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Watchful waiting

BMJ Group Medical Reference

Introduction

This information is for people who have a hernia. It tells you about watchful waiting, a treatment used for hernias. It is based on the best and most up-to-date research.

Does it work?

We don't know what the effect of watchful waiting is for most people who have a hernia. Most people have an operation straight away.

What is it?

Most people who have a hernia are advised to have an operation to repair it. But if your hernia is small and doesn't hurt, you might want to wait a while and see what happens.

Your hernia won't go away. There's not much research to say what will happen. [43] But there are three possibilities:

  • It might stay the same, and not cause you any more problems

  • It might get bigger, or start to hurt

  • You might have a serious complication, where the hernia gets trapped and the blood supply is cut off. This is called a strangulated hernia. If this happens, you will need an emergency operation to repair it.

How can it help?

If your hernia isn't bothering you, and you wait rather than having a hernia operation straight away, you may be able to avoid having surgery at all.

We found one study that looked at 720 men who had a small hernia that wasn't causing them many problems. [44] Half had open surgery to repair the hernia straight away, while the others waited to see what happened.

During the next two years, 23 in 100 men who waited eventually decided to have the operation because the hernia started to hurt. One man got a strangulated hernia and needed an emergency operation.

But 77 in 100 men who waited didn't feel the need to have an operation. At the end of the two years, they felt as well as the men who had undergone surgery straight away, and didn't have any more pain.

Another study looked at 160 men with small hernias. It compared men who had surgery straight away with men who waited to see what happened. [45] Over one year, 29 in 100 men who waited decided to have an operation. Those who didn't have the operation had no more pain than men who had surgery straight away. But men who had surgery straight away were more likely to feel better about life overall.

Long-term results showed that just over half of the men had surgery within eight years. The main reasons were that the hernia had become painful, although two of the men needed an emergency operation. [46]

How does it work?

Some hernias are small, don't hurt, and don't get worse. If it's possible to live with a hernia like this, you can avoid having an operation. Unfortunately, we can't say for sure which hernias will get worse.

Last Updated: October 07, 2013
This information does not replace medical advice.  If you are concerned you might have a medical problem please ask your Boots pharmacy team in your local Boots store, or see your doctor.

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