Skipping some hernia surgeries

Many men diagnosed with a common type of hernia who are not experiencing symptoms may be able to safely forgo surgery.

In a study published in the Jan. 18 issue of the Journal of the American Medical Assn., researchers followed 720 men with asymptomatic hernias for up to five years, with roughly half undergoing surgery and half told to monitor the condition for pain or other symptoms.

Nearly one-quarter of those who did not have surgery opted for the repair later mostly because of pain, but complications were rare among those who did not have surgery. Meanwhile, about the same proportion of patients who did have surgery reported pain symptoms after two years, the report said.

Protective hernia surgery for patients who do not suffer symptoms may become a thing of the past, much the way tonsils and the appendix are now left alone as long as they do not pose problems, said a researcher commenting on the study in an editorial published in the journal.

“For years, surgeons have been struggling to find the best way to avoid the greatest harm in patients with incidentally identified hernias,” wrote David Flum of the University of Washington in Seattle. “Avoiding harm in this case is easy -- it can best be accomplished by counseling and educating patients and only repairing hernias that cause symptoms.”