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Do All Hernia Patients Require Surgery?

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Hernias can occur at any age and are due to a number of factors. However, as we age and the muscle tissue in our bodies begins to degrade, we are more likely to develop a hernia. While having hernia surgery is typically recommended for young, otherwise healthy patients, the decision whether to have hernia surgery becomes less clear as a patient gets older. This is for a number of important reasons, some of which will be discussed here.

Man in gray sweater holds pressure against lower abdominal hernia may need hernia repair. MASJax logo at top center.

First, elderly patients may not be good candidates for hernia surgery. As we age and experience more general medical issues, our suitability for surgery is diminished. If the risks of having hernia surgery, including general anesthesia, outweigh the benefits, we may not perform the procedure and instead, carefully watch the hernia for progression.

Second, older patients tend to have a weaker abdominal musculature and as a result are less at risk of incarceration or strangulation of the hernia. Of course, strangulation is always a concern, but this concern is greater in younger patients. It is important to remember, however, that hernias are progressive and will become larger and more difficult to repair in the future. This is a decision that will have to be made with your surgeon after careful consideration.

The hernia may not be impeding lifestyle or causing pain or discomfort. Typically, we do not repair asymptomatic hernias unless they represent a significant risk of strangulation. If the hernia is not causing undue pain or discomfort and if the patient is able to continue their lifestyle even with the hernia, we typically suggest watchful waiting.

While there are times that we suggest hernia surgery be postponed or delayed, it is important to have a regular check up with your surgeon to ensure that the hernia has not progressed to a problematic state. Your surgeon will also give you the warning signs of a more serious hernia issue. Incarceration, when the contents of the hernia get stuck, requires urgent surgery. Strangulation, when blood is cut off to the hernia contents, is an emergency that needs to be treated immediately. Any serious abdominal pain should be evaluated immediately by a qualified physician and if you feel like you may be having an emergency, call 911 or go to your nearest ER.

Some hernias, especially femoral hernias, most often found in women, have a high risk of strangulation and should almost always be repaired as soon as possible.

If you are experiencing a bulge or mild pain associated with a hernia, the first and most important step is to schedule a consultation with one of our highly experienced hernia surgeons to find out the best course of action for your circumstance. We look forward to helping you manage your hernia through surgical or non-surgical means.

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