Surgery for posterior inguinal wall deficiency in athletes

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

“…Steele et al [56] showed no significant difference in outcome between subjects who had an abnormal ultrasound scan on the symptomatic side and those who had a normal scan. There was a significant difference in outcome between patients who had a bone scan with increased uptake at the symptomatic pubic tubercle and those who did not (p \ 0.04).…”

“…The bowel obstruction can develop due to adhesions between omentum or epiploic appendices and suture line, between the mesh and the intestines, e.g., by inadequate closure of a peritoneal lesion [54][55][56]. The peritoneal opening must be thoroughly closed to prevent contact of viscera with the prosthetic mesh material and to reduce the risk of bowel obstruction.…”

“…TAPP and TEP seem to be similarly effective, although there is a scarcity of data comparing both techniques directly [56].…”

“…The use of CT scans could help to identify posterior inguinal wall deficiencies and hernias in some cases [56] and may be employed in difficult cases to help define the anatomical extent of a groin injury [18]. On the other hand, MRI provided an accurate depiction of pubic bone alterations and of adjacent myotendinous structures [6,52] and also was very useful to determine the presence of inguinal hernias [6], because allows the direct visualization of the hernial sac within the inguinal canal.…”

Pubic inguinal pain syndrome: the so-called sports hernia

“…Other muscles likely to be aVected include the rectus femoris muscle and tendon. The history is a good guide to identifying muscle and tendon injury [1,2,19,20].…”