I have an inguinal hernia that’s causing me symptoms. What are my treatment options?

Inguinal hernia symptoms

Many people find that they notice a bulge in their groin while they are in the shower. Sometimes this bulge is painless, and just worrisome. As long as it is soft, and can be easily pushed back into the abdomen, it’s likely to be an asymptomatic inguinal hernia. An evaluation by a primary care provider, or hernia specialist is important to make sure there is nothing else going on. Groin hernias that are not uncomfortable, can be safely watched for years in most patients.

Symptomatic inguinal hernia

About 80% of people with an inguinal hernia develop symptoms in the first 10 years. These symptoms can range from mild discomfort or aching at the end of the day, to more significant pain that interferes with daily activities. Rarely an inguinal hernia can become incarcerated (stuck) and necessitate an emergency operation. Surgery is the best treatment option for a symptomatic inguinal hernia.  

Inguinal hernia treatment options:

Most surgeons divide hernia surgery into two types of approaches – Anterior and Posterior

The Anterior Approach is used to repair the abdominal wall from the outside.  This can be done with or without mesh.

  • We have written extensively on non-mesh inguinal hernia surgery
  • Traditional open mesh repair is something we have written about and rarely ever perform since recent literature suggest that posterior mesh placement is superior for inguinal hernia surgery

The posterior approach is used to repair the hole in the abdominal wall with a patch on the inside. 

Mesh is placed underneath all of the abdominal muscles, relying on the abdominal pressure to keep the mesh in place. Most high volume hernia surgeons and medical research now agree that the posterior approach is the best way to fix an inguinal hernia when using mesh. Boston Hernia has used these methods for the last 15 years when using mesh to repair an inguinal hernia. Both Dr. Reinhorn and Dr. Fullington each performed over 500 laparoscopic inguinal hernia surgeries before learning the advanced open preperitoneal repair.   

The posterior repair can be performed in two ways:

  • Laparoscopic or robotic – these require general anesthesia and are best suited to certain body types and patients with certain specific medical conditions.
  • Advanced open preperitoneal repair – this can typically be done under local anesthesia with sedation and can be performed in the hospital or in an ambulatory surgery center.


We typically recommend the advanced open preperitoneal repair in suitable patients because it offers the best of both worlds. It typically offers faster recovery without the need for general anesthesia and reduced pain medication requirements than laparoscopic hernia surgery. For patients looking for a non-mesh hernia repair, we have offered the Shouldice technique since 2015.  We look forward to meeting prospective patients and speaking with them about their options as each patient benefits from a consultation with our providers. Call us or fill out the contact us form in order to schedule a consultation.


About Dr. Reinhorn & Dr. Fullington

Dr. Michael Reinhorn is a specialist in inguinal hernia and umbilical hernia.  Dr. Reinhorn started his practice as a full service general surgeon in 2001. In 2012 Dr. Reinhorn started to focus on the care of hernia and pilonidal patients. In 2020, Dr. Nora Fullington was recruited from her work as a general surgeon performing hundreds of laparoscopic hernia repairs to Boston Hernia. Together with their physician assistant team, they provide a focused practice designed to provide a superior clinical experience. The team performs approximately 700 hernia surgeries every year and offers a tailored approach for each patient from anesthesia type to consideration of mesh and no mesh repairs, laparoscopic and open surgery. We have published outcomes and continue to participate in hernia and surgery societies.  Our research led to a reduction in opioid prescribing after hernia surgery. Currently, Dr. Reinhorn serves as the chair of the Opioid Reduction Task Force of the Americas Hernia Society Quality Collaborative.