Endoscopic Preperitoneal Herniorrhaphy in Professional Athletes with Groin Pain

Abstract

Groin pain in athletes is a difficult problem requiring a multidisciplinary approach to diagnosis and treatment planning. Endoscopic preperitoneal herniorrhaphy is an effective treatment for obscure groin pain when the pain is associated with an inguinal hernia and allows for a short recovery time back to full athletic activity.

A Literature Review on the Role of Totally Extraperitoneal Repairs for Groin Pain in Athletes

“…2,6,9,14,[22][23][24][25][26][27] Two articles focused on osteitis pubis confirmed on MRI or bone scan. 2,27 Eight studies 6,9,14,[22][23][24][25][26] investigated a total of 196 patients. From the 8 studies (Table 1), sixty-five percent were football players.…”

“…6,9,14,23,24,26 The type of preoperative pain was not well described by any of the studies and was stated as being a dull ache or pulling sensation in 2 articles. 14,25 Pain was reported to occur at rest in 81% of patients 6,14,22,24 and had lasted between 2 and 13 months. 6,9,14,22,[24][25][26] Most studies reported an initial conservative approach incorporating measures such as rest, steroids, physiotherapy, hydrotherapy, and analgesics.…”

“…14,25 Pain was reported to occur at rest in 81% of patients 6,14,22,24 and had lasted between 2 and 13 months. 6,9,14,22,[24][25][26] Most studies reported an initial conservative approach incorporating measures such as rest, steroids, physiotherapy, hydrotherapy, and analgesics. 6,[22][23][24]26 Ninety-six percent of patients reported pain in the groin 6,9,14,22,24,26 ; other sites included the lower abdomen and pubic bone, and 29% of athletes had bilateral pain.…”

“…6,9,14,22,[24][25][26] Most studies reported an initial conservative approach incorporating measures such as rest, steroids, physiotherapy, hydrotherapy, and analgesics. 6,[22][23][24]26 Ninety-six percent of patients reported pain in the groin 6,9,14,22,24,26 ; other sites included the lower abdomen and pubic bone, and 29% of athletes had bilateral pain. 6,14,22,24,26 On examination, only 18% of patients were diagnosed with an inguinal hernia.…”

Pubic inguinal pain syndrome: the so-called sports hernia

“…The history must include questions directed at referred lumbar abnormalities, including back pain, radiculopathy and sensory disturbances [1,2,6,16,[22][23][24]27]. Night pain and persistence of pain at the rest may indicate the presence of a neoplasm.…”