Inguinal hernias are divided into 2 different types, direct and indirect.
Both occur in the area of where the skin crease at the top of the thigh joins the torso (the inguinal crease). Both of these types of hernias can appear as a bulge in the inguinal crease. Distinguishing between the direct and indirect hernia, however, is not that important because both are treated the same. Hernias occur at this site as there is an inherent weakness here due to a natural opening to allow blood vessels to travel to the scrotum and the vas deferens (a narrow tube) to carry sperm back from the testicle.
Indirect inguinal hernia:
An indirect hernia follows the pathway that the testicles made during prebirth development. It descends from the abdomen into the scrotum. This pathway normally closes before birth but remains a possible place for a hernia. Sometimes the hernia sac may protrude into the scrotum. This type of hernia may occur at any age.
Direct inguinal hernia:
The direct inguinal hernia occurs slightly to the inside of the site of the indirect hernia, in a place where the abdominal wall is naturally slightly thinner. It rarely will protrude into the scrotum. Unlike the indirect hernia, which can occur at any age, the direct hernia almost always occurs in the middle-aged and elderly because their abdominal walls weaken as they age.