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What Is the Difference between Direct & Indirect Inguinal Hernia

When organs push through weak areas of the surrounding muscle, a hernia occurs. An inguinal hernia is a hernia that occurs in the abdomen through the inguinal canal. These are passages that run on either side of the groin down the lower abdomen. This type of hernia usually manifests as a groin bulge.


Direct and indirect inguinal hernias are both possible. The distinction is due to anatomical location. Direct hernias protrude through the inguinal canal’s posterior (back) wall. Inguinal hernias protrude from the inguinal ring.

Inguinal hernias are classified into two types:


Develops over time as a result of straining and is caused by abdominal muscle weakness. Adults are more likely to make this mistake than children.


Caused by an abdominal wall defect that has typically existed since birth. It is most common in children, affecting up to 5 percent of newborns and up to 30 percent of premature babies. It is frequently discovered in the first year of life, but it can go undetected until adulthood.

Inguinal hernias are up to ten times more common in men than in women, with one in every four men developing one at some point in their lives. Here are some important facts about hernias. The main article contains additional information and details.

  • Groin pain, which can be severe, is one of the symptoms of both.
  • Age-related stress and weakened muscles in the inguinal canal are common causes of direct inguinal hernias.
  • Indirect inguinal hernias are caused by a persistent opening that does not close during pregnancy.
  • Surgery is the only way to repair an inguinal hernia.


Symptoms can appear gradually or suddenly. Sometimes a person is asymptomatic and the inguinal hernia is discovered during a physical examination. However, a person will frequently experience symptoms such as:

  • groin ache
  • a swell that comes and goes
  • A groin burning or aching sensation
  • a heavy or dragging sensation in the groin, particularly at the end of the day or after strenuous activity
  • in boys and men, a swollen or enlarged scrotum
  • Activities that put a strain on the abdomen can cause the bulge to grow. Coughing and lifting objects are examples.
  • straining for whatever reason
  • Infants who cry
  • Symptoms can be difficult to detect, particularly if the hernia is not severe or large.


The cause of an inguinal hernia can be either direct or indirect.

Direct Hernia

These are most common in adult males. The muscles surrounding the inguinal canal can weaken as a result of aging, stress, or strain. Previous surgery in the lower abdomen can also cause muscle weakness. Females are much less likely to develop a direct hernia. This is due to the uterine round ligament within the inguinal canal acting as an additional barrier alongside the muscle. Females also have a smaller inguinal canal.

Indirect Hernia

Up to 30 percent of premature babies have indirect hernias. There is an internal opening to the inguinal canal while a fetus is still in the womb, but this usually closes before birth. When the inguinal canal opening does not completely close by the time the baby is born, a portion of fat or intestine can slip through and cause an indirect hernia. In females, the ovaries and other reproductive organs can pass through the opening and cause a hernia. The most common type of inguinal hernia is an indirect hernia. Although they occur in both sexes, males are more likely to have them than females.


A doctor can tell if a patient has an inguinal hernia in several ways. They are as follows:

Physical examination –

The doctor will examine the patient, frequently asking them to stand and cough or strain because this is when a bulge is most likely to occur.

Imaging examinations –

Imaging tests, such as X-rays, will be performed by specially trained technicians in a doctor’s office, an outpatient center, or a hospital. The images are then interpreted by a specialist known as a radiologist. Anesthesia is rarely required. The tests include:

  • Abdominal X-ray
  • Computerized tomography (CT) scan
  • Ultrasound


In developing and developed countries, inguinal hernia surgery is the most common general surgical procedure, with approximately 2 out of every 1,000 people undergoing the procedure each year. Surgery does not always have to be performed right away, but if an inguinal hernia is discovered, it must be closely monitored by a doctor to see if the symptoms worsen. If the hernia tissue becomes trapped or incarcerated, surgery becomes more urgent. The two main types of surgery for hernia are:

Open hernia repair is typically performed under general anesthesia. A groin incision is made, and the fat and intestines are moved back into the abdomen. The synthetic mesh is frequently placed over the weak area to prevent it from recurring.

In Laparoscopic hernia repair small cuts are made and a laparoscope, a thin tube with a camera on the end, is inserted. The repair is completed using the camera images as a guide.

Most people recover faster from laparoscopic hernia repair than from open hernia repair, but complications are uncommon in both cases. Intense activity and heavy lifting are not advised for several weeks, and pain relievers are frequently prescribed. Hernias can reoccur after repair, so patients must adhere to their doctor’s aftercare instructions and advice to reduce the risk of recurrence.


Because indirect inguinal hernias are frequently congenital, they cannot be avoided. However, there are some precautions you can take to reduce your chances of developing a direct inguinal hernia, such as:

  • Lifting heavy objects should be done with caution.
  • When having a bowel movement, avoid straining.
  • Constipation treatment (difficulty moving your bowels).
  • Take care of a persistent cough.
  • If you have to strain to urinate, seek medical attention.
  • Maintain a healthy weight for yourself.


Indirect inguinal hernias are frequently congenital, which means they can be detected at birth. Males are more likely to develop both types of inguinal hernias. The main symptom is a groin or scrotum bulge, which may be accompanied by pain. Physical examination is used to make the diagnosis, which can be confirmed with imaging. Surgery is then required to correct the problem. You should be aware that inguinal hernias are quite common. Most of the time, they are not causing concern. However, if you notice a bulge in your groin or the groin of your child, you should consult a doctor. Surgery is the only treatment for both indirect and direct inguinal hernias.

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