Does delaying repair of an asymptomatic hernia have a penalty?

Background: The incidence of hernia accident for inguinal hernias in men who are minimally symptomatic is sufficiently low that watchful waiting is an acceptable alternative to routine repair. Our aim was to determine whether a delay in hernia surgery affects short- and long-term outcomes. Methods: Patients from a multicenter randomized clinical trial of immediate tension-free repair versus watchful waiting for minimally symptomatic inguinal hernias were studied. Patients (n = 353) underwent tension-free repair and were classified as immediate repair (<= 6 months, N = 288) or delayed repair (> 6 months, N = 65). Results: Patients were similar at baseline with respect to age, American Society of Anesthesiologists classification, pre-existing conditions, hernia type, and hernia characteristics. Patients undergoing immediate and delayed repair had comparable surgical time, surgical complications, recurrence rates, and satisfaction with outcome. Multivariate analyses found no relation between duration until hernia repair and operative time, incidence of complications, long-term pain, or functional status. Conclusions: Delaying hernia repair in patients who are minimally symptomatic does not have an adverse effect on subsequent operation and on other outcomes. (c) 2008 Excerpta Medica Inc. All rights reserved.