Hello, The hernia does not produce symptoms unless it is large enough to protrude through the external inguinal ring. There are various precipitating factors which raise the popping loops of intestine to more prominent over the surface of the groin - Coughing - Abdomen distension as constipation - Urinary retention - Weight lifting or other strenuous activities It is best recommended to undertake the ultrasound report of the abdomen and pelvis with the size evaluation for the hernia defect involving both of the inguinal regions. The surgery is recommended in certain situation like: - Persistent discomfort - Increasing size of hernia - Patient concern - Morbid obesity - Activities requiring straining abdomen - Sudden increase pain, vomiting or signs of obstruction, incarceration Following conditions need not to be operated unless and until indicated: - Persistent small size - Absolutely no discomfort - No abdomen pressure activities - Patient concern - Absence of highly active life style - Lean and thin patient maintaining body weight Take care. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Bhagyesh V. Patel, General Surgeon