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Surgery VS Watchful Waiting
Wow. So many great questions.
Scientifically, we don’t have perfect answers for everything you are asking.
Some comments limited to inguinal hernias in particular:– all hernias in women do NOT need to be repaired. Femoral hernias are the exception. Femoral hernias should be repaired if they are diagnosed, as they are at highest risk of strangulation. The timing of that repair is unclear.
– hernias that are symptomatic should be considered for surgical repair. The size is not a determinant of repair. For sure there are super small hernias that are very symptomatic, and the reverse may also be true. I routinely repair very symptomatic often debilitating hernias that are very small. They are called occult hernias. A lot of surgeons don’t agree with me. I presented my data for these naysayers: 87% cure.
– nerve blocks do not treat hernias nor their pain. In fact, in most cases, it may increase the pain. It’s a diagnostic tool
– exercise can help reduce symptoms from the hernia and/or reduce their size.
– strangulation is most risky with Bowel. Bladder does not strangulate. Rarely it can incarcerate. Fat can strangulate
– almost al the data we have about hernia outcomes is with men. A few of us are adding women to the pot.
In short, hernia repair, as with any elective surgery, is a personal decision. You must weigh its risks and benefits. If performed by an expert, the risks should be less. This is especially true for women