Tom Reeve Academic Surgical Clinic  ·  St Leonards

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Thomas J. HughSpecialist Hepato-Biliary & General Surgeon
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Patient resources · Hernia treatment

How do I know if I need hernia surgery?

A hernia can often be diagnosed from the history and examination, with imaging used when the diagnosis is uncertain. Some hernias can be observed, while pain, enlargement, functional limits and the type of hernia may support repair after individual assessment.

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/ 01Overview

How can I tell whether a lump is a hernia?

A hernia often forms a groin, belly-button or scar-site lump that becomes more obvious when standing, coughing or straining and may reduce when lying down. Muscle separation, lymph nodes and other lumps can look different, so examination establishes the likely diagnosis.
/ 02Patient information

Can a hernia go away by itself?

An established abdominal wall defect usually remains, although its lump and symptoms can vary. Observation can still be reasonable for selected hernias with few symptoms. Support garments may improve comfort for some people but do not close the defect.
/ 03Patient information

When is observation an option?

Observation may suit selected men with minimally symptomatic inguinal hernias and some small abdominal wall hernias after assessment. Follow-up should cover changes in pain, size and reducibility, along with circumstances that should prompt earlier review.
/ 04Patient information

When may repair be considered?

Repair may be considered when pain, enlargement or activity limits outweigh operative risks, or when the hernia type carries a different clinical concern. The choice between open and keyhole repair, and whether mesh is used, depends on anatomy, prior surgery and health.
/ 05Patient information

Which symptoms require urgent assessment?

A suddenly painful lump that cannot be reduced, especially with vomiting, abdominal swelling or inability to pass stool or wind, requires urgent assessment. These symptoms can occur when bowel is trapped. Emergency services or an emergency department can arrange immediate evaluation.
/ 06Patient information

What risks come with repair?

Material risks include bleeding, infection, fluid collection, recurrence, persistent pain or numbness, mesh-related complications when mesh is used, injury to nearby structures, blood clots and anaesthetic complications. Frequency and personal impact vary by operation and patient.
/ 07Common questions

Several conditions can cause a groin lump. Clinical examination, and imaging when needed, identifies the likely cause.

Exercise can support general strength and function but does not close an established abdominal wall defect.

Many people continue usual activity according to comfort during observation. Increasing pain, enlargement or difficulty reducing the lump should prompt review.

Mesh is commonly considered for adult hernia repair, while technique and material depend on the hernia, contamination risk, prior surgery and individual factors.

Rectus divarication is widening between the central abdominal muscles rather than a true hernia defect. Examination helps distinguish the two.

/ 08Evidence and review

What evidence supports this information?

Current independent guidelines provide the main basis for treatment information. Professor Hugh’s publications are listed separately as research and practice context, with the limits of each study stated.

Independent guidelines and reviews

  1. International guidelines for groin hernia management. HerniaSurge guidance covering observation, repair approaches, mesh, recovery and chronic pain. Recommendations require individual assessment.
  2. Update of the international HerniaSurge guidelines for groin hernia management. The 2023 update reviews newer evidence while identifying areas where certainty remains low.

Research involving Professor Hugh

These publications provide research and practice context. Their design, population and age limit how broadly each finding can be applied.

  1. Hugh et al. Divarication or incisional hernia? (1991). A clinical test report concerning diagnosis. Its age and scope limit broader treatment conclusions.
  2. Hugh. Getting a grip on the hernia literature (2020). An editorial perspective rather than a systematic review or treatment guideline.
  3. Groin-MAP outcomes measurement study (2023). A consensus-based project concerning outcome measurement. It does not compare treatment effectiveness for an individual.

Reviewed by Professor Thomas J. Hugh, MBBS, FRACS, MD

Published 25 August 2026. Last reviewed 25 August 2026.

/ 09Related reading

Last updated 25 August 2026