tears, the sequence is acute groin pain which, at first, can be completely crippling, then gradually subsiding with chronic, repetitive, sharp pain and aching groin - more marked with certain movements. The first treatment, frequently given, is intensive physiotherapy, ultrasound, injections and graduated exercise. This is often successful in healing muscle strains. Where no lump is apparent and where physiotherapy fails to correct the problem, it is possible that the groin-area muscles have torn. This tear must be repaired, a procedure which gives good results.

Where a lump is present, however, early surgery is necessary. Hernia, derived from the Latin word for "rupture,” occurs when an organ, part of an organ or other structure such as the omentum (part of the abdominal cavity) or fat protrudes through the wall of the structure that contains it.

Hernias are the second most common cause of intestinal obstruction and generally occur in the groin, abdomen and upper thigh. Many different factors contribute to the development of hernias, including a congenital condition present from birth, trauma to the area, prior surgery, smoking, advanced age, or ascites – an accumulation of fluid in the peritoneal (abdominal) cavity.

You may feel pain and/or a bulge in your groin, abdomen or upper thigh; or your physician may detect a hernia during a routine physical exam.

Hernias affect both men and women, though overall they are 8 to 20 times more common in men. Specifically, inguinal (groin) hernias are more common in men, while femoral (top of the thigh) hernias are more common in women.

A hernia will NOT go away? An untreated hernia will not get better without hernia surgery and a strangulated hernia is a life-threatening condition that kills 12-13% of sufferers. Unless a significant medical condition prevents it, all hernias should be repaired with surgery.

Hernias are usually repaired by outpatient hernia surgery, one of the most common surgeries done in the United States. There are over 20 million hernia repair surgeries done worldwide each year. Following hernia repair surgery, most patients return to full, unrestricted activity.

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