The argument that minimally symptomatic hernias may be left unoperated upon is well supported by data described by Preshaw1 and cited in my article,2 that show irreducibility rates associated with a nonoperative approach and focus on patients with asymptomatic and mildly symptomatic inguinal hernias.
The patient described in my article2 had a painful hernia that was felt during sporting activities and affected his work.
There is a paucity of information on hernia-related risks in untreated patients with symptomatic inguinal hernias, because symptomatic patients usually have operations. In countries where that is not the case, a substantial burden of disease exists because of morbidities and deaths attributed to hernias.
Most often, surgery is indicated for an otherwise suitable patient who understands the risks, benefits and alternatives to surgery — information a surgeon should convey during the decision-making process.