Hernias are a very common condition, but only a small fraction of those who develop hernias get them repaired. There are two reasons for this…First, many hernias are asymptomatic, meaning they show no bulge and do not cause any pain. Therefore, patients may never know they exist. Other times, a hernia may be known, but for some reason or other, the patient ultimately decides not to have it repaired.
The question posed in this blog touches on both circumstances. A patient who discovers they have a hernia from an incidental exam has likely been living with that hernia for quite a while. Indeed, many hernias go unnoticed and undiagnosed for years, decades or even the remainder of the patient’s life. Asymptomatic hernias, as they are known, do not warrant treatment, in most cases, because we simply do not know they exist, but also because the risk of strangulation is very low. Ultimately, if the potential hernia does not cause any interference in lifestyle, there would be no reason to repair.
In this case, diagnostic imaging or a medical exam for a different condition has yielded the diagnosis of a hernia. At this point, the patient should most definitely consult with an experienced hernia surgeon. During this consultation, a physical exam will be performed once again to determine exactly what kind of hernia and any risks that the patient may have because of it. Certain hernias, for example femoral hernias, almost always need to be repaired as they have a high incidence of strangulation. Other hernias, depending on their location and characteristics might be better left alone.
The decision to have hernia surgery or to wait until later depends on the patient. Please consider the following points:
- Is the patient younger or of advanced age? Younger, fit patients are good candidates for surgery and since hernias only get worse over time, it is probably worth repairing sooner rather than later. Older patients, with larger hernias that do not cause discomfort, may usually wait as the risks of surgery increase with age and declining general health.
- Size of the hernia will play a part in deciding whether it is appropriate to repair. Smaller hernias have a greater chance of causing symptoms such as discomfort, pain, or rarely, strangulation, while larger hernias are less likely to strangulate. While the size of the hernia is a consideration, it is again worth repeating that hernias will only get worse over time, requiring a larger and more complex repair.
- Patient preference is, of course, the deciding factor with any non-emergency hernia situation. Unless the hernia is strangulated, there is no urgent reason to have a hernia repaired. Most hernias are repaired due to patient quality of life issues related to the hernia. If the hernia is symptomatic, i.e. causes discomfort and/or pain, then a repair is usually performed. If the patient does not wish to undergo surgery, they can choose not to do so.
With all the above being said, an experienced hernia surgeon such as Dr. Lublin will repair many thousands of these defects over the course of their career. Most hernia cases are straightforward and come with minimal risk. Scheduling a consultation with Dr. Lublin or a qualified experience surgeon in your area is the first step to understanding whether repairing a hernia is appropriate for your circumstance.