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Is it Endometriosis or a Hernia?

I had my first and only lap over 16 years ago at the tender age of 23.

My laparoscopy experience

By that point, I was having abdominal pains so severe that I was winding up several times a month in the ER, convinced I was in the midst of some sort of organ rupture or failure. I was rarely treated seriously by the ER doctors, though they did consent to have me scanned and imaged. When they couldn’t find anything, they told me it was just my IBS and told me to go home.

So, when I had my lap that same Spring and they found widespread endo all throughout my pelvic cavity, much of it fusing organs together and infiltrating sensitive areas, I felt relief that at least SOMETHING mechanical- that could be viewed and removed- was causing my complications.

Surprise! It’s a hernia

However, the endo isn’t the only thing that was found. A few weeks after my operation, when I went to my follow-up with the surgeon, he told me they also found a small, inguinal hernia in my low right side. At the time, they didn’t attempt to repair it since he said that wasn’t his specialty and he didn’t want to tinker with such a sensitive area. I felt even further vindicated by this news. After all, the largest source of my abdominal pain had been in my low right side, making me suspect at the time something was wrong with my appendix. An inguinal hernias can cause pain similar to appendicitis. My hernia was small enough to escape detection by imaging, but surgery found it, and now the screaming pain I had when that part of my body was pressed down on made some sense.

What is a hernia?

Having a small hernia has both positives and negatives as compared to having a large one (though of course, having none would be best). A small hernia sometimes is less likely to cause complications and even can (though rarely) resolve or heal on its own. However, the downside of a small hernia is that it often escapes detection by imaging or with a pelvic exam (a large one can usually be felt or even seen through the skin). This means doctors sometimes don’t catch it until a serious complication occurs-that is, that the hernia becomes trapped in the abdominal wall and starts to die, which can cause organ failure of the intestines and can be fatal.

Should I get more surgery?

I decided against surgery for the hernia at the time- and all these years later, I am unsure if I still have a hernia. At the least, it hasn’t become much bigger if it still exists, as doctors still can’t see it or feel it, and imaging doesn’t pick it up. Though I still do get pain, especially with pressure, in my low right side, this can also be credited to either endo itself, or other issues like IBS or ovarian cysts (or all three).

As I approach my second lap, tentatively planned for early next year, I am eager to know if I still have the hernia and discuss how to treat it. I’ve been Googling and studies seem to indicate that sometimes endometriosis of the low intestines can be mistaken for an inguinal hernia. While my surgeon for my first lap was much more versed and experienced in endo than most, he still wasn’t an endo excision specialist, so part of me wonders if the hernia was a misdiagnosis.

The research on endometriosis and hernias

According to one peer review study, the vast majority of inguinal endometriosis -or 90%- occur on the ride side of the body- as does/did mine. Additionally, in some cases, a person can have both an inguinal hernia AND inguinal endometriosis- and when that happens, it seems they are sometimes connected. The study noted one survey where “37% of patients suffered from inguinal endometriosis associated with a groin hernia“.1

This means I could potentially have both an inguinal hernia and inguinal endo, and one could have predisposed me to the other (at least in that particular spot inside my abdomen). Anecdotally, I have several friends who had hernias that were also discovered during their laps, though most of them had them repaired during that surgery. In some ways, I am glad this didn’t happen with me as meshes (which are used in the majority of hernia repairs surgeries) have been found to cause complications and residual pain in some studies of post-surgery hernia patients.2 This way, I can make a decision about how I would like my hernia surgically treated (likely, sans mesh)- if at all. That is, if I still have it or if it is confirmed to still be a hernia rather than endo.

Why are hernias and endo connected?

It’s hard to know what the causes are for the intersection between endo and hernia, though I can make some safe guesses. Endo can infiltrate the intestines and weaken abdominal walls, which could predispose someone to developing a hernia. Additionally, those with endo are also more likely to have irritable bowel syndrome and interstitial cystitis than those who do not, which may cause straining during urination and defecation- both of which can increase risks of getting a hernia.

Did you (or do you) have a hernia? Did you get it repaired (and during your lap)? Has the surgery helped or hurt? Answer in the comments section below!

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The Endometriosis.net team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.

  1. Albutt K, Glass C, Odom S, Gupta A. J Surg Case Rep. 2014;2014(5). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4021386/. Accessed June 17, 2019.
  2. Deerenberg E, Verhelst J, Hovius S, Lange J. Mesh expansion as the cause of bulging after abdominal wall hernia repair. International Journal of Surgery Case Reports. 2016;28:200-203. https://www.sciencedirect.com/science/article/pii/S2210261216303935. Accessed June 17, 2019.

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