FAQs and Patient Resources

Whether your hernia should be fixed depends on what type of hernia, what symptoms you have, and what are the risks of future complications. See our section titled – “Should I get my hernia fixed”

Unfortunately not. If you have a hole in your abdominal wall, it will not close on its own without a surgery.

You may not need a surgery if (1) you don’t find the hernia bothersome; (2) your surgeon does not feel it is at a high risk of strangulation. Some people are able to use an abdominal binder to manage their symptoms as well to avoid surgery. 

Surgeons don’t typically make recommendations for surgery just based on an ultrasound for a few reasons:

1. Small hernias seen on an ultrasound are often not hernias at all, and just a small amount of fat sitting in the inguinal canal.
2. Small hernias seen on an ultrasound that cause little to no symptoms don’t always need surgery and can often be watched for many years.
3. Small hernias seen on ultrasound but cannot be felt by your surgeon are often not the cause of groin discomfort.

Most surgeons will make recommendations based on whether they (A) feel a hernia and (B) they can attribute your symptoms to your hernia.

Whether a hernia should get fixed depends on (1) what kind of hernia; (2) if it bothers you; (3) if there’s a chance that it can cause a blockage or choke off your organs (strangulation).

Small umbilical (belly button) hernias that are not bothersome do not need to be fixed.

Hiatal hernias that are not causing symptoms, or the symptoms are managed with an acid reducing medication (PPI), often do not need to be fixed.

Inguinal hernias that are not causing any symptoms or minimal symptoms do not have to be fixed and often can be watched closely (“watch and wait”), depending on your preference. Many of them will eventually get larger and require fixing, but there is no harm in waiting.  

There are situations where you might not need mesh – like very small umbilical hernias or most hiatal hernias – or where mesh might not recommended – such as infected wounds or concurrent intestinal surgery. In the majority of groin and incisional hernias, mesh is recommended as it significantly reduces the risk of recurrence. For a small subset of patients with groin hernias, a non-mesh approach can be considered after discussing with your surgeon. Check out our “Mesh and Non-Mesh Approaches” section.

Your surgeon will explain the indication, risks, and benefits of mesh and make a tailored recommendation to you.

Like other medical devices in surgery like prosthetic joints and heart valves, mesh in hernia surgery is very safe and complications are rare.

The controversies that you may have heard about for mesh are related to surgeries elsewhere in the body (urogynecology). 

For more information about mesh in hernia surgery, go to our section “Mesh and Non-Mesh Approaches in Hernia Surgery”.

If you have an umbilical or groin hernia, pain is fairly minimal and ice packs and Tylenol are generally sufficient.

If you have major open hernia surgery, you can expect mild to moderate incisional pain that will require Tylenol and opioids for a short period.

Check out our “Post-Operative Care” section for more information.

Recovery time depends on your surgery. For umbilical and groin hernias, typically you can resume your normal activities as soon as you can tolerate and most people are back to work in a few days.

If you have had a major open hernia surgery, recovery is around 4-6 weeks.

For more detailed info, go to our “Post Operative Care” section.

Lots of people are told you should avoid heavy lifting if you have a hernia – this is not true.

Exercise, improving your cardiovascular healthy, and weight loss are all important before hernia surgery and are strongly encouraged. Try aerobic exercises including walking, running, swimming, or cycling. Other exercises including weight lifting can be performed so long as it does not cause significant discomfort and it has not be restricted by your surgeon.

For exercise after surgery, check out our “Post Operative Care” section.

The ACHQC Abdominal Core Surgery  Rehabilitation Protocol also has a good guide for exercises before, during, and after your hernia surgery.

Most of the time, a bulge after a hernia surgery is a seroma, a normal collection of physiological fluid that fills the empty space left behind after we fix your hernia. Most of these will go away on their own. Sometimes, your surgeon will need to aspirate (place a needle and pull the fluid out) the seroma.

If you have a sudden bulge after coughing or heavy lifting, a bulge that is painful and tender, or a bulge with associated nausea and vomiting, your repair may have fallen apart and your hernia come back. Go to the nearest emergency department. 

A surgical drain might be left in place by your surgeon to help pull out fluid from the spaces where your hernia was fixed, to prevent buildup of fluid and improving healing.

Most small hernias (umbilical, inguinal) do not need a drain.

If you had a large hernia or complicated surgery, you may need a drain and even go home with one.

Your surgeon will give you instructions and may arrange home care for your drain. If you want to learn more about how to care for your drain, check out this video. 

The occasional twinge and ache, especially after coughing

Chronic pain, most commonly groin pain, is a rare complication after hernia surgery (1-5%).

Most of the time, surgeons will advise waiting up to 3 months after your surgery. That allows any sutures that are causing tugging or nerve pain to be dissolve. During that time, your surgeon will likely suggest multimodal analgesia, using a combination of acetaminophen, NSAIDs, and neuropathic (targeting nerve pain) medications to manage your symptoms.

If you have pain that persists after 3 months, then you may need more tests and procedures.

Some of the causes of chronic pain include:

• Partial nerve injury or nerve erosion/irritation from a foreign body (mesh, suture, tack)
• Mesh folded up or migrating
• Metal tacks or permanent sutures tugging at tissue causing pain
• Hernia recurrence

Things that can be done to address nerve pain include:

• Medications (multimodal) – acetaminophen, NSAIDs, neuropathic medications (pregabalin, gabapentin)
• Nerve blocks – injecting long acting analgesia to numb the nerves in the area. Can be done temporarily or permanently
• Reoperative surgery to remove mesh or tacks
• Neurectomy – a surgery where the nerves leading to the area of chronic pain are isolated and divided, removing the pain and leaving you with decreased sensation. 

If you have chronic pain, speak to your surgeon. Sometimes, you may need to be referred to a specialized hernia center.