Fifty percent of patients with hernias have pain. Fifty percent of patients with a hernia do not have pain. Pain is not a reliable symptom for diagnosing a hernia. The most reliable symptom for diagnosing a hernia is a reducible bulge in the groin or abdomen.
Pain prior to mesh hernia surgery is a risk factor for developing chronic hernia mesh pain. These are the patients that I most strongly recommend a non-mesh hernia repair.