Hernia Surgery: Is it Necessary?

Hernias don’t disappear on their own; people need surgery to fix them. But not everyone needs hernia surgery right away. And some people may never need surgery to repair a hernia.

“Whether or not you may delay or avoid surgery depends on your symptoms,” says Adam Rosenstock, M.D., general and robotic surgeon and assistant professor of surgery at Hackensack University School of Medicine. “But most importantly, be sure to see a doctor instead of making the call on your own.”

What is a Hernia, and Why Does it Happen?

A hernia develops when tissue (fat or intestine) pokes through weakened abdominal wall muscle. Hernias may be small or large, and they may or may not be painful.

Common areas where hernias develop include:

• The groin area
• The navel (belly button)
• An area adjacent to an abdominal scar
• The upper stomach (commonly known as hiatal hernia)

Men are more likely to develop hernias than women. Hernias may also appear in children.

Certain activities may increase the risk of developing a hernia, such as:

• Straining to make a bowel movement
• Lifting heavy objects
• Coughing hard
• Smoking
• Strenuous exercise

How to Tell if You Can Delay or Avoid Hernia Surgery

After your doctor examines you, you’ll find out whether or not you need surgery. Doctors may suggest a wait-and-see approach for your hernia if:

• Your hernia is small and it doesn’t cause pain or other symptoms
• Your hernia only causes minor symptoms that aren’t bothersome
• You can easily push the hernia back in
• Your hernia seems to disappear when you lie flat on your back

More tissue may poke through your abdominal wall over time, complicating matters. If your doctor recommends watchful waiting, be sure to continually monitor your hernia for changing symptoms.

Signs that Hernia Surgery is Necessary

Some people who see the doctor about a hernia need to schedule surgery quickly. Your doctor may recommend surgery if:

• The hernia causes constant pain or discomfort
• You can’t push the hernia back into the abdomen
• The skin over your hernia becomes discolored or darkened
• You experience a fever or nausea, along with pain at the hernia site

“Getting the hernia repaired should minimize your abdominal bulge and eliminate your pain,” says Dr. Rosenstock. “It may also help you to avoid complications."

If your child has a hernia, don’t delay treatment. Children almost always need surgery scheduled quickly.

Hernia-related Complications That May Arise

Hernias don’t go away on their own, and they also don’t always remain stable. Some hernias grow larger as the muscles around the abdominal opening get weaker.

When a hernia grows in size, it’s more likely to develop complications. If your hernia is hurting or bulging more than before, see your doctor again.

Doctors recommend hernia-repair surgery when they’re concerned about the risk of strangulation. 

During strangulation:

• Fat, intestine or other tissue pokes through the abdominal wall
• The tissue becomes trapped in the hernia
• Blood supply is unable to reach the intestine or tissue within the hernia
• The trapped tissue dies, which may lead to gangrene

“It’s hard to predict if a hernia will strangulate, but strangulation may lead to life-threatening complications,” says Dr. Rosenstock. “If you suspect a strangulated hernia, don’t wait, go to the Emergency Department, it is a true emergency.”

Small, pain-free hernias are unlikely to cause strangulation. In those cases, it may be reasonable to delay surgery, if your doctor agrees.

Next Steps & Resources:

• Meet our source: Adam Rosenstock, M.D.
• To make an appointment with Dr. Rosenstock, or a doctor near you, call 800-822-8905 or visit our website.