7 questions to ask before having inguinal hernia surgery

1. Are my symptoms really hernia symptoms or something else?

It’s important to ask your hernia surgeon if they are sure that your symptoms are from a hernia and not a muscle strain.  Muscle strains often mimic hernia symptoms. When this happens, the hernia doctor will not feel a bulge during the office visit.  Having inguinal hernia surgery for a muscle strain is not in anyone’s best interest. In our practice one in 6 patients diagnosed with a hernia elsewhere has a strain and not a hernia.  People with a muscle strain often have pain at night and even in bed. Activities like rolling over in bed or getting in and out of the car are often uncomfortable. Patients with hernias rarely every have symptoms when they are in bed at night. 

2. Do I need to have hernia surgery now?

Not necessarily!  Whether or not you need hernia surgery depends on your hernia symptoms. Recent medical research indicates that patients who have either little or no discomfort from their hernias have such a low rate of complications that surgery is not immediately necessary. In our practice , we advise about 1 in 3 patients that they can delay surgery because their hernia symptoms do not yet interfere with their lifestyle.

3. Are there non-surgical treatments for my hernia?

Maybe.  You and your hernia are unique.  Your care should be individualized to you.  Patients who have a groin strain and not a hernia need physical therapy to improve their core imbalance.  Patients who have a hernia with minimal symptoms can often safely wait to have surgery. Some patients with a diagnosed hernia can use a hernia belt or truss to delay hernia surgery, while other patients need hernia surgery soon to relieve symptoms and reduce the risk of an incarcerated hernia.  

 4. What are the treatment options for my inguinal hernia surgery?

There are dozens of surgical techniques for repairing hernias.  There are dozens of medical device companies producing hundreds of types of meshes to use in inguinal hernia surgery.  You have options.

Your hernia surgeon should be able to offer different approaches based on the type of hernia and your particular medical history.  Almost all techniques for inguinal hernia repair fall into four basic categories:

  • Suture (no-mesh) repair – Example Shouldice Repair
  • Mesh repair between the layers of the muscle – Example Lichtenstein Repair
  • Mesh repair under all the muscle layers using general anesthesia –  laparoscopic and robotic hernia repair
  • Mesh repair under all the muscle layers using local anesthesia with sedation – Our most commonly used approach at Boston Hernia.

Recent international guidelines suggest that placing the mesh under the muscles is better than placing it between the muscle layers, and that using local anesthesia is better than general anesthesia for hernia surgery.  For most patients, Dr. Reinhorn recommends placing mesh under the muscles, using local anesthesia, an approach he started using in 2003. In some situations, he recommends a no mesh repair. We have created a video demonstrating the differences, as well as a full page explanation of techniques.

 5. What should I expect my hernia surgery recovery to be like?

Hernia surgery recovery depends on the type of hernia repair you undergo.  It’s important to ask your hernia doctor about what they expect for the best and worst case scenarios for recovery.  Some patients and some repairs allow people to work the next day, while others require more time off. In our practice, 75% of working patients missed 3 or less days of work.

 6. What are the risks of inguinal hernia surgery?

This is probably the most critical question to ask.  Different repairs carry different risk. It is important to ask about the risk of chronic pain and the risk of hernia recurrence.  As hernia researchers learn more about the risk of chronic pain after inguinal hernia surgery, new recommendations and guidelines are being created to help patients.  For example, the use of a mesh plug is now considered more risky than beneficial.  

 7. How many hernia surgery operations do you do each year?

Medical literature has shown that high-volume surgeons in high-volume facilities have better outcomes than their counterparts with lower volumes.  Most general surgeons in the US perform less than 50 hernia repairs per year, about one per week on average. 



About Boston Hernia

Boston Hernia was established to enhance the hernia patient experience.  We are focused entirely on ambulatory inguinal, umbilical and epigastric hernias.  We evaluate over 1000 new hernia patients and perform close to 500 hernia operations each year.