When should a pediatric hernia repair be indicated?

In the context of pediatric hernia repair, intervention is generally indicated if the hernia persists beyond 3 years of age. Most pediatric inguinal hernias are diagnosed in infancy and typically require surgical repair to prevent complications, such as incarceration or strangulation. While many hernias will close spontaneously before 1 year of age, those that do not resolve by the age of 3 are less likely to close on their own, thus warranting surgical intervention.

Inguinal hernias that appear late, particularly after the age of 5, often indicate increased risk for complications and also suggest a need for evaluation and possible repair. However, the strongest guideline for intervention remains the age of 3, emphasizing that the risk of complications increases with age if the hernia persists.

Other factors, such as size of the hernia or whether it is symptomatic, may influence the urgency and necessity of repair, but the current best practice dictates addressing hernias that are not resolved by 3 years of age to mitigate risks.