How should I manage a patient presenting with a hernia, and when is surgical intervention necessary?

Appropriate management of a patient presenting with a hernia involves initial assessment to determine the type, size, symptoms, and impact on quality of life. Conservative management may be considered if the hernia is asymptomatic or minimally symptomatic. Surgical intervention is indicated when the hernia causes significant symptoms, complications such as incarceration or strangulation, or if it adversely affects the patient's daily activities and quality of life. Surgery aims to repair the defect and prevent complications.

Surgical intervention is particularly indicated when non-surgical management fails to improve symptoms or when the patient declines conservative treatment. The choice of surgical technique should be individualized, considering patient factors and the type of hernia. Shared decision-making using decision aids is recommended to discuss the benefits, risks, and possible complications of surgery, including the risk of recurrence and potential impact on urinary, bowel, and sexual function.

Postoperative follow-up is important to monitor for recurrence or complications. In cases involving mesh repair, monitoring for mesh-related complications is essential, and any adverse events should be reported to regulatory authorities.

Note: The provided guideline context primarily addresses pelvic organ prolapse and urinary incontinence management, which includes surgical decision-making principles relevant to hernia repair, such as shared decision-making, consideration of non-surgical options, and careful assessment of risks and benefits of surgery. However, specific hernia management guidelines are not detailed in the provided context.