University Hospital Southampton NHS Foundation Trust|

Inguinal hernia in girls

Your baby has been diagnosed as having an inguinal (groin) hernia. This is quite a common problem and one in six premature babies will get a hernia. Your baby will need an operation to mend the hernia.

What is a hernia?

A small hole has developed in the muscle in the baby's groin. Some of the intestine is poking out through this hole. We do not know why this happens in some babies but not in others.

Hernia girlsWhy is an operation needed?

The intestine in the hernia usually moves in and out of the abdomen quite easily. Sometimes the intestine may get stuck in the hernia leading to blockage of, and possibly damage to the intestine.

If this happens emergency surgery may be needed and the intestine may be damaged. In about half of baby girls the ovary can be felt in the hernia and there is a risk that the ovary can become twisted. If this happens the hernia will be very tender and there is a danger that the baby could lose the ovary. We aim to fix your baby’s hernia before either of these complications can happen.

Where will the operation take place?

Your baby would be admitted to the neonatal unit in Princess Anne Hospital, Southampton on the day of surgery. If your baby is still in a newborn unit at another hospital she will be transferred to the Princess Anne Hospital. If your baby is at home you will receive details of where and when to bring your baby to us. You will also receive instructions as to when your baby should stop feeding prior to surgery.

However you should continue giving your baby water until you arrive on the neonatal unit. You and your baby will meet both the surgeon and the anaesthetist who will explain the operation and the anaesthetic. The operation will be done later that day.

What does the operation involve?

Under anaesthetic, a cut will be made in the baby's groin, the hole in the muscle will be repaired with stitches and the skin closed with stitches under the surface. A small dressing may be applied. Local anaesthetic will also be used to numb the skin to reduce any pain the baby may feel after waking. Your baby will then be woken up and returned to the high care nursery.

What happens following surgery?

Occasionally, following anaesthetic, we know that babies may have a change in their breathing pattern for a few hours, therefore your baby will be observed carefully for signs of apnoea (irregular breathing).

Milk feeds can be given as soon as your baby demands. Usually your baby should be ready to return home or your local newborn unit the next morning.

What are the complications and risks of the operation?

Surgery is usually very straightforward. However there can be difficulties in small babies.

  • Wound infection may occur causing redness and discharge of pus a few days after surgery and antibiotics may be needed.
  • Bruising at the site of hernia repair can be quite marked and can cause some swelling in a few babies. It usually resolves in a few days.
  • In rare cases the hernia may come back and a further operation may then be needed. This can even happen within a day or two of the surgery.

    Although most babies only have a hernia on one side, some have a hernia on both sides at the time of surgery. If this is the case in your baby both hernias will be fixed at the one operation.

 

Some babies who only have one hernia to begin with develop another hernia within the next two years requiring a later operation.

Very rarely, a girl with a hernia will have some male chromosome material. This can have implications for later life but a blood test to look at the baby’s chromosomes can be done to exclude this condition. It is our normal practice to do this test before surgery and this will be discussed with you.

What is the best way to care for my baby after surgery?

Your baby can be bathed as normal although water on the wound may sting in the first two days. If there is any dressing this can be removed at five days and a nurse will arrange this for you.

If there is any redness or discharge from the wound please seek medical advice. You may give your baby paracetamol as prescribed every six hours for 24 – 48 hours.

What after care will there be for my baby?

If you have any concerns please contact us|.

We will arrange for your baby to be followed up by a doctor at about 6 weeks following the operation. This will be at the outpatient department in either Southampton or your local hospital.

Disclaimer

University Hospital Southampton NHS Foundation Trust produce guidelines as an aid to good clinical practice. They represent recognised methods and techniques of clinical practice, based on published evidence. The ultimate judgement regarding a particular clinical procedure or treatment must be made by the clinician in the light of the clinical data presented by the patient and the diagnostic or treatment options available. The guidelines issued are not intended to be prescriptive directions defining a single course of management and departure from the local guidelines should be fully documented in the patient's case notes at the time the relevant decision is taken.