Evidence checked as of October 2026. Written by The Wellness Team.
What is a groin hernia?
A groin hernia is a bulge that appears when tissue, usually fat or a loop of bowel, pushes through a weak point in the abdominal wall near the groin. The most common type is an inguinal hernia. A femoral hernia is less common, sits slightly lower, and carries a higher chance of complications.
Many hernias are found because someone notices a lump that appears on standing, coughing or lifting and settles when lying down. Others cause only an ache or dragging feeling. A lump in the groin is not always a hernia. Enlarged lymph nodes, a cyst or a problem in the testicle can look similar, which is why examination matters.
What are the symptoms?
Typical features are a soft bulge in the groin or scrotum, discomfort that is worse with effort, and a sense of heaviness. The lump may reduce when you lie down or press gently on it. Pain that is sharp, constant or increasing deserves prompt review.
Which signs are an emergency?
A hernia can become trapped, called incarcerated, and then lose its blood supply, called strangulated. Go to A&E or call 999 if a hernia lump becomes firm, tender and cannot be pushed back, turns red, purple or dark, or comes with vomiting, a swollen abdomen, fever or being unable to pass wind or stools. A BMJ practice review advises asking about fever, nausea and change in stooling to identify an obstructed or strangulated hernia, and referring painful, newly irreducible hernias or those with skin colour change for urgent surgical assessment.
How are groin hernias assessed?
Most hernias are diagnosed on examination. The same BMJ review notes there is no routine need to work out whether a hernia is direct or indirect, or to request imaging, before referral when the examination is clear. Ultrasound can help when the lump is difficult to examine, the diagnosis is uncertain, or another cause such as a testicular or lymph node problem needs excluding. A consultant radiologist report is useful in those cases.
Do all hernias need surgery?
No. The Academy of Medical Royal Colleges' Evidence-Based Interventions guidance states that watchful waiting is a safe option for people with minimally symptomatic inguinal hernias. Acute incarceration is uncommon, and many people with minor symptoms may never need an operation. The guidance applies to adults aged 19 and over.
Surgery is considered when symptoms interfere with daily life, the hernia is growing, or there has been a complication. Repair is usually done by keyhole or open surgery, often as a day case.
Why are women referred more urgently?
The same guidance states that in women, all suspected groin hernias should be urgent referrals. Femoral hernias are more common in women and have a higher risk of strangulation, and a lump in the groin in a woman needs a firm diagnosis rather than a wait and see approach.
What can you do while you are waiting?
Avoid heavy lifting and straining where you can. Treat constipation, since straining increases pressure in the abdomen. A supportive truss is sometimes used in selected people, but it is not a cure and a doctor should advise whether it is appropriate. If you smoke, stopping reduces wound complications after surgery. Keep an eye on the lump and know the emergency signs above.
How can The Online GP help?
A doctor can examine you by video, ask the right questions about red flags and decide whether you need a same-day surgical review, an ultrasound or a routine referral. As of October 2026, a video consultation with The Online GP is £150 and a telephone consultation is £59. Ultrasound at The Wellness is available from £445 with a consultant radiologist report. If a hernia needs surgery, a referral can be arranged.
Call +44 20 3951 3429, message on WhatsApp on 07961 280835 or email team@thewellnesslondon.com. Same-day availability is confirmed at the time of booking.
Evidence and limits
Academy of Medical Royal Colleges, Evidence-Based Interventions: repair of minimally symptomatic inguinal hernia. https://ebi.aomrc.org.uk/interventions/repair-of-minimally-symptomatic-inguinal-hernia/
BMJ 2024: assessment of a groin lump. https://www.bmj.com/content/386/bmj-2024-079531
NHS: inguinal hernia. https://www.nhs.uk/conditions/inguinal-hernia/
This is general information, not personal medical advice. A painful, firm hernia that will not go back in is an emergency.