Femoral hernias happen when tissue or part of your bowel pokes through the abdominal wall and into your femoral canal near the top of your inner thigh. They are relatively uncommon, accounting for only 3% of all hernias. They are also ten times more common in women than men because of the wider shape of the female pelvis.¹

Contact your healthcare provider immediately if you experience severe symptoms or complications, including:

• Intense stomach pain.
• Sudden groin pain.
• Nausea or vomiting.
• Difficulty urinating or passing a bowel movement.
• Increased pain, swelling, redness, tenderness.
• If your hernia looks bigger or becomes incarcerated and can’t be pushed back in.
  

These may signify a serious condition called 'strangulation’ where an obstruction of your intestines can cut off blood flow causing intestinal or bowel tissue to die. Strangulation can happen in all hernias but is more common in femoral and inguinal due to their narrow passageways.¹ Additionally, around 30% of femoral hernia cases will present as an emergency obstruction or strangulation.⁴

Most of the time, the exact cause of femoral hernias is unknown. Some femoral hernias may be present due to a birth defect while others may result from overstraining and a weakening of the muscle walls. Contributing factors may also include:

• Childbirth 
• Chronic constipation
• Chronic cough
• Intense, heavy lifting
• Obesity
• Straining during urination or bowel movements
   

To identify whether you have a femoral hernia, your healthcare provider will likely begin with a physical examination. During the exam, they will gently touch the area; if the hernia is large, the bulge will likely be felt. If the hernia isn’t detectable by touch or visible from the outside, a diagnostic test such as an ultrasound, CT scan or MRI of the abdominal or groin area may be ordered to make a diagnosis. 
 

If your femoral hernia is small-to-moderate in size, your doctor may recommend you ‘watch and wait’ where your condition will be monitored to see if symptoms progress. If your femoral hernia is moderate-to-large and causing you discomfort, or detracting from your quality of life, your doctor may recommend surgery. 

There are three primary surgical options for femoral hernia repair: open and laparoscopic. The appropriate type of surgery for you may depend on the size, severity, and location of your hernia. Ask your doctor about which option is right for you.

Surgical methods

• Open surgery: As the traditional surgical method, an open surgical procedure involves making a large incision over the area of the hernia. The hernia bulge is returned to its correct position and a mesh is often placed to help strengthen and support the weakened area before closing up the incision.
• Robotic surgery: A robotic hernia repair is a minimally invasive surgery requiring small incisions where the surgeon controls the procedure from a specialized robotic console.⁵ Patients may also experience a faster recovery, less pain, and fewer complications following robotic surgery compared to an open surgery.⁶
• Laparoscopic surgery: Similar to robotic repair, a surgeon will use several small, ‘key-hole’ sized incisions during laparoscopic surgery. Instruments, such as a camera, are then inserted through the incisions to perform the operation.⁷

Types of hernia mesh

• Synthetic mesh: Synthetic meshes made from plastic materials (e.g., polypropylene, polyester, etc.) are permanent implants used to repair hernias. These non-absorbable meshes remain in the body to help provide support to the site of the repair and are considered a more traditional approach.⁸
• Bioabsorbable mesh: Bioabsorbable (or “absorbable”) mesh is an alternative to synthetic mesh designed to degrade over time. It provides temporary support to the tissue while healing, leaving no residual material after about 18 months, minimizing the risk of chronic infection and eliminating the need for explantation in the case of reoperations.⁹
• Non-mesh tissue repair: In some cases, a surgeon may repair the hernia using the patient's own tissue without an implant. This approach may be considered for smaller hernias, certain patient profiles, or when mesh is not appropriate. Hernia recurrence rates are generally higher with non-mesh repairs than with mesh.¹⁰ 
  

Your surgeon can help determine which approach is right for your specific situation. Learn more about surgical techniques and mesh options.

If you have symptoms of a femoral hernia, it’s important to meet with a healthcare provider as soon as possible to have it diagnosed and to rule out other possible causes of pain. Visit our Surgeon Finder to find hernia care near you and download our Doctor Dicsusion Guide to help you on your journey.

The guidance provided in this article follows general rules that should be discussed with your doctor. This article is for informational and educational purposes only. It does not substitute for medical advice. If in doubt, always consult your doctor.