Surgery has generally been recommended for all inguinal hernias to avoid complications such as strangulation, in which a loop of intestine becomes tightly trapped in a hernia, cutting off the blood supply to that part of the intestine.
If a hernia in an adult can be pushed back (reduced), surgery can be done at the person's convenience. If it cannot be pushed back, surgery must be done sooner. But surgery may not be needed if the hernia is small and you do not have symptoms. Consult with your doctor to decide if you need hernia repair surgery.
Surgery in children
Infants 6 months of age and younger who have inguinal hernias have a much higher risk of strangulation than older children and adults. So surgery for inguinal hernias in infants is not delayed like it can be for adults.
- Synthetic patches are not needed to repair an inguinal hernia in an infant.
- Some infants with inguinal hernias may need to be hospitalized for surgery rather than have surgery in an outpatient setting. These include infants who have lung problems, seizure disorders, or heart diseases from birth or those who were born prematurely.
One of the major decisions concerning infants and children is whether to explore the opposite groin area for a hernia during a hernia repair. A hernia develops in the other side of the groin in about 30 out of 100 children who have had hernia surgery.
Things to think about in deciding whether the other side should be explored include the overall health of the child, the risk of incarceration of a hernia, and the experience level of the surgeon (how many of these surgeries the doctor has done and his or her recurrence rates).
Two types of surgery are done to repair inguinal hernias:
What to think about
Laparoscopic surgery may not be possible for a person who has tissues that have grown together (adhesions) from previous abdominal operations.
Most hernias that will recur do so within 5 years after surgery.
The risk of a hernia coming back after surgery varies depending on a surgeon's experience, the type of hernia, if mesh is used, and the person's age and overall health.
- Recurrence rates after hernia repair are lower when experienced surgeons do the procedure, especially for laparoscopic techniques.3
- The chance of a hernia coming back after surgery ranges from 1 to 10 out of 100 surgeries done.4
- Using mesh to repair the weak muscle in the belly wall decreases the chance the hernia will come back by more than half.5
There are some considerations before having inguinal hernia repair surgery, such as what kind of hernia repair is done most at the hospital or clinic. Talk with your doctor so that you make the best decision for your condition.
Recurrent inguinal hernias are harder to repair and pose more risks than initial hernia repairs. The risks linked with recurrent hernia surgery are more scar tissue, numbness and pain after surgery, and a greater chance of injury to a testicle or the spermatic cord.
Conditions that might increase the risk of recurrence include abdominal muscles that are not strong or healthy enough to "hold" the stitching (suture) material and bleeding or infection that weaken the repair.
Fertility is usually not affected by an inguinal hernia or hernia surgery. But in males there is a chance that surgery or an incarcerated hernia can cause injury to the vas deferens, the tube that carries sperm from the testicles to the urethra. It is not yet known how often or to what degree this affects a man's ability to father a child. In rare cases, surgery or an incarcerated hernia may injure the blood vessels that supply one or both testicles with blood, which may cause the affected testicle to shrink.