When to fix a hernia; when to wait

Hernia repair is one of the most common surgical procedures in the U.S. But if a person is not very active and the hernia has been present for a long time, it could stay as it is and not cause any problems.

Many things can cause a hernia, which is a break in the abdominal wall with a segment of the abdomen pushing through it. It usually occurs in the lower abdomen where weak spots develop with age. Lifting can cause it, but so can a bad cough, hard sneezing, or straining during a bowel movement.

People first notice it in the shower or bath when they find a soft lump which disappears when they lie down. In other cases, people feel a dull ache or sensation of heaviness in their groin.

There is no rule about who should or shouldn't have surgery to repair a hernia. If it is very large, surgery is recommended. New laparoscopic surgery requires three small incisions and is done under general anesthesia. Recovery time is shorter, but the procedure is expensive. Conventional repair involves an incision that is several inches long but can be done with local anesthesia.

In either procedure, a piece of plastic mesh is placed inside the patient to close the hernia.

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