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Inguinal Hernia: Should I Have Surgery Now, or Should I Wait


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Decision Point

Inguinal Hernia: Should I Have Surgery Now, or Should I Wait?

You may want to have a say in this decision, or you may simply want to follow your doctor's recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them.

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Inguinal Hernia: Should I Have Surgery Now, or Should I Wait?

Get the facts

Your options

  • Have surgery now to repair the inguinal hernia, even if you do not have symptoms.
  • Take a "wait and see" approach to surgery because the hernia does not bother you much.

This decision aid is not for parents of infants and children who have inguinal hernias. Infants and children always need surgery to repair a hernia because of the increased risk of incarceration and strangulation.

Key points to remember

  • Hernias don't go away on their own. Only surgery can repair a hernia.
  • Many people are able to delay surgery for months or even years. And some people may never need surgery for a small hernia. If the hernia is small and you don't have any symptoms, or if the symptoms don't bother you much, you and your doctor may simply continue to watch for symptoms to occur.
  • Over time, hernias tend to get bigger as the muscle wall of the belly gets weaker and more tissue bulges through.
  • Many doctors recommend surgery because it prevents a rare but serious problem called strangulation. This occurs when a loop of intestine or a piece of fatty tissue is trapped inside the hernia and is cut off from its blood supply.
  • Talk with your doctor before wearing a corset or truss to hold in your hernia. These devices are not recommended for treating hernias and sometimes can do more harm than good.
FAQs

What is an inguinal hernia?

An inguinal hernia (say "IN-gwuh-nul HER-nee-uh") occurs when tissue pushes through a weak spot in your groin muscle. This causes a bulge in the groin, scrotum, or labia. The bulge may hurt or burn, or it may not hurt at all.

Why do hernias need to be repaired?

Many doctors recommend surgery because it can prevent a rare but serious problem called strangulation. This occurs when a loop of intestine or a piece of fatty tissue is trapped in a hernia and the blood supply is cut off, killing the tissue.

Repairing the hernia can also relieve the symptoms of pain and discomfort and make the bulge go away. The hernia won't heal on its own.

If your hernia does not bother you, most likely you can wait to have surgery. Your hernia may get worse, but it may not. Over time, hernias tend to get bigger as the muscle wall of the belly gets weaker and more tissue bulges through.

In some cases small, painless hernias never need repair.

What kinds of surgery are used for inguinal hernia?

There are two types of hernia repair surgeries:

  • Open hernia repair surgery. The hernia is repaired through a cut (incision) in the groin. Open surgery is safe and effective and has been done for many years.
  • Laparoscopic hernia repair. This is another method for hernia repair in adults. A surgeon inserts a thin, lighted scope through a small incision in the belly. Surgical tools to repair the hernia are inserted through other small incisions in the belly. Laparoscopic hernia surgery may have some advantages over open surgery in certain cases. Studies show that people have less pain after this type of surgery and can return to work and other activities more quickly than after open repair. But this surgery costs more than open repair.

It can take up to 4 weeks after open hernia surgery before you can begin normal strenuous activities. If you have laparoscopic surgery, you may recover sooner.

When is it safe to delay surgery?

You and your doctor may want to put off surgery if:

  • The hernia is small and you don't have any symptoms, or if the symptoms don't bother you much.
  • The hernia can be pushed back into the belly or it goes away when you lie down. (If it cannot be pushed back, surgery must be done sooner.)

It may also be a good idea to put off surgery if:

  • You are taking medicines such as blood thinners that cannot be stopped for surgery.
  • You have other health problems that make surgery dangerous.
  • You have a skin infection that could also infect the material used to repair the hernia.
  • Your doctor has suggested that wearing supports (trusses or corsets) could help.

Talk with your doctor before wearing a corset or truss for a hernia. These devices are not recommended for treating hernias and sometimes can do more harm than good. There may be certain cases when your doctor thinks a truss would work, but these are rare.

Compare your options

Compare

What is usually involved?









What are the benefits?









What are the risks and side effects?









Have surgery now Have surgery now
  • You may be asleep during the operation. Or the doctor may keep you awake and simply numb the area around your groin.
  • You don't need to stay overnight in the hospital.
  • Surgery prevents the rare but serious problem called strangulation.
  • It relieves any swelling or feeling of heaviness, tugging, or burning in the area of the hernia.
  • The hernia could come back.
  • Risks of surgery include:
    • A bad reaction to the anesthesia.
    • Infection and bleeding.
    • Nerve damage, numb skin, or a loss of blood supply to the scrotum or testicles that could cause the testicles to waste away. But these are rare.
    • Damage to the cord that carries sperm from the testicles to the penis. This could affect your ability to father children.
    • Damage to the artery or vein in the thigh.
    • Damage to the intestines or bladder for certain types of hernias or if the surgery is a laparoscopic repair.
Wait and see Wait and see
  • You will get regular checkups to watch for changes.
  • You don't have the risks of surgery.
  • A rare but serious problem called strangulation could occur.

Personal stories

Are you interested in what others decided to do? Many people have faced this decision. These personal stories may help you decide.

Read More
close

Personal stories about having surgery for inguinal hernia

These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.

I work on a loading dock and often have to lift heavy boxes for my job. One day I noticed a tender bulge in my groin that became more and more painful on the job. My doctor said I had an inguinal hernia. I decided to have surgery to repair it, because I just couldn't work anymore with the hernia.

Boyce, age 45

My inguinal hernia does not bother me much. So I could live with it. But it makes a big bulge, and I don't like the way it looks. So I decided to have surgery to have it repaired and make the bulge go away.

Seaton, age 42

Over the last few years I had gotten overweight. So I went on a crash diet to lose the extra weight fast. Afterward I got a cold and coughed a lot. Later I noticed a small bulge in my groin area that hadn't been there before. My doctor said it was an inguinal hernia and showed me how to push it back into my belly. Although I could have surgery to repair it, I decided to wait to see if it gets worse.

LaMar, age 57

I have a hernia and I am pregnant. It bothers me some, but I have decided to wait until after my baby is born to have the hernia repaired. I just think there is too great a chance of harm to my baby from the anesthesia and surgery to have the hernia repaired before delivery.

Brie, age 31

What matters most to you?

Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.

Reasons to have surgery now

Reasons to wait

My hernia is keeping me from doing daily activities or from returning to work.

My hernia doesn't bother me at all.

More important
Equally important
More important

I want to have the hernia repaired while my insurance or worker's compensation will help cover the costs.

I am worried about being able to afford the operation.

More important
Equally important
More important

I will be traveling to an area where health care may not be available, so I want to take care of this now.

I have no plans to travel to places where health care may not be available.

More important
Equally important
More important

Surgery would be convenient for me at this time.

This is not a good time for me to have surgery.

More important
Equally important
More important

My other important reasons:

My other important reasons:

More important
Equally important
More important

Where are you leaning now?

Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.

Having surgery now

Waiting to have surgery

Leaning toward
Undecided
Leaning toward

What else do you need to make your decision?

Check the facts

1.

One reason for me to have surgery for my inguinal hernia is to prevent a rare but serious problem called strangulation.

  • TrueYou're right. Many doctors recommend surgery because it prevents strangulation, which happens when a piece of tissue gets trapped inside the hernia and is cut off from its blood supply.
  • FalseSorry, that's wrong. Many doctors recommend surgery because it prevents strangulation, which happens when a piece of tissue gets trapped inside the hernia and is cut off from its blood supply.
  • I'm not sureIt may help to go back and read "Get the Facts." Many doctors recommend surgery because it prevents a problem called strangulation.
2.

I need surgery even though my hernia is small and doesn't bother me.

  • TrueNo, that's wrong. If your hernia is small and your symptoms don't bother you, you can delay surgery. Some people never need surgery.
  • FalseYou're right. If your hernia is small and your symptoms don't bother you, you can delay surgery. Some people never need surgery.
  • I'm not sureIt may help to go back and read "Get the Facts." If your hernia is small and your symptoms don't bother you, you can delay surgery. Some people never need surgery.
3.

I can wait for my hernia to go away on its own.

  • TrueSorry, that's wrong. An inguinal hernia won't go away on its own. Only surgery can repair it.
  • FalseYou're right. An inguinal hernia won't go away on its own. Only surgery can repair it.
  • I'm not sureIt may help to go back and read "Key points to remember." An inguinal hernia won't go away on its own. Only surgery can repair it.

Decide what's next

1.

Do you understand the options available to you?

2.

Are you clear about which benefits and side effects matter most to you?

3.

Do you have enough support and advice from others to make a choice?

Certainty

1.

How sure do you feel right now about your decision?

Not sure at all
Somewhat sure
Very sure
3.

Use the following space to list questions, concerns, and next steps.

Your Summary

Here's a record of your answers. You can use it to talk with your doctor or loved ones about your decision.

Your decision

Next steps

Which way you're leaning

How sure you are

Your comments

Your knowledge of the facts

Key concepts that you understood

Key concepts that may need review

Getting ready to act

Patient choices

What matters to you

Credits

Credits
CreditsHealthwise Staff
Primary Medical ReviewerAnne C. Poinier, MD - Internal Medicine
Specialist Medical ReviewerC. Dale Mercer, MD, FRCSC, FACS - General Surgery
You may want to have a say in this decision, or you may simply want to follow your doctor's recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them.

Inguinal Hernia: Should I Have Surgery Now, or Should I Wait?

Here's a record of your answers. You can use it to talk with your doctor or loved ones about your decision.
  1. Get the facts
  2. Compare your options
  3. What matters most to you?
  4. Where are you leaning now?
  5. What else do you need to make your decision?

1. Get the facts

Your options

  • Have surgery now to repair the inguinal hernia, even if you do not have symptoms.
  • Take a "wait and see" approach to surgery because the hernia does not bother you much.

This decision aid is not for parents of infants and children who have inguinal hernias. Infants and children always need surgery to repair a hernia because of the increased risk of incarceration and strangulation.

Key points to remember

  • Hernias don't go away on their own. Only surgery can repair a hernia.
  • Many people are able to delay surgery for months or even years. And some people may never need surgery for a small hernia. If the hernia is small and you don't have any symptoms, or if the symptoms don't bother you much, you and your doctor may simply continue to watch for symptoms to occur.
  • Over time, hernias tend to get bigger as the muscle wall of the belly gets weaker and more tissue bulges through.
  • Many doctors recommend surgery because it prevents a rare but serious problem called strangulation. This occurs when a loop of intestine or a piece of fatty tissue is trapped inside the hernia and is cut off from its blood supply.
  • Talk with your doctor before wearing a corset or truss to hold in your hernia. These devices are not recommended for treating hernias and sometimes can do more harm than good.
FAQs

What is an inguinal hernia?

An inguinal hernia (say "IN-gwuh-nul HER-nee-uh") occurs when tissue pushes through a weak spot in your groin muscle. This causes a bulge in the groin, scrotum, or labia. The bulge may hurt or burn, or it may not hurt at all.

Why do hernias need to be repaired?

Many doctors recommend surgery because it can prevent a rare but serious problem called strangulation. This occurs when a loop of intestine or a piece of fatty tissue is trapped in a hernia and the blood supply is cut off, killing the tissue.

Repairing the hernia can also relieve the symptoms of pain and discomfort and make the bulge go away. The hernia won't heal on its own.

If your hernia does not bother you, most likely you can wait to have surgery. Your hernia may get worse, but it may not. Over time, hernias tend to get bigger as the muscle wall of the belly gets weaker and more tissue bulges through.

In some cases small, painless hernias never need repair.

What kinds of surgery are used for inguinal hernia?

There are two types of hernia repair surgeries:

  • Open hernia repair surgery. The hernia is repaired through a cut (incision) in the groin. Open surgery is safe and effective and has been done for many years.
  • Laparoscopic hernia repair. This is another method for hernia repair in adults. A surgeon inserts a thin, lighted scope through a small incision in the belly. Surgical tools to repair the hernia are inserted through other small incisions in the belly. Laparoscopic hernia surgery may have some advantages over open surgery in certain cases. Studies show that people have less pain after this type of surgery and can return to work and other activities more quickly than after open repair. But this surgery costs more than open repair.

It can take up to 4 weeks after open hernia surgery before you can begin normal strenuous activities. If you have laparoscopic surgery, you may recover sooner.

When is it safe to delay surgery?

You and your doctor may want to put off surgery if:

  • The hernia is small and you don't have any symptoms, or if the symptoms don't bother you much.
  • The hernia can be pushed back into the belly or it goes away when you lie down. (If it cannot be pushed back, surgery must be done sooner.)

It may also be a good idea to put off surgery if:

  • You are taking medicines such as blood thinners that cannot be stopped for surgery.
  • You have other health problems that make surgery dangerous.
  • You have a skin infection that could also infect the material used to repair the hernia.
  • Your doctor has suggested that wearing supports (trusses or corsets) could help.

Talk with your doctor before wearing a corset or truss for a hernia. These devices are not recommended for treating hernias and sometimes can do more harm than good. There may be certain cases when your doctor thinks a truss would work, but these are rare.

2. Compare your options

Have surgery now Wait and see
What is usually involved?
  • You may be asleep during the operation. Or the doctor may keep you awake and simply numb the area around your groin.
  • You don't need to stay overnight in the hospital.
  • You will get regular checkups to watch for changes.
What are the benefits?
  • Surgery prevents the rare but serious problem called strangulation.
  • It relieves any swelling or feeling of heaviness, tugging, or burning in the area of the hernia.
  • You don't have the risks of surgery.
What are the risks and side effects?
  • The hernia could come back.
  • Risks of surgery include:
    • A bad reaction to the anesthesia.
    • Infection and bleeding.
    • Nerve damage, numb skin, or a loss of blood supply to the scrotum or testicles that could cause the testicles to waste away. But these are rare.
    • Damage to the cord that carries sperm from the testicles to the penis. This could affect your ability to father children.
    • Damage to the artery or vein in the thigh.
    • Damage to the intestines or bladder for certain types of hernias or if the surgery is a laparoscopic repair.
  • A rare but serious problem called strangulation could occur.

Personal stories

Are you interested in what others decided to do? Many people have faced this decision. These personal stories may help you decide.

Personal stories about having surgery for inguinal hernia

These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.

"I work on a loading dock and often have to lift heavy boxes for my job. One day I noticed a tender bulge in my groin that became more and more painful on the job. My doctor said I had an inguinal hernia. I decided to have surgery to repair it, because I just couldn't work anymore with the hernia."

— Boyce, age 45

"My inguinal hernia does not bother me much. So I could live with it. But it makes a big bulge, and I don't like the way it looks. So I decided to have surgery to have it repaired and make the bulge go away."

— Seaton, age 42

"Over the last few years I had gotten overweight. So I went on a crash diet to lose the extra weight fast. Afterward I got a cold and coughed a lot. Later I noticed a small bulge in my groin area that hadn't been there before. My doctor said it was an inguinal hernia and showed me how to push it back into my belly. Although I could have surgery to repair it, I decided to wait to see if it gets worse."

— LaMar, age 57

"I have a hernia and I am pregnant. It bothers me some, but I have decided to wait until after my baby is born to have the hernia repaired. I just think there is too great a chance of harm to my baby from the anesthesia and surgery to have the hernia repaired before delivery."

— Brie, age 31

3. What matters most to you?

Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.

Reasons to have surgery now

Reasons to wait

My hernia is keeping me from doing daily activities or from returning to work.

My hernia doesn't bother me at all.

More important
Equally important
More important

I want to have the hernia repaired while my insurance or worker's compensation will help cover the costs.

I am worried about being able to afford the operation.

More important
Equally important
More important

I will be traveling to an area where health care may not be available, so I want to take care of this now.

I have no plans to travel to places where health care may not be available.

More important
Equally important
More important

Surgery would be convenient for me at this time.

This is not a good time for me to have surgery.

More important
Equally important
More important

My other important reasons:

My other important reasons:

More important
Equally important
More important

4. Where are you leaning now?

Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.

Having surgery now

Waiting to have surgery

Leaning toward
Undecided
Leaning toward

5. What else do you need to make your decision?

Check the facts

1. One reason for me to have surgery for my inguinal hernia is to prevent a rare but serious problem called strangulation.

  • True
  • False
  • I'm not sure
You're right. Many doctors recommend surgery because it prevents strangulation, which happens when a piece of tissue gets trapped inside the hernia and is cut off from its blood supply.

2. I need surgery even though my hernia is small and doesn't bother me.

  • True
  • False
  • I'm not sure
You're right. If your hernia is small and your symptoms don't bother you, you can delay surgery. Some people never need surgery.

3. I can wait for my hernia to go away on its own.

  • True
  • False
  • I'm not sure
You're right. An inguinal hernia won't go away on its own. Only surgery can repair it.

Decide what's next

1. Do you understand the options available to you?

2. Are you clear about which benefits and side effects matter most to you?

3. Do you have enough support and advice from others to make a choice?

Certainty

1. How sure do you feel right now about your decision?

Not sure at all
Somewhat sure
Very sure

2. Check what you need to do before you make this decision.

  • I'm ready to take action.
  • I want to discuss the options with others.
  • I want to learn more about my options.

3. Use the following space to list questions, concerns, and next steps.

Credits
ByHealthwise Staff
Primary Medical ReviewerAnne C. Poinier, MD - Internal Medicine
Specialist Medical ReviewerC. Dale Mercer, MD, FRCSC, FACS - General Surgery
Note: The "printer friendly" document will not contain all the information available in the online document some Information (e.g. cross-references to other topics, definitions or medical illustrations) is only available in the online version.

Last Revised: April 26, 2011

Author: Healthwise Staff

Medical Review: Anne C. Poinier, MD - Internal Medicine & C. Dale Mercer, MD, FRCSC, FACS - General Surgery


eMedicineHealth Medical Reference from Healthwise

This information does not replace the advice of a doctor. Healthwise disclaims any warranty or liability for your use of this information. Your use of this information means that you agree to the Terms of Use. How this information was developed to help you make better health decisions.

To learn more visit Healthwise.org

© 1995-2012 Healthwise, Incorporated. Healthwise, Healthwise for every health decision, and the Healthwise logo are trademarks of Healthwise, Incorporated.

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