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Evidence summaries

Watchful Waiting Vs Repair of Inguinal Hernia in Men

A strategy of watchful waiting appears to result in similar quality of life outcomes at 2 years compared with quick surgical repair in minimally symptomatic men with inguinal hernia. Complications during watchful waiting are very rare. Level of evidence: "B"

A randomized trial 1 included 720 men with minimally symptomatic inguinal hernias. Participants were randomly assigned to watchful waiting (WW) or to receive standard Lichtenstein open tension-free surgical repair (SR). The primary intention-to-treat outcomes were similar at 2 years: pain limiting activities, 5.1% WW vs 2.2% SR, p=0.52; improvement over baseline of the physical component score of the Short Form-36 version 2 health related quality of life survey, 0.29 points WW vs 0.13 points SR, p=0.79. 23% of men in the WW group crossed over to SR, and 17% in the SR group crossed over to WW. Only one WW patient had acute hernia incarceration within 2 years, and another had acute incarceration at 4 years.

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    References

    • Fitzgibbons RJ Jr, Giobbie-Hurder A, Gibbs JO, Dunlop DD, Reda DJ, McCarthy M Jr, Neumayer LA, Barkun JS, Hoehn JL, Murphy JT, Sarosi GA Jr, Syme WC, Thompson JS, Wang J, Jonasson O. Watchful waiting vs repair of inguinal hernia in minimally symptomatic men: a randomized clinical trial. JAMA 2006 Jan 18;295(3):285-92. [PubMed]

Primary/Secondary Keywords