This is the most common type of hernia, representing 60% of all external abdominal wall hernias. Men have a much higher risk of developing an indirect inguinal hernia than women. That is because, before they are born, men have a natural opening in their groin, where the spermatic cord and the testicles pass out of the abdomen into the scrotum. The path that the testicles travel into the scrotum is called the inguinal canal.

Sometimes, the opening at the top of the inguinal canal does not close properly after the testicles have passed through. The opening weakens the abdominal wall, increasing the risk that a hernia may develop. This is called a congenital weakness because it is usually present when you are born. Women also have an inguinal canal but they are far less likely to develop a weak spot in this area because they do not have a spermatic cord passing out of the abdomen.

If you have an indirect inguinal hernia, it means that fat or, part of your intestine (also called the bowel) has slipped through a weak spot in your abdominal wall. The hernia may appear as a small bulge on one or both sides of your groin. If it is not repaired, an indirect inguinal hernia will almost always get larger, as more fat or tissue bulges through the abdominal wall. In men, the hernia may gradually move right down the inguinal canal into the scrotum.

Direct inguinal hernias occur most often in men but may also affect women. This type of hernia may develop when the body’s continuous cycle of breaking down and building up tissue is no longer in balance, causing weak spots to develop in the muscles and tissue. Increased pressure or straining can also weaken the muscles or connective tissue of the abdomen. Increased pressure can be caused by weight gain, sports injuries or activities such as heavy lifting, chronic coughing, vomiting or straining on the toilet due to constipation. Learn more about the causes of hernias.

If you have a direct inguinal hernia, it means that fat or, in rare cases, part of your intestine (also called the bowel) has slipped through a weak spot in the abdominal wall. Direct inguinal hernias may get bigger over time but do not usually get large enough to reach the scrotum.



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