Q: Is it OK to leave a hernia? I have recently developed one in my groin, but my GP seems reluctant to refer me for surgery to have it repaired. To be honest, it doesn’t bother me at the moment, but I worry about it getting bigger or twisting if I don’t have the operation.
A: It depends on a number of factors. In an otherwise fit and active older person I tend to have a low threshold for seeking a specialist opinion, as new hernias have a higher chance of strangulating (the ‘twisting’ you mention), requiring urgent surgery. And in these cases, planned repair – which can now be done under local anaesthetic – has much better outcomes than emergency surgery. Clues that a groin hernia may be more likely to strangulate include groin and abdominal discomfort, and a lump that you can’t push back in (reduce) when relaxed and lying flat.
However, if the hernia is easily reducible and not bothering you – or if you have other medical conditions that might complicate surgery or recovery – then watchful waiting is a perfectly acceptable option. I have patients who have lived with huge groin hernias for decades, and the risk of strangulation is quite low – roughly 1 in 100 per year for the typical person. Just make sure you report any changes to your doctor, and if you develop signs of strangulation – a painful (and often red) swelling that won’t reduce and/or a distended painful abdomen – then seek help urgently.
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