Is femoral hernia repair urgent?

Yes. Because femoral hernias have a very high risk of strangulation (up to 40%), we recommend that they are repaired as soon as practically possible. Elective surgery is much safer and has better outcomes than emergency surgery for a strangulated hernia.

What is the difference between a femoral and an inguinal hernia?

Both are types of groin hernia, but they occur in different locations. An inguinal hernia passes through the inguinal canal, located above the groin crease. A femoral hernia passes through the femoral canal, located below the groin crease in the upper thigh. Femoral hernias are less common but more dangerous.

How long will I be off work?

This depends on the nature of your job and the type of surgery performed. For desk-based work, most patients return within one to two weeks. For jobs involving manual labour or heavy lifting, you may need to wait four to six weeks. Your surgeon will give you specific advice.

What are the signs of a strangulated hernia?

Warning signs include sudden, severe pain in the groin or thigh, the hernia becoming hard and tender and unable to be pushed back in, nausea and vomiting, and abdominal distension. If you experience these symptoms, you should go to the nearest A&E department immediately.

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Femoral Hernia Repair Surgery

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A femoral hernia occurs when a portion of the intestine or fatty tissue pushes through a natural weakness in the femoral canal, a small passageway located just below the inguinal ligament in the groin. Although less common than inguinal hernias, femoral hernias carry a significantly higher risk of becoming strangulated, where the blood supply to the trapped tissue is cut off. This is a surgical emergency.

For this reason, we strongly recommend that all femoral hernias are repaired promptly, even if they are causing minimal symptoms. At Kinvara Private Hospital, we offer rapid access to experienced consultant surgeons who can assess your hernia and perform a definitive repair.

Medically Reviewed By

Mr Vasu Karri, Medical Director • Updated 2026-01-25

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Femoral hernias are more common in women than in men, likely due to the wider shape of the female pelvis. They often present as a small, firm lump in the upper inner thigh or groin crease. Because the femoral canal is a rigid, narrow space, any tissue that enters it is at high risk of becoming trapped (incarcerated) and losing its blood supply (strangulated).

The consequences of strangulation can include bowel necrosis and perforation, requiring emergency bowel resection. Elective, planned surgical repair is a much safer option than waiting for an emergency to occur. We offer both open and laparoscopic techniques to provide a durable repair tailored to your needs.

Diagnosis and Assessment

Diagnosing a femoral hernia requires a careful clinical examination. Your surgeon will examine your groin while you are standing and will ask you to cough to see if a bulge appears. A femoral hernia typically appears as a lump in the upper inner thigh, below the inguinal crease, whereas an inguinal hernia appears above it. Distinguishing between the two is important because they require slightly different surgical approaches.

In some cases, particularly if the hernia is small or the patient has a higher BMI, an ultrasound or CT scan may be helpful to confirm the diagnosis and assess the contents of the hernia. Once the diagnosis is confirmed, we will arrange for your surgery as soon as possible given the higher risk of complications associated with this type of hernia.

The Anatomy of a Femoral Hernia

The femoral canal is a short, funnel-shaped passage located just below the inguinal ligament in the groin. It normally contains a few lymph nodes and some fatty tissue. The femoral artery, vein, and nerve pass through a separate compartment immediately next to it. A hernia occurs when a piece of bowel or omentum (the fatty apron that covers the intestines) is pushed into this canal by increased abdominal pressure.

Femoral hernias account for only about 3% of all hernias, but they are responsible for a disproportionately high number of hernia-related emergency admissions. The narrow, rigid ring of the femoral canal makes it very likely that any tissue entering it will become stuck. Studies show that up to 40% of femoral hernias present as emergencies due to strangulation. This is why we advocate for prompt elective repair as soon as the diagnosis is made.

Benefits of Surgery at Kinvara

Rapid access to surgery to minimise the risk of strangulation
Experienced consultant surgeons with expertise in groin hernia repair
Choice of open or laparoscopic techniques
Modern mesh repair for a low recurrence rate
Comfortable private hospital environment

Why Do Femoral Hernias Occur?

The exact cause of femoral hernias is not always clear, but they are associated with increased pressure within the abdomen combined with a weakness in the femoral canal. Factors that raise intra-abdominal pressure include chronic straining during bowel movements (constipation), persistent heavy coughing, heavy lifting, and pregnancy or childbirth. The stretching of the pelvic tissues during pregnancy is thought to be a key reason why femoral hernias are more common in women.

Obesity is another significant risk factor, as excess weight places constant strain on the abdominal wall. Age also plays a role, as the connective tissues of the groin can weaken over time. In some cases, a femoral hernia may develop at the site of a previous inguinal hernia repair.

Surgical Repair Techniques

Conservative Management

Unlike some other hernias, there is no role for watchful waiting with a femoral hernia. Due to the high risk of strangulation, all femoral hernias should be repaired surgically. A truss or supportive garment is not effective and may delay necessary treatment.

Surgical Options

Femoral hernia repair can be performed using open or laparoscopic techniques. The open approach involves an incision in the groin, through which the surgeon reduces the hernia contents and closes the femoral canal, usually with a mesh plug or a flat mesh. The laparoscopic (keyhole) approach uses small incisions and a camera to perform the repair from the inside of the abdomen. This technique often allows for a faster recovery and can be advantageous for repairing hernias on both sides at the same time. Your surgeon will discuss the best approach for your individual circumstances.

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