Delaying Hernia Repair Is Safe

Men who delay surgical repair of a hernia until the hernia becomes uncomfortable fare as well as those who undergo immediate surgery, according to a new study.

In this study, published in the January 18, 2006, issue of the journal of the American Medical Association (JAMA), 720 men with inguinal hernia were randomly assigned to either "watchful waiting” or standard hernia repair surgery and followed up for two to four-and-a-half years.

Of the 364 men assigned to watchful waiting, 23% later chose to have surgery, usually because of increased pain. Waiting did not increase the rate of complications from surgery in those patients who eventually had it, and the rate of complications from hernias left unrepaired was even lower. After two years, the same proportion of men in each group reported developing pain great enough to interfere with everyday activities, but both groups overall reported less pain at the end of the two years.

The authors conclude that a strategy of watchful waiting is "a safe and acceptable option” for men whose hernias are not causing discomfort that interferes with their day-to-day activities. Hernia complications occur only rarely, and patients who develop symptoms have no greater risk of operative complications than those undergoing preventative hernia repair.

"There are a lot of men walking around with hernias who say, ‘If it's not bothering me, I won't bother it,'” said Dr. Olga Jonasson, professor of surgery at the University of Illinois (Chicago, IL, USA), who initiated the study. "We wanted to know if it was safe to delay surgery altogether.”





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