Surgery · 3 h ago
Long-term follow-up adherence was low during watchful waiting for inguinal hernia
A retrospective cohort study of 400 patients in an inguinal hernia watchful-waiting protocol found that 60% did not maintain scheduled surveillance. No emergency operations were identified among patients who remained under institutional follow-up or those successfully contacted after dropping out.
- 60% discontinued scheduled long-term surveillance.
- Younger patients had higher rates of follow-up discontinuation.
- No emergency operations were identified in traced patients.
- Survey response among those lost to follow-up was 32%.
Watchful waiting is an established option for selected patients with asymptomatic or mildly symptomatic inguinal hernia, but it depends on ongoing follow-up. This retrospective cohort included 400 patients enrolled in a surveillance protocol from May 2013 to May 2026. Visits were scheduled every six months during the first year and annually thereafter. Patients lost to follow-up were contacted using a structured questionnaire.
By the end of the study, 240 patients (60.0%) had stopped attending scheduled surveillance, with attrition increasing over time. Discontinuation was associated with younger age: rates were 92.9% among patients younger than 30, 63.6% among those aged 30–50, and 56.4% among those older than 50 (p=0.015). Of the patients who discontinued, 77 (32%) responded to the survey. They most often cited having no symptoms (36%) or not knowing the recommended follow-up intervals (27%). Eleven respondents (14.1%) reported elective repair at another institution.
No emergency surgery was identified among patients still followed by the institution or those successfully contacted after discontinuation. The findings support watchful waiting as an acceptable strategy in selected patients, but highlight difficulty sustaining surveillance. Interpretation is limited by the retrospective, single-protocol cohort and low survey response; the results do not establish outcomes for patients who could not be contacted.
In practice
For clinicians managing selected patients with asymptomatic or oligosymptomatic inguinal hernia, this cohort highlights that scheduled follow-up may not be sustained: 60% of 400 patients discontinued surveillance, with the highest dropout among those younger than 30. Patients commonly reported no symptoms or lack of awareness of follow-up intervals. No emergency operations were identified among patients retained or successfully contacted, but this does not establish safety for those who could not be reached. The retrospective findings and 32% survey response do not justify changing management, but indicate that follow-up expectations should be clearly communicated.
AI-generated clinical interpretation · Not editor-reviewed
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Surgical Endoscopy: Long-term follow-up in asymptomatic or oligosymptomatic inguinal hernias: watchful or watchless waiting? ↗This is an automated AI-condensed summary that has not yet been reviewed by an editor. Always consult the full item at the original source.