Pediatric inguinal hernia (groin)

What is a pediatric inguinal hernia (groin)?

Inguinal hernias (in·​gui·​nal -  her·​nias) in children occur when the pathway from the abdomen to the scrotum or labia does not close.

• In boys, the testicles develop in the abdomen and then travel through this pathway into the scrotum.

• In girls, the round ligament of the uterus follows the same path.

When the pathway fails to close, there is a persistent communication between the abdomen and scrotum or labia. Abdominal contents (most commonly the intestine or an ovary) can then slide in and out of this pathway. This condition is called a hernia. When fluid is contained in the hernia sac within the scrotum, it is called a hydrocele. Hernia and hydrocele can present together.

What are the signs and symptoms of a pediatric inguinal hernia (groin)?

Symptoms for a hernia can include:

• Discomfort in the groin, especially when bending, coughing or lifting

• Noticeable bulge in the stomach, scrotum or pubic bone

• Pain in the groin region such as pressure or “heavy” feeling (often described as something is pulling on the groin)

• Swelling in the testicles and vomiting

Hernias do not cause symptoms and will resolve on their own by the age of 5 years.

What are the causes of a pediatric inguinal hernia (groin)?

Children are more likely to develop a hernia if they are African American (higher risk for umbilical hernias), have a sibling or parent who had a hernia as an infant or have a history of:

• Cystic fibrosis (CF)

• Developmental dysplasia of the hip

• Genital and urinary abnormalities

• Prematurity - if they have a sibling or parent who had a hernia as an infant

• Undescended testes (UDT)

How is a pediatric inguinal hernia (groin) treated?

Generally, these hernias do not go away on their own and require surgery to prevent complications such as the bowel getting stuck in the hernia sac. Depending on the age of your child, some surgeons may recommend looking for a hernia on the other side at the same time as part of the initial hernia surgery. Depending on your surgeon, the procedure can be performed through a small incision in the groin or by using the laparoscope (minimally invasive surgery).