Inguinal Hernia: Treatment Overview

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Treatment Overview

Surgery is the only treatment and cure for inguinal hernia. Hernia repair is one of the most common surgeries done in the United States. About 750,000 people have hernia repairs each year.² But if an inguinal hernia does not cause any symptoms, it may not need treatment.

Surgery

Many doctors recommend surgery to repair a hernia because it prevents strangulation, which occurs when a loop of intestine is trapped tightly in a hernia and the blood supply is cut off, killing the tissue. Strangulation requires immediate surgery, although the condition is rare in adults.

There are two types of hernia repair surgeries:

Open hernia repair surgery. During open surgery, the hernia is repaired through an incision in the groin. Open surgery has been done for many years.

Laparoscopic hernia repair. Laparoscopic hernia repair is a newer method for repairing an inguinal hernia in adults. A surgeon inserts a thin, lighted scope through a small incision in the abdomen. Instruments to repair the hernia are inserted through other abdominal incisions.

If your hernia does not bother you, you may not need to have surgery. Waiting to have surgery does not increase the chance that part of your intestine or abdominal tissue will get stuck in your hernia. Waiting will also not increase your risk for problems, if you decide to have surgery later. In some cases, hernias that are small and painless may never need to be repaired.

Often an inguinal hernia can be pushed back, or reduced, into the abdomen with gentle pressure. In an adult, a hernia that can be pushed back can be surgically repaired at a convenient time. Surgery can be delayed for months. But surgery cannot be delayed that long in infants and children because of the increased risk of incarceration and strangulation. See the Surgery section of this topic for more information.

Should I have surgery for inguinal hernia now, or should I wait?

Other treatments

Inguinal hernia cannot be treated with medicines. But pain medicine is given after hernia surgery.

Talk with your health professional 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.

Hernias in children

In a child, a hernia that is incarcerated may be pushed back into the abdomen by a doctor. But surgery is still needed because of the increased risk of strangulation.

• If the doctor cannot push the hernia back at the time of the exam, the child may be sedated and laid down with his or her head lower than the body, with an ice pack over the hernia.
• If the hernia does not reduce on its own, the doctor may try to push it back into the abdomen.
• If the hernia is reduced, surgery can be delayed for a short time.
• If the hernia cannot be reduced, immediate surgery is necessary.

What To Think About

In adults, if the hernia can be pushed back into the abdomen, surgery can be delayed. If strangulation is likely to occur, you may need surgery sooner.

Some doctors will watch and wait indefinitely with small hernias that bulge out directly through the abdominal wall and are not getting bigger. If these hernias do not cause symptoms, surgery may not be necessary.

A surgeon's experience plays an important role in the risk of a hernia recurring. If you are considering hernia surgery, ask the surgeon how many of these surgeries he or she has performed and about his or her recurrence rates. Recurrence rates tend to be higher for laparoscopic surgery and for other surgeries that do not use mesh (a synthetic patch).

Some people with other medical conditions may choose not to have surgery or may not be able to have hernia surgery.

• People with major health problems, such as uncontrolled diabetes, may need to bring these conditions under control before having hernia surgery.
• Conditions that cause coughing or straining to pass stools or urine (such as lung diseases or prostate problems) may need to be corrected before surgery so that the hernia is less likely to recur after repair.

Having laparoscopic surgery has some advantages over open surgery. The pain after surgery seems to be less with the laparoscopic surgery and people return to work earlier. But laparoscopic surgery is much more expensive and the hernia is more likely to come back. Laparoscopic surgery also has a higher risk of rare but serious complications.

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Last updated:	May 16, 2007
Author:	Monica Rhodes
Reviewed By:	Kathleen Romito, MD - Family Medicine, Jerome B. Simon, MD, FRCPC, FACP - Gastroenterology
Editors:	Kathleen M. Ariss, MS, Pat Truman