Delaying Hernia Surgery
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Is it safe to delay hernia surgery?
No, not entirely. We generally recommend that a patient have
their hernia fixed as soon as it is practical. Below we
detail the risks
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Is there ever a good reason to delay surgery?
If you do not have insurance and you cannot afford to pay
for surgery you may have no choice. But you should really
explore all options. For children with hernias we admonish
the parents to find a way. Give up something and get your
child's hernia fixed. Adults can accept for themselves the
responsibility and the consequences of not doing something
that they know that they should do.
We usually do not recommend weight loss prior to hernia
surgery. Delaying surgery for this reason usually only
allows the hernia to grow larger and exposes the patient to
the risk of strangulation.
Medical problems may be legitimate reason to delay surgery.
This is in particular true for acute infections such as
pneumonia and bladder infections which are expected to be
cured with a short course of antibiotics. Heart problems may
also mandate delay.
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How long may surgery be delayed?
When we evaluate a patient and recommend surgery we
customarily expect this surgery to be done within one month.
Patients who ask to wait longer than this are given a
caution. A request to wait six months or more will earn the
patient a strong warning.
It is true that we have seen patients successfully evade
surgery for decades. It is also true that we have seen
patients die of a hernia that they were not even are aware
that they had.
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What are the risks of delaying hernia surgery?
Progression and strangulation are the two main
consideration.
All hernias get larger over time. They never get smaller.
This is called progression. A small hernia is easier to fix
and the recovery is shorter compared to a large hernia.
Strangulation of a hernia is the complication of a hernia
which may result in loss of life. We cannot assign a
percentage over time risk estimate for this problem.
Patients are individuals and applying a statistic to try to
manage this risk is nothing but dangerous. Something else
that makes it difficult to try to manage this risk is the
fact that you will get no warning signs before it happens.
One day you feel fine and the next you are in emergency
surgery getting your hernia strangulation repaired.
A question that I am frequently asked is "What is risk of
strangulation if I wait a few months?" This is a very
difficult question to fairly and accurately answer. The best
I can answer is with a question: Do you want something
dangerous and unpredictable hanging over your head?
