Pubic Magnetic Resonance Imaging Findings in Surgically and Conservatively Treated Athletes with Osteitis Pubis Compared to Asymptomatic Athletes during Heavy Training

Abstract

This study indicated that the placement of retropubic mesh was an efficient method for the treatment of severe pubic enthesopathy in athletes. Abnormal magnetic resonance imaging findings were also common in asymptomatic athletes, which decreases the value of magnetic resonance imaging in surgical decision-making.

Guidelines for laparoscopic (TAPP) and endoscopic (TEP) treatment of inguinal Hernia [International Endohernia Society (IEHS)]

“…They should be retracted and eventually resected, because they may become symptomatic or mimic a recurrent hernia [49]. An overlooked lipoma is one of the known reasons for ''recurrence'' [50]. Although the published data provide low evidence, the search for and exclusion of such masses is integral part of the endoscopic hernia repair [51,52].…”

“…Greenberg et al [50] concluded after a systemic review of laparoscopic and open repair of inguinal hernia that a shorter recovery time and shorter off work period after laparoscopic hernia repair could compensate for the increased hospital expenditures. Kapiris et al [24] reported that the operation expenses can be reduced by eliminating the need for a fixation device.…”

“…In the current literature on endoscopic groin hernia repair, insufficient or no data are available about the relationship between pain and the management of strangulated and incarcerated hernias, port defects, scrotal hernias, and cord lipomas. Although several publications have reported on pain and nerve management in open groin hernia surgery [48][49][50][51][52][53], no data are available on nerve manipulation and pain in endoscopic hernia repair. …”

“…It should be considered that abnormal magnetic resonance imaging findings are common in asymptomatic athletes, which decreases the value of magnetic resonance imaging in surgical decision-making [50]. …”

“…During the operation, the inguinal canal should be thoroughly explored to find the different entities that could be detected during surgery, such us a true inguinal hernia, wide internal ring and peritoneal dimple [57], hernia femoralis [35], preperitoneal lipoma [59], hernia obturatoria [35], prevascular hernia [3], obvious musculotendinous tear [50], muscle asymmetry [50], or a significant bulge in the posterior wall [40]. Even if no clear pathology is identified, reinforcement of the wall using a mesh offers good clinical results for athletes with idiopathic groin pain [60], although other authors have recommended not using the mesh in these cases [33].…”