What Are Hernias? An Overview of Different Types

Most of us have heard of hernias, but how much do we really know about them? Essentially, a hernia occurs when an organ or tissue protrudes through a weak spot or opening in the muscle or surrounding tissue that typically holds it in place. One common type of hernia is an inguinal hernia, which occurs in the groin area when part of the intestine pokes through a weak spot in the abdominal wall, often causing testicular pain.

For someone experiencing hernia testicular pain, it can be quite uncomfortable and concerning. The pain may worsen with activities that increase abdominal pressure like coughing, lifting, or straining during bowel movements. Some even have hernia pain in the testicles when sleeping.

If you or someone you know is experiencing testicular pain from a potential hernia, it is important to seek medical attention, as untreated hernias can lead to serious complications. Fortunately, by evaluating hernia testicular pain promptly, treatment can be prescribed to help relieve the hernia pain and prevent further issues. 

Inguinal Hernia and Its Relationship with Testicular Pain

An inguinal hernia is a type of hernia that occurs in the groin area. It develops when part of the intestine or abdominal lining protrudes through a weak spot or tear in the lower abdominal muscle wall, into the inguinal canal.

The inguinal canal is a passage in the lower abdomen where the spermatic cord (which contains the vas deferens and testicular blood vessels and nerves) passes through on its way from the abdomen to the scrotum in males.

An inguinal hernia can directly cause testicular pain because the protruding tissue from the hernia descends into the inguinal canal and can extend down into the scrotum, putting pressure on or irritating the testicle on that side.

This pressure and irritation from the hernia contents pressing on the spermatic cord structures in the inguinal canal is what leads to the characteristic dull, aching, or dragging testicular pain that many men experience with an inguinal hernia. 

The proximity of the inguinal canal to the testicle, and the fact that an inguinal hernia protrusion can extend down into the scrotum, is what allows this type of hernia to directly impact the testicle and cause pain in that area. Our advanced reconstructive physicians recommend consulting a physician incase hernia surgery is needed.   

Femoral Hernia: Rare But Potentially Painful

Another common type of hernia is a femoral hernia. A femoral hernia is a relatively rare but potentially painful type of hernia that occurs in the upper thigh and groin area. Its location and path the protruding tissue takes makes it different from the more common inguinal hernia.

A femoral hernia develops when part of the intestine or abdominal lining pushes through a weak spot or tear in the femoral canal, which is the channel in the upper thigh and groin through which the femoral artery, vein, and nerve pass.

This weak spot is typically just below the inguinal ligament in the upper thigh crease. Instead of descending into the inguinal canal like an inguinal hernia, the protruding tissue in a femoral hernia emerges through this lower area near the femoral vessels.

While femoral hernias do not directly impinge on the testicle and spermatic cord like inguinal hernias can, they can still cause testicular pain in some cases. This occurs when the protruding hernia contents press on or irritate the nearby genital branch of the genitofemoral nerve that runs through this region and provides sensation to the scrotum and upper thigh.

Another key distinction to make is femoral hernias are considered higher risk. This is because the protruding tissue can more easily become trapped or strangulated in the rigid confines of the femoral canal. This makes prompt surgical repair highly recommended for femoral hernias.

Umbilical and Epigastric Hernias: Less Common but Possible Causes

Umbilical and epigastric hernias are types of abdominal wall hernias that can potentially cause hernia testicular pain in certain cases as well.

Umbilical Hernia

An umbilical hernia occurs when part of the intestine or abdominal lining protrudes through a weakness or opening in the abdominal muscles around the navel (umbilicus). These hernias are common in infants but can also develop in adults, especially those with increased abdominal pressure from obesity, pregnancy, or frequent straining.

Epigastric Hernia

An epigastric hernia is a small protrusion that occurs between the navel and lower part of the breastbone (sternum), in the area called the epigastrium. It happens when fatty tissue or part of the intestine pokes through a weakness or tear in the abdominal lining.

Potential Causes of Umbilical and Epigastric Hernias:

• Congenital weakness in the abdominal wall present from birth
• Increased intra-abdominal pressure (obesity, pregnancy, straining, coughing)
• Previous abdominal surgery
• Injury or trauma to the abdominal area

How They Can Cause Testicular Pain

While umbilical and epigastric hernias do not directly impinge on the testicles or spermatic cord like an inguinal hernia can, they may still cause hernia testicular pain in some cases.

These are the most common causes of hernia testicular pain from an umbilical or epigastric hernia:

1. Compression/irritation of nerves: If the protruding hernia contents put pressure on or irritate nearby nerves like the ilioinguinal nerve, this can radiate pain to the groin, scrotum, and testicles.
2. Referred pain: Due to the close proximity of the hernias to the groin/pelvic region, pain from the hernia itself may be perceived as testicular or scrotal discomfort in some cases.
3. Increased abdominal pressure: The increased strain and abdominal pressure that can contribute to these hernias may also increase pressure in the inguinal region, potentially causing referred testicular pain.

While testicular pain is not as common with umbilical and epigastric hernias as with inguinal hernias, it can still occur, so proper diagnosis and treatment of any abdominal wall hernia is important to alleviate potential pain and prevent complications.

How Hernias Lead to Testicular Pain

Hernia testicular pain can be caused by one of several different types of hernias. However, the pain implications and methods of treatment are largely dependent on which type of hernia a person has experienced.

Here is how each type of hernia can lead to testicular pain:

1. Inguinal Hernias

An inguinal hernia occurs when abdominal contents (intestine or abdominal lining) protrude through a weakness in the inguinal canal, which is the passage where the spermatic cord passes through on its way to the scrotum. The protruding hernia sac can descend into the scrotum, putting direct pressure on the testicle and spermatic cord, leading to dull, aching testicular pain.

2. Femoral Hernias

These occur just below the inguinal ligament in the upper thigh and groin area. While they do not directly involve the spermatic cord, the protruding hernia contents can irritate or compress the nearby genital branch of the genitofemoral nerve, which provides sensation to the scrotum and testicles. This nerve irritation can radiate pain to the testicles.

3. Umbilical/Epigastric Hernias

As mentioned earlier, these abdominal wall hernias do not directly affect the spermatic cord or testicles. However, they may cause referred testicular pain due to compression/irritation of nearby nerves like the ilioinguinal nerve, or increased abdominal pressure that radiates pain to the groin and scrotal area.

4. Obturator Hernias

This rare type occurs when abdominal contents protrude through the obturator foramen (a bony opening in the pelvis). While not directly impacting the testicles, obturator hernias can compress the obturator nerve, which contributes to sensation in the groin and scrotum, potentially causing referred hernia testicular pain.

5. Incisional/Ventral Hernias

These develop at the site of previous abdominal surgery incisions. Like umbilical hernias, they may cause referred testicular pain due to increased abdominal pressure or nerve compression, but do not directly involve the spermatic cord structures.

Pressure and Strain: The Connection Between Hernias and Testicular Pain

No matter which type of hernia a person has experienced, its correlation with testicular pain remains relatively similar. The pressure and strain exerted by a protruding hernia either directly on the spermatic cord structures or indirectly through nerve compression or increased abdominal pressure, is the underlying culprit that can result in testicular pain. 

Ultimately, the only difference is the severity of the pain, which correlates with the size of the hernia and the degree of pressure or compression involved. This might determine the course of action regarding hernia repair treatment and surgery. 

Symptoms of Hernias and Testicular Pain: What to Watch For

If you are experiencing sudden testicular pain, such as if your balls ache when sitting, you may have a hernia. Here are some other key clues to watch for: 

Hernia Symptoms

• A visible bulge or protrusion in the groin, abdomen, or scrotum area that may increase in size with coughing, straining, or standing
• A dull aching or dragging sensation at the bulge site
• Pain or discomfort when coughing, bending, or lifting
• A feeling of weakness, pressure, or pulling sensation in the groin or abdomen

Testicular Pain Symptoms

• A dull, aching pain or heaviness in the testicle(s)
• A dragging or pulling sensation in the groin or scrotum
• Increased testicular pain with activities that increase abdominal pressure (coughing, straining, etc.)
• Pain or discomfort that may radiate from the groin or abdomen to the testicle(s)
• Swelling or enlargement of the testicle(s)

Additional Concerning Symptoms

• Severe, sudden onset of groin or testicular pain
• Nausea or vomiting along with the pain
• Fever
• Redness, warmth, or tenderness around the bulge or testicle(s)
• Inability to push the bulge back into the abdominal cavity

These symptoms may indicate a potentially complicated or strangulated hernia, which is a medical emergency requiring immediate surgical treatment. Fortunately, early detection and treatment of hernias can help prevent complications and alleviate any associated testicular discomfort or pain.

Testicular Pain: When Should You Be Concerned?

If a person is noticing any of the symptoms listed above, they should consider seeking medical attention right away. Here are some additional situations in which a person with hernia testicular pain should be concerned: 

Severe or Worsening Pain

Any sudden onset of severe testicular pain or pain that progressively worsens over time warrants urgent medical attention. This could indicate a serious condition like testicular torsion (twisted spermatic cord cutting off blood supply) or strangulated hernia.

Swelling, Redness, or Fever

Testicular swelling, redness, warmth, or the presence of fever along with the pain could signal an infection or inflammation, like epididymitis or orchitis, which requires prompt treatment.

Nausea or Vomiting

Testicular pain accompanied by nausea or vomiting is an emergency sign that needs to be evaluated immediately, as it may indicate testicular torsion or other serious conditions.

Recent Trauma or Injury

Any testicular pain following a direct injury or trauma to the genital area should be evaluated for testicular rupture or other complications.

Persistent or Recurring Pain

Intermittent or chronic testicular pain that persists or keeps recurring, even if mild, warrants medical attention to identify and address the underlying cause.

Presence of a Lump or Mass

The development of any abnormal lumps or masses in or around the testicle needs further investigation to rule out potential cancers or other conditions.

In general, any unexplained, severe, or persistent testicular pain should not be ignored, as prompt diagnosis and treatment are crucial for preventing potential complications and preserving testicular health and function.

When to Seek Medical Attention for Hernias and Testicular Pain

No one wants to be that "false alarm" patient, so it's understandable why some wait until the last minute to finally seek medical attention. However, it is best to consult a healthcare professional for testicular pain. 

If a person is experiencing any one or several of these symptoms, it is important they seek medical attention right away:

• Severe or worsening pain around the testicles
• Nausea, vomiting, or fever 
• Swelling or redness around the scrotum or groin area
• An inability to push back the bulge
• A new appearance of a bulge or swelling in the groin or scrotum

While not all hernias cause significant testicular pain, any persistent or worsening pain in the presence of a hernia should be evaluated by a healthcare professional to determine the appropriate course of action, which may include surgical repair of the hernia.

Consult Our Experts for Relief from Testicular Pain After Hernia Repair