Can You Wait for Hernia Surgery?
Hernias do not always present with obvious signs or symptoms and many patients will live for decades, or even their entire lives not knowing they have a hernia. Because of the relatively low risk of strangulation, we do not actively screen for asymptomatic hernias and only consider hernia surgery once they become symptomatic.
However, symptomatic hernia may cause interference with lifestyle pursuits and this is the best indication for corrective surgery. Interestingly, the relationship between the size of the hernia and the pain that it causes is not linear. In other words, small hernias may be very painful while large hernias may not be. So, whether or not a patient should have surgery is more a result of the kind of hernia and its symptoms versus its size.
The keys to deciding whether hernia surgery is appropriate
Ultimately, the biggest considerations revolve around the risk of strangulation, risk of surgery and personal preference.
- If the pain is not significant and does not interfere with lifestyle issues and the bulge, if any does not bother them, patients may wish to wait until the hernia progresses before having surgery. Older patients have weaker abdominal muscles, usually leading to larger hernias with a lower risk of strangulation. Some older patients may also be poor candidates for surgical intervention because of other ailments and failing health
- We recommend that younger patients get their symptomatic hernia repaired sooner rather than later, mostly because their stronger abdominal muscles increase the risk of incarceration or strangulation. Also, younger patients are typically excellent candidates for surgery.
- As to personal preference, it is important to remember that while hernia surgery is most often not an emergency procedure, it can be. A strangulated hernia must be corrected within a few hours of onset to avoid major complications. This usually involves intestinal tissue and will often require a colectomy if not treated immediately. Emergency intervention for hernias and related strangulated tissue has lower success rates and a higher chance of complications and long-term problems.
- An important caveat to the above it Is for patients who have a femoral hernia. This is a hernia that presents with a bulge in the upper thigh. Female patients have a much higher risk of developing a femoral hernia and this type of hernia has a strangulation rate of up to 25%, much higher than others such as inguinal or groin hernias. Therefore, patients with a femoral hernia should have surgery as soon as possible.
The best way to evaluate your risk, as well as to understand more about hernia surgery and whether is right for you is to schedule a consultation with one of our experienced hernia surgeons.