Femoral Hernia: Symptoms and Treatment of a Femoral Hernia | Information & Specialists

A femoral hernia is also known as a thigh hernia. The term refers to a condition in which weak areas of tissue below the inguinal ligament can no longer withstand the pressure within the abdominal cavity.

As a result, parts of the abdominal organs protrude outward through the weak spot. A so-called hernial sac or hernial opening forms on the inner side of the thigh, next to the great saphenous vein.

Most often, the omentum majus—a net-like structure covering the digestive organs—protrudes into the hernial sac. However, parts of the intestine or the ovaries may also be affected.

The risk with any hernia is always that the organs may become strangulated. If this happens, they can no longer function properly. In a femoral hernia, the opening is very narrow and located in a highly mobile area of the body. Therefore, the risk of strangulation is particularly high with this type of hernia.

For the same reasons, the pain associated with a femoral hernia is usually more severe than, for example, with an inguinal hernia. To prevent damage to the organs and treat the symptoms, surgical repair is almost always necessary.

Illustration of a hernia (general): Parts of the intestine protrude outward through a gap in the tissue © blueringmedia | AdobeStock

Women are affected by femoral hernias significantly more often than men. Being severely overweight or lifting heavy objects increases the risk of developing one. Previous pregnancies or weak connective tissue also raise the risk.

When men are affected, the cause is usually a previous inguinal hernia surgery. Therefore, thorough follow-up care after surgical treatment is essential.

A typical symptom of a femoral hernia is a palpable bulge or swelling on the thigh. However, this bulge is often barely noticeable—especially in patients who are severely overweight—or may even be completely absent. This makes diagnosing a femoral hernia more difficult.

The same symptoms do not always occur. Some patients experience no symptoms at all for a long time. Possible symptoms include:

• nonspecific pain in the groin area
• a pulling pain in the groin area
• irregular bowel movements.

If the prolapsed organs become incarcerated, severe pain usually occurs. This pain radiates from the groin into the thigh and worsens with physical exertion. In such cases, immediate surgery is usually necessary to prevent damage to the organs and the abdominal wall.

To make a diagnosis, the doctor uses ultrasound examinations in addition to a medical history and physical examination. These usually provide a clear picture and help rule out other problems.

After a CT scan, the surgeon decides whether to perform open surgery or a minimally invasive inguinal hernia repair with small incisions below the groin to push the trapped organs back into the abdominal cavity and close the hernial ring. 

However, it is not always a femoral hernia. A swollen lymph node can also present with symptoms similar to those of a femoral hernia.

If a femoral hernia has developed, the doctor usually recommends surgery as part of what is known as hernia repair. If severe symptoms are already present, the surgery is urgent and usually required on an emergency basis.

But even if no symptoms have yet appeared, the opening in the tissue should be closed as quickly as possible. The goal is to prevent the prolapsed organ parts from becoming strangulated.

Various surgical methods are possible. Which ones are appropriate in each individual case depends

• on the treating physician,
• the exact findings, and
• the patient’s condition

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For an inguinal or femoral hernia, the TEP technique may be used for femoral hernia surgery. This laparoscopic procedure is minimally invasive and requires only small skin incisions. A synthetic mesh is inserted to securely close the hernial orifice and prevent the hernia from recurring. This also provides stability to the hernial sac.

After surgery for a femoral hernia, careful postoperative care—including rest, avoiding heavy lifting, and regular medical checkups—is important to prevent complications and recurrences.

Serious complications are rare following this surgery. As with any surgery, wound infections or bleeding are possible. In rare cases, embolisms (blockage of a blood vessel) may also occur, which can be dangerous if left untreated. Therefore, if you experience sudden symptoms after surgery, you should always inform your treating physician immediately.

With careful surgery and follow-up care, the inguinal hernia usually remains permanently resolved. Only in about one to ten percent of cases does the inguinal hernia recur later.

If you experience diffuse pain in the groin, you should see a doctor as soon as possible to rule out a femoral hernia. With modern surgical methods, the problem is usually resolved quickly.

What are the symptoms of a femoral hernia?
Typical signs include a small, often hard-to-detect swelling on the inner side of the thigh, as well as diffuse pain in the groin. In overweight individuals, the bulge may sometimes be unnoticeable. Severe, sudden-onset pain indicates that organs are trapped (incarceration). Femoral hernias are less common in men; women are most often affected.

Is a femoral hernia dangerous?
Yes, a femoral hernia can be dangerous, especially if sections of the intestine or other organs become trapped in the hernial ring. In this case, an acute medical emergency may occur that requires immediate medical attention. The risk of ileus (intestinal obstruction) is very high in such cases. 

Does a femoral hernia require surgery?
Yes, surgery is the only effective treatment. Without surgical intervention, the hernial ring remains open, and the risk of complications increases. The surgery can be performed using a minimally invasive approach (with just a small skin incision), such as the TEP method, or as open surgery—depending on the individual findings.