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Query: UMLS:C0019270 (hernia)
 15,856 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

This review is based on the results of 308 operations for unexplained, chronic groin pain suspected to be caused by an imminent, but not demonstrable, inguinal hernia: the 'sportsman's hernia' (SH). No differences in perioperative findings between cured and non-cured athletes were found. However, there was a remarkable difference between the various perioperative findings in the studies. It was characteristic that further clinical investigation of the noncured, operated athletes gave an alternative and treatable diagnosis in more than 80% of cases. Herniography was used consistently in the diagnostic process in all the studies on SH. However, in 49% of cases hernias were also demonstrated on the opposite, asymptomatic groin side. In conclusion, the final diagnosis (and treatment) often reflects the speciality of the doctor and the present literature does not supply proper evidence to the theory that SH constitutes a credible explanation for chronic groin pain.
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PMID:The sportsman's hernia--fact or fiction? 889 91

Protagonists of laparoscopic hernia repair with mesh emphasize the tension-free repair as a main advantage. Thus, conventional techniques of hernia repair with tissue approximation and suture lines are questioned. Postulated advantages of the tension-free repair are less postoperative pain, shorter labour disability, less recurrences and less complications. The results of our own patients (primary hernia n = 2025, recurrent hernias n = 897) operated with the Shouldice technique were evaluated with regard to the postulated advantages of the tension-free repair. 95% of our patients were operated under local anesthesia. The amount of analgetic drugs/patient decreased from 45% first postoperative day to 20% second postoperative day. The individual judgement of pain with a visual analogue scale decreased to zero at the second postoperative day. Chronic groin pain persisted in 1.4% after primary hernia repair and 2.6% after repair of recurrent hernias in our patients. Mobilizing the patient from the operating table the postoperative hospital stay is 3,7 days after primary hernia and 6,7 days after recurrent hernia. The length of labour disability correlated significantly with the occupation. 90% of self-employees are back at work 3 weeks postoperatively while, in the group of employers, it lasts 8 weeks. 5-year follow-up reveals a recurrence rate of 1.3% after primary hernia and 3.1% after recurrent hernia. With the Shouldice repair the modern goals of hernia surgery are feasible. Therefore, a primary tension-free repair is not a "conditio sine qua non".
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PMID:[Pro-Shouldice: primary tension-free hernia repair--conditio sine qua non?]. 896 34

Herniographies were performed on 106 outpatients with obscure groin pain. A total of 39 hernias were found in 38 patients (36%) and the 46 patients either operated on (40 patients) or who had undergone laparoscopy (six patients), included one false positive and two false negative ones. All three cases were inpatients who had earlier undergone surgery for inguinal hernia 27% of the patients with a normal clinical finding (19/70), 67% of those with previous inguinal herniotomy (8/12) and 50% of those with symptoms suggestive of hernia (12/24) had diagnostic findings on herniography. Thirteen out of the 48 women (27%) and 25 of the 58 men (43%) had positive finding at herniography. The valve of herniography was that 56 patients were spared subsequent surgical exploration because of normal herniographic finding. Our results indicate that herniography is a useful tool for the examination of patients with unexplained groin pain.
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PMID:The value of herniography in the diagnosis of unexplained groin pain. 901 58

Herniography is a useful investigation in adults with unexplained groin pain in whom there is no clinical evidence of a hernia, thus ensuring appropriate surgery. The technique is described, normal anatomy and different types of hernias illustrated.
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PMID:Herniography in the investigation of groin pain in adults. 983 82

Groin pain in the soccer athlete is a common problem accounting for 5% of soccer injuries. Groin distribution has proved to be the most common cause of groin pain. Other causes are direct trauma, ostetis pubis, muscle injuries, fractures, bursitis, hip problems, and hernia and referred pain. Soccer players with groin pain present a complex management problem that is discussed.
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PMID:Groin pain in the soccer athlete: fact, fiction, and treatment. 992 2

Chronic pain on the ventral surface of the scrotum and the proximal ventro-medial surface of the thigh especially in athletes has been diagnosed in various ways; recently, in Europe the concept of "sports hernia" has been advocated. However, since few reports discuss the detailed course of the nerves in association with the pain, we examined the cutaneous branches in the inguinal region in 54 halves of 27 adult male cadavers. From our results, in addition to the cutaneous branches from the ilioinguinal n. (in 49 of 54: 90.7%), cutaneous branches originating from the genital branches of the genitofemoral nerve were found in the inguinal region in 19 of 54 halves (35.2%). In 7 cases (in 7 of 54: 13.0%) the genital branch and the ilioinguinal nerve united in the inguinal canal. In 6 cases the genital branch pierced the inguinal lig. to enter the inguinal canal, and in three cases the genital branch pierced the border between the ligament and the aponeurosis of the obliquus externus m. to be distributed to the inguinal region. Therefore, the courses of the genital branches vary considerably, and may have a very important role in chronic groin pain produced by groin hernia. In addition, entrapment by the ligament may be a reasonable candidate for the cause of chronic groin pain.
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PMID:Anatomic basis of chronic groin pain with special reference to sports hernia. 1037 Sep 86

Groin pain in athletes is a common problem that can result in significant amounts of missed playing time. Many of the problems are related to the musculoskeletal system, but care must be taken not to overlook other more serious and potentially life threatening medical cases of pelvis and groin pain. Stress fractures of the bones of the pelvis occur, particularly after a sudden increase in the intensity of training. Most of these stress fractures will heal with rest, but femoral neck stress fractures can potentially lead to more serious problems, and require closer evaluation and sometimes surgical treatment. Avulsion fractures of the apophyses occur through the relatively weaker growth plate in adolescents. Most of these will heal with a graduated physical therapy programme and do not need surgery. Osteitis pubis is characterised by sclerosis and bony changes about the pubic symphysis. This is a self-limiting disease that can take several months to resolve. Corticosteroid injection can sometimes hasten the rehabilitation process. Sports hernias can cause prolonged groin pain, and provide a difficult diagnostic dilemma. In athletes with prolonged groin pain, with increased pain during valsalva manoeuvres and tenderness along the posterior inguinal wall and external canal, an insidious sports hernia should be considered. In cases of true sports hernia, treatment is by surgical reinforcement of the inguinal wall. Nerve compression can occur to the nerves supplying the groin. In cases that do not respond to desensitisation measures, neurolysis can relieve the pain. Adductor strains are common problems in kicking sports such as soccer. The majority of these are incomplete muscle tendon tears that occur just adjacent to, the musculotendinous junction. Most of these will respond to a graduated stretching and strengthening programme, but these can sometimes take a long time to completely heal. Patience is the key to obtain complete healing, because a return to sports too early can lead to chronic pain, which becomes increasingly difficult to treat. Management of groin injuries can be challenging, and diagnosis can be difficult because of the degree of overlap of symptoms between the different problems. By careful history and clinical examination, with judicious use of special tests and good team work, a correct diagnosis can be obtained.
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PMID:Groin injuries in sport: treatment strategies. 1049 31

A rare case of pre-vascular hernia is reported in a woman complaining of chronic obscure groin pain following an inguinal hernia repair. The condition was only diagnosed by means of a herniogram, emphasising the value of this investigation in unexplained groin pain. The hernia was successfully repaired using a polypropylene mesh plug, a simple technique widely employed in both femoral and recurrent inguinal hernia, but never before described in pre-vascular hernia.
Hernia 2001 Mar
PMID:Pre-vascular hernia: a rare cause of chronic obscure groin pain after inguinal hernia repair. 1138 26

Although athletic injuries about the hip and groin occur less commonly than injuries in the extremities, they can result in extensive rehabilitation time. Thus, an accurate diagnosis and well-organized treatment plan are critical. Because loads of up to eight times body weight have been demonstrated in the hip joint during jogging, presumably even greater loads can occur during vigorous athletic competition. The available imaging modalities are effective diagnostic tools when selected on the basis of a thorough history and physical examination. Considerable controversy exists as to the cause and optimal treatment of groin pain in athletes, or the so-called "sports hernia." There has also been significant recent attention focused on intraarticular lesions that may be amenable to hip arthroscopy. This article briefly reviews several common hip and groin conditions affecting athletic patients and highlights some newer topics.
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PMID:Hip and groin injuries in athletes. 1147 97

Groin injuries comprise 2 to 5 percent of all sports injuries. Early diagnosis and proper treatment are important to prevent these injuries from becoming chronic and potentially career-limiting. Adductor strains and osteitis pubis are the most common musculoskeletal causes of groin pain in athletes. These two conditions are often difficult to distinguish. Other etiologies of groin pain include sports hernia, groin disruption, iliopsoas bursitis, stress fractures, avulsion fractures, nerve compression and snapping hip syndrome.
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PMID:Groin injuries in athletes. 1168 83


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