I have had an epigastric hernia for several months, the bulge is about 2.5 -3 inches in diameter and not painful except for occasionally a mild burning sensation. I am 60 yo and run/walk ultra marathons and do cardio exercise up to 1.5-2 hours/day, 4-5 days/week, with no problems related to the hernia. I can manually push the bulge back in. Is elective surgical repair without mesh an option or is it likely the area needing repair is much larger under the skin and it would be better to use mesh? If mesh is needed, is polypropolene the best choice? Would it be prudent to wait on surgery because of the smaller size, the location - center and high up on the abdomen and is it less likely to become estrangulated because of these factors? I am thinking the surgery and adhesion formation/incarceration risks are high when compared to just waiting and watching. My doctors say it is only likely to increase in size but there has been no change in 7 months. I do not want to subject myself to dire unnecessary medical problems if I can live with it as it is but how likely is it that it won t develop into an emergency. Ultimately how do I know which decision to make? It seems an unknown gamble either way.