A femoral hernia is not a hernia of the “buttock”
The name leads many people to think a femoral hernia develops in the buttock. In fact, “femoral” refers to the thigh, as in the femur and femoral artery. A femoral hernia occurs at the femoral canal, on the lower outer side of the groin where the thigh meets the torso. It has nothing to do with the buttock.
How is a femoral hernia different from an inguinal hernia?
Both are broadly considered groin hernias and are easily confused, but they protrude through different openings:
- Inguinal hernia: Protrudes through the inguinal canal or the abdominal wall around it; it is higher and more medial.
- Femoral hernia: Protrudes through the femoral canal below the inguinal ligament; it is lower and more lateral, near the upper inner thigh.
A physician should confirm the actual location with a physical examination, because appearance alone can sometimes make the two difficult to distinguish.
Why is a femoral hernia more common in women?
Women generally have a wider pelvic structure and a relatively larger femoral canal. Together with the effects of pregnancy and childbirth on the pelvic and abdominal-wall structures, this makes femoral hernias more common in middle-aged and older women who have had multiple births. But they can also occur in men. Overall, femoral hernias account for a relatively small share of all hernia types; because the population in which they commonly occur differs from that of inguinal hernias, clinicians still need to distinguish between the two.
Causes
As with other hernias, femoral hernias are often associated with a long-term rise in intra-abdominal pressure:
- Chronic constipation and straining during bowel movements
- Chronic coughing
- Heavy lifting
- Obesity
- Straining to urinate because of an enlarged prostate (in men)
- The effects of pregnancy and childbirth on pelvic structure (in women)
Symptoms
- A lump near the groin at the top of the thigh, more noticeable when standing, lifting heavy objects, or straining
- No obvious symptoms in some patients; it may be found only during a physical examination or imaging study
- Abdominal pain or nausea may mean the intestine has become trapped and require immediate medical attention
Why does a femoral hernia call for attention?
The femoral canal is relatively narrow. Clinically, femoral hernias have been observed to develop incarceration — with the intestine trapped — early even when the bulge is still small. Once a femoral hernia is confirmed, it is therefore advisable to discuss the timing of treatment with a physician early, even if there are no obvious symptoms, rather than waiting until symptoms develop.
Diagnosis
Diagnosis mainly relies on a medical history and physical examination. A physician uses palpation to confirm the location and form of the bulge. When needed, ultrasound may be arranged to help distinguish a femoral hernia from an inguinal hernia.
Treatment options
The abdominal-wall defect caused by a femoral hernia will not heal by itself and requires surgical treatment. Because the anatomical position of the femoral canal differs from that of an inguinal hernia and its space is narrower, the surgical plan is adjusted according to the actual position and size of the hernia. Discussing an appropriate approach thoroughly with a physician is recommended.
Key takeaways
- A femoral hernia occurs at the femoral canal, lower and more lateral than an inguinal hernia; it has nothing to do with the buttock
- It is more common in middle-aged and older women who have had multiple births, but it can also occur in men
- Because the femoral canal is narrow, incarceration can occur early even when the bulge is still small
- Once diagnosed, discuss the timing of treatment with a physician early; it is not necessary to wait for symptoms
