A child with one inguinal hernia has an increased risk of developing another one on the opposite side. Opinion is divided about exploring the asymptomatic side at the time of unilateral hernia repair. The operation consists of tying off the sac at the internal ring, to close the open processus. Unlike adults, children do not routinely need to have the hernia floor closed. The operation is generally performed on an outpatient basis.
Some pediatric surgeons prefer to operate on all inguinal hernias whenever they are diagnosed.
However, in the absence of symptoms, many recommend a delay until three months of age for term infants and longer for premature infants. The very young are at risk for breathing difficulties following general anesthesia. When surgery is necessary these infants must be watched in the hospital overnight. Unlike hernias, hydroceles may resolve within the first year of life. After that year, a hydrocele that persists or develops should be repaired because the narrow sac can widen and turn into a hernia.