Femoral Hernia

In brief, a femoral hernia is a type of inguinal hernia or groin hernia. There is a small space next to the femoral vein where it exits the body to enter the leg. As that space widens, internal adipose tissue or intestine can migrate into that space.

Femoral hernias can present as a small lump that appears and disappears located near the crease between the leg and the lower abdomen. The lump can be painless or can hurt. The lump can feel soft or hard, and can either be pushed back in (reducible) or feel stuck (incarcerated).

Femoral hernias can form as a result of a number of health conditions and physical situations that put pressure and strain on the intra-abdominal cavity. These can include:

• Smoking
• Obesity
• Heavy lifting
• Coughing
• Constant straining while constipated

Patients who suffer from connective tissue disorders, chronic obstructive pulmonary disease (COPD), or those with a family history of the formation of femoral hernias may be at an increased risk for developing them.

While a few of the symptoms of femoral hernias may mimic the feeling of everyday growing pains, it’s important to recognize the symptoms and note when improvement has not been made. In other cases, femoral hernias may not cause any noticeable symptoms at all, which is why it is important to visit your doctor regularly for a health evaluation. 

If you experience any of the following symptoms and see no improvement, you may need femoral hernia treatment:

• Pain in the upper thigh
• Groin pain
• Discomfort in the groin and abdomen when standing, straining, or lifting heavy objects
• Abdominal pain
• Nausea
• Vomiting

Some hernias are obvious and do not require further imaging. If the diagnosis is uncertain, then a sonogram, CT scan, or MRI may be ordered. All can help determine if you have a femoral hernia if the clinical exam is not obvious.

Dr. Jacob believes that all femoral hernias should be repaired. Waiting to repair a femoral hernia could increase the risk of strangulation, which can be avoided by performing surgery in an elective setting. If the hernia is painless or the pain is intermittent, the surgery should be scheduled but is not considered emergent. If there is continuous pain, then the surgery may be more emergent and you should contact your doctor immediately.

Dr. Jacob prefers a minimally invasive (laparoscopic or robotic) approach with mesh using general anesthesia, for femoral hernias. They can be repaired using an open mesh or non mesh repair, but the recurrence rates and potentially chronic pain rates may be increased with an open approach compared to a laparoscopic or robotic approach.

Preparing ahead of time for your femoral hernia surgery can increase your chances of a complication-free procedure and recovery. Before arriving at your appointment, consider doing the following a few weeks in advance:

• Consult your primary doctor about stopping any prescribed medications that may interfere with your femoral hernia surgery.
• Quit smoking at least two weeks before your surgery.
• If you are diabetic, keep your blood sugar levels under control.
• Being overweight and undergoing surgery may increase the chances of complications during recovery. Committing to a healthy diet and light exercise routine may help your body physically heal faster following your surgery. However, be sure not to engage in physical activity that strains your groin or abdomen further.
• Wear comfortable clothing on the day of your surgery.
• Arrange transportation plans with a loved one.
• Prepare to take time off work to recover properly.
• Avoid eating or drinking anything after midnight the night before your surgery.

Recovery and return to normal function after a femoral hernia is the same as after repair of an inguinal hernia as the surgery is basically the same. Most patients are able to do full and unrestricted activity within 7 to 10 days. The recovery page for inguinal hernias can be reviewed here: