Hernias: Symptoms, Treatment, and When to Consider Surgery

Q: Hernias: Symptoms, Treatment, and When to Consider Surgery

Hello： This response is for reference only and cannot replace a physician's evaluation. <br>If it is indeed a hernia, it often protrudes when straining in the abdomen or standing for a long time. <br>You can stand and cough forcefully; if there is no protrusion or it is very subt

Hernia issues

Hello, I occasionally notice a round bulge in my groin that resembles a tumor.
It is not painful.
I went for a consultation, but when I was there, the bulge did not appear.
I explained my condition to the doctor, who said it "should" be a hernia.
The doctor recommended surgery, but due to the pandemic, we couldn't determine a specific timeline and I'm waiting for further notification.
Recently, I've noticed that the bulge is appearing less frequently.
This month, it has only come out on its own twice.
If this is a hernia, does that mean it is gradually improving? If it is a hernia and is not painful, can I avoid surgery?

Hu Tu Chong, 30~39 year old female. Ask Date: 2021/08/02

Dr. Liu Mingyue reply Urology

Hello: This response is for reference only and cannot replace a physician's evaluation.
If it is indeed a hernia, it often protrudes when straining in the abdomen or standing for a long time.
You can stand and cough forcefully; if there is no protrusion or it is very subtle, further confirmation is needed.
In the case of a hernia, initially, because the opening is small, it may only appear occasionally and may not be painful, so it is not an urgent situation requiring immediate surgery.
However, if the opening gradually enlarges, it may protrude for extended periods and could become painful or uncomfortable, indicating some time pressure to address it.
If left untreated, there is a risk of subsequent complications, although there are clinical cases where individuals have delayed treatment for several years.
Nevertheless, if it is indeed a hernia, the opening will not heal on its own.
Wishing you good health.

Reply Date: 2021/08/02

More Info

Hernias are a common medical condition characterized by the protrusion of an organ or tissue through an abnormal opening in the surrounding muscle or connective tissue. The most common types of hernias include inguinal hernias (occurring in the groin), femoral hernias, umbilical hernias, and ventral hernias. Symptoms can vary widely, but they often include a noticeable bulge in the affected area, discomfort, or pain, especially when lifting heavy objects, coughing, or straining.

In your case, you mentioned experiencing a bulge in the groin area that resembles a tumor, which is a classic sign of a hernia. The fact that it does not cause pain is not uncommon, as many hernias can be asymptomatic, especially in the early stages. However, it is essential to understand that the absence of pain does not necessarily indicate that the hernia is improving or resolving on its own. Hernias typically do not heal without surgical intervention; they may remain stable or potentially worsen over time.

Your doctor’s recommendation for surgery is based on the principle that hernias can lead to complications, such as incarceration (where the protruded tissue becomes trapped) or strangulation (where the blood supply to the trapped tissue is compromised). These complications can lead to severe pain and require emergency treatment. Therefore, even if your hernia is currently asymptomatic, it is crucial to monitor it closely.

Regarding your observation that the bulge has become less frequent, it is possible that changes in your activity level or body position may influence the hernia's appearance. However, this does not mean that the hernia is healing; rather, it may be temporarily reduced in size or less noticeable. It is essential to follow up with your healthcare provider to discuss these changes and determine the best course of action.

In terms of treatment, surgery is the definitive solution for hernias. The procedure typically involves pushing the protruded tissue back into place and reinforcing the weakened area of the abdominal wall, often with the use of a mesh implant. The timing of surgery can vary based on individual circumstances, including the severity of symptoms, the risk of complications, and the availability of surgical resources, especially in light of the ongoing pandemic.

If you are concerned about the need for surgery, it is advisable to have a thorough discussion with your healthcare provider. They can provide you with information about the risks and benefits of surgery versus conservative management, which may include lifestyle modifications, such as avoiding heavy lifting or straining, and monitoring the hernia for any changes.

In summary, while your hernia may not currently be causing pain, it is essential to take it seriously and consider surgical intervention to prevent potential complications. Regular follow-ups with your healthcare provider will help ensure that you make informed decisions about your health and well-being.

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