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"If It's Not Broken, Don't Fix It"

David R. Flum, MD, MPH

JAMA. 2006;295:328-329.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

Inguinal hernia is a common clinical entity, with more than 600 000 herniorrhaphy procedures performed yearly in the United States.¹ While hernias are often identified when patients notice groin discomfort, many hernias are discovered by clinicians in patients who have no or few symptoms.² The natural history of inguinal hernia is not well understood, because most hernias remain undetected and many detected hernias are surgically repaired. An unknown proportion of patients without hernia-related complaints will develop symptoms over time. While all patients with hernias have a risk of developing hernia-related complications such as incarceration or bowel compromise, there has been little evidence to quantify these risks.

When considering whether to have surgical repair for inguinal hernia, the risks and benefits of the procedure must be balanced against the risks and benefits of living with the hernia. For patients with hernia-related symptoms, this balance is most often . . . [Full Text of this Article]

Author Affiliations: Department of Surgery, University of Washington, Seattle. Dr Flum is also Contributing Editor, JAMA.

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