Do Hernias Always Need to be Repaired?
After the initial relief of finding out that the worrisome bulge in your groin or the nagging “muscle strain” in your abdomen was actually a hernia all along, you’re probably wondering: now what?
Unfortunately, a hernia won’t heal or go away on its own, and only surgery can repair it. Even so, many people can delay treatment — for months or sometimes longer — before surgical repair becomes necessary.
As a board-certified surgeon who specializes in minimally invasive laparoscopic hernia repair, Johnny L. Serrano, DO, FACOS can help you understand your treatment options so you can determine your next best step with confidence.
Hernia overview and types
A hernia occurs when a separation or weak spot in your muscle and connective tissues allows underlying tissues to push through. Most hernias appear in the groin or along the abdominal wall.
Hernias often develop spontaneously when a physical strain, such as lifting something heavy, puts acute pressure on a weak area of your abdominal wall. They can also emerge gradually, with ongoing pressure and strain from something like chronic constipation.
Although hernias can occur in people of all ages, including congenitally in newborns, they’re most common in middle-aged and older adults, especially men.
The telltale sign of a hernia is an abnormal bump in your abdomen or groin that looks more prominent when you’re standing or straining. The area may feel painful or achy whenever you cough, bend, or lift something heavy, or you may experience continuous pressure or swelling at the site.
The most common hernia types and their locations are:
- Inguinal (inner groin area)
- Femoral (upper thigh/outer groin)
- Ventral (external abdominal wall)
- Incisional (at an abdominal incision)
- Umbilical (belly button area)
Not all hernias appear just beneath the surface of your skin; the hiatal hernia occurs deep within the abdomen when part of the stomach pushes upward through a weak area in the diaphragm. A hiatal hernia can trigger indigestion and heartburn, among other symptoms.
Hernia treatment options
The most important thing to keep in mind when you’ve been diagnosed with a hernia is that it won’t get better over time or resolve on its own — in fact, most hernias will eventually worsen if left untreated for too long.
Unfortunately, there are no conservative treatment options for correcting a hernia. There’s no medication or physical therapy regimen that can help it improve, and wearing a compression garment like a corset or a truss to “hold in a hernia” can wind up doing more harm than good.
While infants and children with hernias require prompt surgical repair, many adults can initially choose between watchful waiting and surgery.
Watchful waiting
If your hernia is small, can be easily pushed back in, or disappears when you’re lying down, and doesn’t cause bothersome symptoms, Dr. Serrano may recommend starting with an initial period of watchful waiting. With this approach, he conducts regular assessments to ensure the hernia isn’t growing larger or causing problems.
Many people can safely delay surgical repair for several months to a year or longer. In some cases, people with small, non-progressing hernias never need surgery.
He may also advise you to enter a period of watchful waiting if you have health problems that make surgery too risky, if you’re taking blood thinners that can’t be stopped for surgery, or if you have a skin infection that could transfer to the surgical mesh that’s used to reinforce weak tissues at the hernia site.
Surgical repair
If your hernia is large, painful, or limits your ability to engage in physical activity, Dr. Serrano will likely advise you to have it repaired promptly. Surgery is the only way to correct a hernia and resolve the pain and limitations it causes.
Surgery is also the only way to prevent a rare but serious complication called strangulation. This medical emergency occurs when part of your intestine or some fatty tissue becomes trapped in the hernia, causing it to become infected, blocked, or cut off from its blood supply.
Even if you don’t have troublesome symptoms, it’s important to recognize that most hernias grow progressively larger over time as abdominal tissues weaken with age. In many cases, this makes surgical repair an eventual necessity.
Laparoscopic hernia surgery
Every year, about 800,000 people undergo a hernia repair, making it one of the most common surgeries in the United States. Three in four hernia repair procedures are done to correct an inguinal hernia, by far the most common type.
If hernia repair surgery is the best next step for you, you’re in good hands with Dr. Serrano: Whenever possible, he performs minimally invasive hernia repair using laparoscopic techniques to help minimize tissue damage, reduce the risk of infection, and foster a faster recovery.
To learn more about minimally invasive hernia repair at Precision Surgery and Advanced Vein Therapy in Glendale, Arizona, call 602-393-1304 or click online to book an appointment with Dr. Serrano today.