When does an inguinal hernia operation absolutely have to be done?

STRANGULATION!!!: The only absolute indication for hernia surgery is when intestine gets stuck within the hernia and cannot be reduced. This requires emergency surgery to check if the blood supply to the intestine has been cut-off; sometimes we have to remove the involved intestine. Obviously, it is best to have a hernia repaired before this happens, but it is not always predictable.

Never: Even if it is a life threatening emergency, you can choose death over repair. This could be the case for someone's demented parent living in a nursing home being kept alive with machines. For a healthy 45 year old, it is also ok to observe the hernia, unless you are more of a preventative maintenance person. If the symptoms are progressive, see a general surgeon for a consultation for sure.

Yes: An ounce of prevention (hernia repair electively) is worth a pound of cure(emergent repair when strangulated bowel leads to need for life saving surgery!).

Emergency: Hernia conditions may include painful hernia incarceration or strangulation. It is noted by marked groin pain, hard painful groin mass that does not go back inside, and can have vomiting and inability to eat. Do not wait for a hernia emergency to occur. See a doctor sooner than later.