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Your Hernia
Patient Guide
Understand your hernia, compare your treatment options and prepare the questions that matter to you before meeting your surgeon.
It does not replace a conversation with Peter or Tom. Together, you can consider your symptoms, your individual hernia, the available options and what matters most to you before deciding whether surgery is right for you.
Your hernia journey
Work through the guide in order, or go straight to the section most useful to you. You can return at any time before or after your consultation.
Your consultation is a chance to understand your hernia, compare watchful waiting with surgery, consider the benefits and risks, and decide what is right for you.
A quick welcome
This guide is designed to help you understand your hernia, consider your options and prepare for a useful conversation with Peter or Tom.
Learn about your hernia, when watchful waiting may be reasonable and what surgery involves if repair is being considered.
If something matters to you, save it to My questions so you can discuss it at your consultation.
Share the guide with a partner, family member or support person if you would like to work through it together.
Use the guide to understand the main issues, think about what matters to you and bring any questions to your consultation. Peter or Tom will help you apply the information to your individual situation.
Who are you seeing?
Select your surgeon so later prompts can use the right name. You can save questions throughout the guide and bring them to your consultation.
Questions you save remain on this device. Review them before your consultation and mark them as discussed as you work through them together.
Understanding your hernia
A hernia happens when tissue pushes through a weak point or opening in the abdominal wall. Its position, symptoms and effect on your life help guide what happens next.
Some hernias can be safely watched. Others are more likely to benefit from repair. Chapter 2 explains how those options are considered.
What is a hernia?
Your abdominal wall is made from layers of muscle and connective tissue that normally hold the tissues inside your abdomen in place.
If a weak point or opening develops, fat, bowel or other tissue can push through it and create a lump or bulge.
Why can the lump come and go?
A hernia may become more noticeable when pressure inside your abdomen increases, such as when you stand, cough, lift or strain.
It may become smaller or disappear when you lie down or relax as the tissue moves back through the opening.
Where can a hernia occur?
The position of the weak point determines the type of hernia. The illustration below shows the common locations.
What type of hernia do I have?
Hernias are usually named according to where the weakness occurs. The location and type of hernia can influence the symptoms you experience and the treatment options available.
Inguinal hernia
An inguinal hernia occurs in the groin. You may notice a lump, aching or discomfort, particularly when standing, lifting, coughing or exercising.
Umbilical hernia
An umbilical hernia develops through a weakness at or close to the belly button and often appears as a visible bulge.
Epigastric hernia
An epigastric hernia develops through the abdominal wall in the midline between the belly button and the lower part of the breastbone.
Incisional hernia
An incisional hernia develops through a weakness in the abdominal wall at or close to the site of a previous surgical incision.
What symptoms can a hernia cause?
Hernias affect people differently. Some cause very little trouble, while others cause symptoms that interfere with work, exercise or everyday activities.
What does “reducible” mean?
A reducible hernia is one where the contents of the hernia can move back through the opening in the abdominal wall, either by themselves or with gentle pressure.
A hernia may therefore be obvious when you are standing and much less noticeable when you lie down.
How is a hernia diagnosed?
Many groin and abdominal wall hernias can be diagnosed from your symptoms and examination.
Your surgeon may examine the area while you are standing and may ask you to cough or strain gently so the hernia becomes easier to assess.
A scan is sometimes useful when the diagnosis is uncertain or when more information about the abdominal wall is needed, but not every hernia requires imaging.
What will we want to understand?
What changes should I take seriously?
A hernia that suddenly becomes very painful, firm, increasingly swollen or no longer goes back in needs prompt medical assessment, particularly if you also develop vomiting, worsening abdominal pain or feel unwell.
Your surgeon will assess the type of hernia you have and, importantly, how much it is affecting you. This helps guide the decision about whether treatment is worthwhile.
Save a question for your appointment
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Understanding the risks
Most people recover well after hernia surgery, but complications can occur. Understanding the important risks helps you weigh surgery against your other options.
Published figures describe groups of patients. Your own risk depends on the type of hernia, the operation being considered, your health and whether the repair is straightforward or complex.
What is normal after surgery?
Pain, tenderness, bruising and some swelling around the operation site are common during early recovery and do not necessarily mean that something has gone wrong.
These usually improve as healing progresses. Chapter 6 explains recovery and the warning signs that should prompt further advice.
What problems can occur?
The exact risks vary between different types of hernia repair, but the following are among the issues commonly discussed.
Persistent pain
A proportion of people develop ongoing groin pain or discomfort lasting beyond the expected recovery period and affecting normal activities.
Severe or disabling persistent pain is much less common, estimated at roughly 0.5 to 6 in 100 after groin hernia repair.Bleeding or haematoma
Bruising is common. Less often, a collection of blood can develop around the operation site and form a haematoma.
Seroma or fluid collection
Fluid can collect where the hernia used to be and create a temporary lump or swelling. This often settles without treatment.
The likelihood varies considerably with the size and type of hernia and the repair performed.Wound infection
A surgical wound can become infected. Increasing redness, heat, discharge, worsening pain or feeling unwell should be assessed.
Infection involving implanted mesh is uncommon but can be more difficult to treat.Difficulty passing urine
Some people have temporary difficulty passing urine after surgery and anaesthesia and may need treatment before going home.
The hernia can return
Repair reduces the weakness in the abdominal wall, but no operation can guarantee that a hernia will never recur.
Recurrence risk varies with the type of hernia, repair technique and individual factors.Mesh-related problems
Mesh is widely used in adult hernia surgery. Uncommonly, problems can occur such as infection, persistent pain or other complications involving the implant.
Injury to nearby structures
Depending on the hernia, nearby structures can include nerves, blood vessels, bowel, bladder and structures within the groin. Injury is uncommon but recognised.
Imagine 100 people having similar surgery. If a problem occurs in 10 in 100 people, around 10 might experience it and around 90 would not.
These figures describe groups of patients rather than predicting exactly what will happen to you.
Are there risks from anaesthesia or surgery itself?
Yes. As with other operations, complications can include reactions to medicines or anaesthesia, breathing or heart problems and blood clots.
How relevant these are depends strongly on your age, medical history and general health.
What can change the risk?
“Are any of these risks particularly important for me?”
No operation is completely risk-free
The aim is not to find a risk-free option. It is to understand whether the likely benefits of repair outweigh its risks and recovery for you.
Check your understanding
This is not a test. Choose the answer that best reflects what you have just read.
Questions you may want to ask
Tap any question to add it to your My questions list.
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Preparing for your consultation
You now know the main treatment options and risks. The next step is to think about what matters to you and what you want to discuss before making a decision.
Two people with similar hernias may reasonably make different choices because their symptoms, activities, concerns and priorities are different.
What would make treatment worthwhile?
Choose any priorities that feel important. Your selections stay on this device and appear in My questions.
Your selections are saved automatically on this device.
What would a good outcome look like for you?
Work, sport, exercise, caring responsibilities or another everyday activity.
This might include recovery, pain, complications, mesh or time away from work.
You may be concerned about worsening symptoms, emergency problems or continuing restrictions.
You should understand your options before deciding
Good consent is more than signing a form. You should have the opportunity to understand the information relevant to you and discuss anything that remains unclear.
Ready for your consultation?
You do not need to remember everything. Review what matters to you and the questions you want to discuss.
What matters to me
You have not selected any priorities yet.
My questions
Review the questions you have saved while reading the guide.
Let your surgical team know
You have 0 saved questions that you have not yet marked as discussed.
If you would like these addressed before your operation, you can let the Compass Surgical team know. Your saved questions stay on this device and are not sent automatically.
This opens your own email app with a short message for Compass Surgical. You can review the message before choosing whether to send it.
Before your appointment
These are prompts, not requirements. Tap any that feel true for you.
Your consultation is still the place to clarify anything that remains uncertain.
Your surgeon will combine what is known about your hernia with your symptoms, priorities and questions before recommending what happens next.
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Getting ready for surgery
This part of the guide is for you if you and your surgeon have decided to proceed with an operation. Your booking information will contain the instructions specific to you.
Your hospital and anaesthetic instructions take priority over general information in this guide because your arrival time, fasting and medication plan may be individual to you.
Your preparation checklist
Tick these off as you get organised. Your progress stays on this device.
You have checked the main practical arrangements. Keep your booking information handy in case anything changes.
When do I stop eating and drinking?
Your fasting instructions will be included with your booking or confirmed by the hospital or anaesthetic team.
Follow those instructions rather than calculating your own fasting time from this guide.
If you accidentally eat or drink outside those instructions, tell the hospital team. Your operation may need to be delayed for safety.
Check before making changes
Do not stop regular medicines simply because you are having surgery. Some need specific instructions before an operation.
Check for final instructions
The hospital may contact you to confirm your arrival time, medication instructions or other practical details.
Keep your phone available and check any messages you receive.
What happens when I arrive?
The hospital team confirms your details and prepares you for the operation.
You are reviewed by the surgical and anaesthetic teams before surgery.
Your identity, operation, consent and important clinical information are checked before theatre.
If something about the operation, alternatives, risks or recovery is still unclear, tell your team before proceeding.
Your care continues with the theatre team
When it is time for your operation, the theatre and anaesthetic teams take over your care. The photograph below shows the type of operating theatre environment you may encounter.
What happens in theatre?
Before surgery begins, the team completes the usual safety checks and confirms your identity, the planned operation and the important information relevant to your care.
Your anaesthetic team looks after you throughout the procedure, while your surgical team performs the hernia repair that has been discussed with you.
Keyhole hernia surgery requires a general anaesthetic. Open repair is also commonly performed under general anaesthesia, although other anaesthetic approaches may sometimes be suitable.
The anaesthetic team will discuss the plan with you before surgery and monitor you throughout the operation.
A little more detail What happens during the hernia repair?
The exact operation depends on the type of hernia and the approach being used, but the underlying principles are similar.
The defect and the tissues involved are identified.
Tissue pushing through the hernia is returned to the correct side of the abdominal wall.
The abdominal wall is repaired and, where appropriate, reinforced with mesh using the technique planned for you.
The incision or keyhole wounds are closed and dressings are applied as needed.
Mesh is positioned to cover and reinforce the weak area rather than simply filling the opening. In most standard mesh repairs, it is intended to remain in place permanently.
Waking up in recovery
When the operation is finished, you are taken to the recovery area. The nursing and anaesthetic teams stay with you as you wake and make sure your immediate recovery is progressing safely.
What happens when I wake up?
A recovery nurse will monitor you as you wake from the anaesthetic and make sure your immediate recovery is progressing safely.
You may feel sleepy at first. The team will check your observations, comfort and wounds, and treat pain or nausea if needed.
Some early effects are expected
The wounds and repaired area will usually feel sore after the operation.
Anaesthetic medicines and surgery can leave you feeling sleepy or tired for a while.
Some people feel sick after anaesthesia. Medication can be given if this happens.
When it is safe, the team will help you sit up, move around and begin preparing for discharge.
When can I go home?
The hospital team will make sure you have recovered sufficiently from the operation and anaesthetic before you are discharged.
The final stage before discharge
Once you are comfortable and the clinical team is happy with your recovery, you may move to a discharge area while your final instructions, transport and other arrangements are completed.
Recovery and follow-up
Recovery is different for everyone. The aim is to keep you comfortable, stay mobile and gradually return to the activities that matter to you.
Some discomfort, swelling and tiredness are expected at first. As these improve, gradually increase what you do according to how you feel and the instructions you were given at discharge.
What should I expect at home?
You may have less energy than usual and the operated area will usually feel sore, particularly when you move, cough or change position.
Take the pain relief recommended in your discharge instructions and keep gently mobile. You do not usually need to stay in bed.
What is commonly expected?
The wounds and repaired area can feel uncomfortable, especially with movement.
Bruising around the wound or groin may become more noticeable before gradually settling.
Some swelling around the operation site is common during early healing.
It is common to have less energy than usual for a while after surgery.
Pain relief
Use the pain relief recommended when you leave hospital. Keeping discomfort controlled can make it easier to move, sleep and gradually return to normal activity.
Looking after your wounds
Follow the wound and dressing instructions given to you at discharge. Check the wounds as they heal and seek advice if you are concerned about how they look or feel.
Do I need to rest in bed?
No. Rest when you need to, but try to get up and move around regularly rather than spending long periods in bed.
Start with short walks and normal gentle activities, then increase what you do as your comfort and confidence improve.
When can I do more?
There is not one recovery timetable that suits everyone. Your operation, your work and how you feel all influence how quickly you return to normal activities.
Exercise and lifting How to build activity back up
Gentle walking can usually begin straight away and is an important part of recovery.
Increase exercise progressively. More strenuous exercise and heavier lifting should be guided by your comfort, the type of repair you have had and any specific advice from your surgical team.
If an activity causes significant pain, reduce the intensity and build back up more gradually.
Returning to work Your job makes a difference
When you return to work depends partly on what your job involves. Someone doing desk-based work may return earlier than someone whose job involves repeated lifting or heavy physical activity.
Discuss any particular work requirements with your surgeon, especially if you need guidance about lifting or restricted duties.
Driving When it is safe to get behind the wheel
Do not drive while the effects of anaesthesia or sedating pain medicines could impair you.
Before driving again, you should be comfortable enough to enter and leave the vehicle, wear the seatbelt and control the vehicle safely, including making an emergency stop.
Check any specific instructions from your surgical team and your insurer if you are uncertain.
Contact the clinical team if recovery is not going as expected
Seek medical advice if you are concerned, particularly if you develop:
Severe or worsening pain rather than gradual improvement
Increasing redness, heat, swelling or discharge from a wound
Persistent vomiting or difficulty keeping fluids down
Increasing abdominal swelling or feeling increasingly unwell
Any other symptom that is causing you significant concern
Use the contact details you were given at discharge
The hospital where your operation was performed should provide information about who to contact if you have a concern during your early recovery.
You can also contact Compass Surgical for non-emergency questions about your ongoing surgical care.
When will I be reviewed?
Follow-up is usually arranged after surgery, often at around six weeks, although the timing may vary depending on your operation and recovery.
Contact the team earlier if you are concerned rather than waiting for a planned appointment.
Save a question
Tap any question to add it to your My questions list.
You do not need to remember everything
The important things are understanding the main choices, knowing what matters to you and knowing where to find help if you need it.
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Your feedback helps us improve future patient information.