Obturator Hernia Comprehensive Guide: Symptoms, Risk Factors, and Surgical Repair
Updated: 2 days ago
Medically reviewed by Dr. Baraa Alnahhal, MD · Last reviewed: October 2026
Quick Answer: Obturator Hernia at a Glance
An obturator hernia is a hernia in which fat or intestine pushes into the obturator canal, an opening in the pelvis, typically in underweight women aged 70 to 90. [1] It causes belly pain, vomiting and pain from the groin into the inner thigh. [1] It is urgent because it can block or strangulate the bowel, and surgery is the only treatment. [1]
Feature | Details |
Definition | Fat or intestine pushes into the obturator canal, an opening in the pelvis. [1] |
Typical patient | Women aged 70 to 90 who are underweight (BMI 18.5 or below). [1] |
Key symptoms | Belly pain, nausea and vomiting, constipation, a swollen belly, and pain from the groin into the inner thigh. [1] |
Main cause | A weak spot in the pelvic floor muscles. [1] |
Urgency | High. It can lead to a blocked bowel or a strangulated hernia. [1] |
Treatment | Surgery is the only treatment: open, laparoscopic, or robotic repair. [1] |
What the research says
Some trapped hernias can be eased back by hand first, but only with close watching. A Japanese hospital reviewed 50 cases of incarcerated (stuck) obturator hernia from 2010 to 2022. Manual reduction was tried in 31 patients (62%) and worked in 21 (42%); most of them then had planned mesh repair. Two patients needed emergency surgery while waiting, because of late-onset constriction and a small bowel perforation. After surgery, complications occurred in 5% of reducible and 22% of irreducible cases, and there were no postoperative deaths. This was a single-hospital, retrospective review, so it is not a do-it-yourself option. (Gokon et al., Sci Rep, 2023) [2]
The diagnosis is easy to miss. A case report described a 65-year-old woman with three days of crampy belly pain, nausea, and vomiting from a small bowel obstruction caused by an obturator hernia. The authors note that signs and symptoms are often nonspecific, that late presentation is linked to significant illness and death, and that the hernia should be considered in elderly patients with an acute surgical abdomen. (Mindaye et al., J Surg Case Rep, 2020) [3]
What Is an Obturator Hernia?
An obturator hernia happens when there is a hernia in your obturator canal, an open spot in your pelvis. [1] Weak pelvic floor muscles let fat or a section of intestine push into the canal. [1] It usually involves the small intestine, though it may involve the large intestine. [1]
It is rare, and it typically affects women aged 70 to 90. [1] Because it sits deep in the pelvis, it is often hard to see or feel from the outside, and the pain it causes can be easy to dismiss as a normal part of aging.
It can be serious. If the hernia gets stuck, it can block the intestine (bowel obstruction) [1], and a blocked intestine is a medical emergency that may need surgery right away. [1]
What are the symptoms of an obturator hernia?
Obturator hernia symptoms include belly pain that spreads across the belly, a swollen stomach, constipation, nausea and vomiting, and pain moving from the groin into the inner thigh. [1]
When to go to the ER
Go to the emergency room right away if you have severe belly pain that comes on very fast, or nausea or vomiting. [1] These can be signs of a strangulated obturator hernia, in which blood can't reach the trapped intestine and the tissue starts to die. [1] Talk to a healthcare provider if you have belly pain or thigh pain that doesn't go away. [1]
What causes an obturator hernia and who is at risk?
Obturator hernias happen when a weak spot in the pelvic floor muscles lets tissue and a section of intestine push into the obturator canal. [1] Several things raise the chance:
Risk factor | Why it matters |
Age | Pelvic floor muscles weaken with age, and age also affects the membrane covering the opening of the canal. [1] |
Chronic constipation | Constantly straining to poop can weaken the pelvic muscles. [1] |
COPD | Chronic coughing puts pressure on the abdominal muscles, which can affect the pelvic muscles. [1] |
Being underweight (BMI 18.5 or below) | Weight loss reduces fat in the obturator canal, which makes room for a hernia to grow. [1] |
What are the complications of an obturator hernia?
Obturator hernia complications include an incarcerated hernia that may block the small intestine and a strangulated hernia, in which the trapped intestine loses blood supply and starts to die. [1]
How Is It Diagnosed?
An obturator hernia is diagnosed with a review of symptoms and a physical exam, and may include the Howship-Romberg test, the Hannington-Kiff test and a confirming CT scan. [1] They may also do:
What are obturator hernia treatment and recovery like?
Surgery to repair the hernia is the only treatment. [1] The surgeon reaches the hernia through a cut in the lower belly or groin, moves the contents back into the lower belly, and fixes the weak spot in the muscles. [1] It may be done as open surgery, laparoscopic surgery, or robotic hernia repair. [1]
If the intestine has been damaged, as can happen with a strangulated hernia, the surgeon may also do a colectomy to remove the damaged section. [1] Possible complications of hernia repair include bleeding, damage to the obturator nerve, and infection at the surgical site. [1]
Recovery depends on the type of surgery (laparoscopic recovery is shorter than open), whether a colectomy was needed (longer recovery), and your overall health. [1] Conditions such as malnutrition or COPD can lengthen recovery. [1] Your surgeon will explain what to expect.
What is the outlook for an obturator hernia?
Hernia repair surgery often cures an obturator hernia and eases its symptoms. [1] It does not treat the conditions that raise your risk, such as malnutrition or COPD, so you may need ongoing medical care to manage them. [1]
What is the bottom line on obturator hernias?
An obturator hernia is rare but serious. Belly pain together with groin or inner thigh pain in an older adult, especially an underweight woman, deserves prompt medical attention. Surgical repair often cures it, and acting early helps avoid a bowel emergency.
Belly or thigh pain that won't go away? Don't write it off as aging. Tell a healthcare provider about the pain, and go to the ER for severe belly pain that starts suddenly, or for nausea and vomiting with it.
Frequently Asked Questions
Can I see an obturator hernia from the outside?
Usually not. It sits deep in the pelvis, so it often does not cause a visible bulge.
Why does it mostly affect women?
An obturator hernia typically affects women aged 70 to 90 who are underweight. [1] Cleveland Clinic links it to weak pelvic floor muscles and a loss of fat in the obturator canal, but does not give a further reason.
Is inner thigh pain always a sign of a hernia?
No. But pain that starts in the groin and moves into the inner thigh, along with belly pain, constipation, or vomiting, is worth discussing with a provider.
What is a strangulated hernia?
A strangulated hernia is one where blood can't reach the intestine inside it, so the tissue starts to die. [1] It is an emergency.
Can I treat an obturator hernia without surgery?
No. Surgery to repair the hernia is the only treatment. [1]
What is the Howship-Romberg test?
Your provider moves your hip and asks whether this causes pain in your inner thigh. [1]
How common are obturator hernias?
Obturator hernias are rare. [1]
Can chronic coughing cause a hernia?
Chronic coughing can raise the risk. COPD causes chronic coughing that puts pressure on the abdominal muscles, which can affect the pelvic muscles. [1]
What is a colectomy?
A colectomy is surgery to remove a damaged section of the intestine. It may be needed if the intestine has been damaged by a strangulated hernia. [1]
Does being underweight increase my risk?
Yes. A BMI of 18.5 or below means less fat in the obturator canal, which makes room for a hernia to grow. [1]
What imaging test is used to diagnose it?
A CT scan is used to confirm an obturator hernia. [1]
Is the surgery dangerous for seniors?
All surgery has risks. Possible complications include bleeding, damage to the obturator nerve, and infection. [1] Recovery takes longer with conditions such as malnutrition or COPD. [1] Your surgeon can explain your own risks.
Can straining during bowel movements cause this?
Chronic constipation and constant straining can weaken the pelvic muscles, which raises the risk. [1]
What is the obturator canal?
The obturator canal is an open spot in the pelvis. [1] In an obturator hernia, fat or intestine pushes into it. [1]
How long does recovery take?
It depends on the type of surgery, whether a colectomy was needed, and your overall health. [1] Your surgeon will explain what to expect.
Related Reading
Femoral Hernia: Causes, Symptoms, and Treatment describes another groin hernia that is more common in older women.
Richter Hernia: Symptoms, Causes, and Emergency Treatment explains a hernia that can trap part of the bowel wall.
Hernia Repair Surgery: Procedures, Recovery, and Outcomes walks through hernia repair options, recovery and expected results.
CT Scan: What It Shows, How It Works, Risks and Results explains the imaging test most often used to find an obturator hernia.
References
Cleveland Clinic. Obturator hernia. Cleveland Clinic. Last updated April 10, 2025. https://my.clevelandclinic.org/health/diseases/obturator-hernia
Gokon Y, Ohki Y, Ogino T, et al. Manual reduction for incarcerated obturator hernia. Sci Rep. 2023;13(1):5504. PMID 37015958. https://doi.org/10.1038/s41598-023-31634-4
Mindaye ET, Giduma D, Tufa TH. Obturator hernia: case report. J Surg Case Rep. 2020;2020(10):rjaa389. PMID 33101641. https://doi.org/10.1093/jscr/rjaa389
Medical disclaimer
This article is for general informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional for diagnosis and treatment decisions. Severe belly pain that comes on fast, especially with vomiting, needs emergency care.
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