Patients are often told they 'have a hernia and need an operation at some point' — and then left wondering whether to book in next week, next month or next year. The honest answer is that most hernias can be repaired electively, but a small group truly need urgent surgery. This guide explains the difference clearly.
Elective (can plan weeks or months ahead)
- •Reducible inguinal or umbilical hernia
- •Small, asymptomatic ventral hernia
- •Long-standing stable bulge that pushes back easily
- •Hernia found incidentally on a scan
Semi-urgent (within 1–4 weeks)
- •Femoral hernia — high strangulation risk
- •Hernia that has become painful or harder to push back
- •Rapidly enlarging hernia
- •Recurrent hernia with new pain
Urgent (within 24–72 hours)
- •Hernia that cannot be reduced (incarcerated) but skin and pain are stable
- •New constant ache without systemic features
- •Patient with previous strangulation episode
Emergency — go to A&E now
- •Severe constant pain at the hernia site
- •Hernia firm, tender, red or skin discoloured
- •Nausea, vomiting or inability to pass wind/stool (bowel obstruction)
- •Fever or feeling systemically unwell
- •Sudden new bulge with severe pain
Why femoral hernias are special
Femoral hernias have a narrow neck and the highest strangulation rate of any groin hernia (15–20% within 3 months of diagnosis). They should be repaired soon after diagnosis even when symptoms are mild.