Inguinal hernia repair in
children
Child Health Service
Parent/Caregiver Information
What is an inguinal hernia?
An inguinal hernia is a swelling in the groin caused
by contents in the tummy passing through a
weakness between the muscle layers in the groin.
Inguinal hernias are common.
What causes an inguinal hernia?
Passing between the muscles in the groin is a
narrow passage called the inguinal canal. In boys,
this canal contains blood vessels going to and from
the testicle together with the tube that transmits
sperm from the testicle (the vas). In girls, the canal
contains a small ligament only. In both sexes, the
canal also contains a thin tube-like extension of the
lining of the inside of the tummy (which looks like
‘Gladwrap’). This tube typically closes soon after
birth but if it remains open, it forms a track
through which a content of the tummy (such as
bowel) can enter the inguinal canal and cause a
lump in the groin.
Inguinal hernias are more common in boys and
premature babies. They often affect one groin only
but may affect both (bilateral).
Can an inguinal hernia get better without
an operation?
No. The swelling in the groin often comes and goes
at first but once a hernia is present, it does not go
away. Surgery is the only way to fix it.
Why does an inguinal hernia have to be
repaired?
Inguinal hernias get gradually bigger with time. The
main reason they need to be repaired is to avoid a
loop of bowel or another structure from inside the
tummy getting stuck in the hernia; this can block
the bowel and cut off its blood supply (called a
strangulated hernia) making your child seriously ill.
A painful hernia or one which becomes hard and
tender needs urgent medical review, as these signs
suggest that something may be stuck in the hernia.
What does the operation involve?
An inguinal hernia is usually repaired under a
general anaesthetic. Once your child is ‘asleep’ the
surgeon makes a small cut in a skin crease in the
groin and finds the hernia ‘sac’ (the thin tube-like
extension of the lining of the tummy). In a boy, the
sac must be separated from the testicular blood
vessels and the vas. The sac is tied off with thread.
The skin is closed with dissolving stitches and a
dressing put on the wound. A local anaesthetic is
often injected during the operation to reduce
wound soreness.
Repair of a hernia on one side usually takes about
15-20 minutes. Your child will be in the operating
theatre for longer because it takes time to safely
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[continued]
put him/her to sleep and to wake them from the
anaesthetic. After the operation he/she will be
transferred to a recovery area where you will be
able to join them.
•
Are there any complications of the
operation?
Repair of an inguinal hernia is a common and
straightforward operation but any operation has a
risk of complications. Fortunately, these are
uncommon.
Complications of the anaesthetic:
Your anaesthetist is the best person to discuss
these.
General complications of any operation:
Bleeding is rare but temporary bruising of the
wound or scrotum occurs occasionally. A wound
infection is uncommon but you should see your
family doctor if the wound becomes red or
increasingly painful in case your child needs
treatment with antibiotics.
Specific complications of the operation:
• A fluid swelling around the testicle (called a
hydrocele) may develop after the operation;
it usually disappears gradually by itself.
• A recurrent hernia happens in less than 1%
of children but is slightly more frequent after
hernia repair in a newborn baby. A recurrent
hernia has to be treated by a further
operation.
• Damage to nearby structures during the
operation including the contents of the
hernia (such as the bowel or, in girls, the
ovary), nerves (causing temporary numbness
of a patch of groin skin), or the blood vessels
or vas connected to the testicle. Damage to
the latter can cause the testicle to shrink
and impair sperm production; fertility then
depends on whether the other testicle
works normally.
The testicle on the side of the hernia repair
occasionally comes to lie nearer the groin
after a hernia repair, needing a subsequent
operation to bring it down to the scrotum.
When will my child be able to go home
after the operation?
In older infants and children, the operation is
carried out as a ‘day case’ so that your child is able
to go home later the same day. You will be advised
to give him/her regular doses of a painkiller such as
Paracetamol during the first 24 hours after the
operation.
Infants under about 3 months of age (or older if
your baby was premature), often need to be
monitored in hospital for one night after the
operation before going home or back to their
referring hospital.
When can my child resume normal
activities?
Children recover rapidly after an inguinal hernia
repair. They can have a quick bath or shower the
next day. The dressing can be peeled off if it is still
on after a week or left to fall off on its own. Older
children can usually get back to school after a
couple of days and resume sports about 2 weeks
after the operation. The general rule is “if it hurts,
stop and wait longer before trying again”.
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