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Hernias: 'Watchful Waiting' Proposed

Researchers Say Men Without Symptoms May Not Need Surgery

What About Women?

The findings from the all-male study cannot be extrapolated to women, who have a more complicated clinical picture when it comes to hernias, Fitzgibbons says. Women are far more likely than men to develop a different type of groin protrusion known as a femoral hernia. These hernias can be hard to distinguish from inguinal hernias and are more likely to result in serious complications.

For this reason, a watchful-waiting approach is probably not appropriate for women in most cases, he says.

Gastrointestinal surgeon David R. Flum, MD, MPH, tells WebMD that the new study confirms what many clinicians have long suspected -- that watchful waiting is an appropriate strategy for the management of hernias that have no symptoms other than the bulging.

He says it will definitely change the way doctors counsel their patients. But it remains to be seen, he adds, if patients will embrace the watchful-waiting approach.

Flum wrote an editorial accompanying the study. He is an associate professor of medicine at the University of Washington, Seattle.

"Many patients perceive a lump in their groin as being broken, even when it doesn't cause them pain," he says. "There will always be folks who want to get rid of the bulge or who don't want to wait around for something to happen, just like there are people who want to avoid surgery unless they absolutely need it."


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