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

2013 ◽  
Vol 97 (4) ◽  
pp. 327-334 ◽  
Author(s):  
Muhammad R. S. Siddiqui ◽  
Makysym Kovzel ◽  
Stephen Brennan ◽  
Oliver H. Priest ◽  
Shaun R. Preston ◽  
...  

Abstract A literature review was made on the role of totally extraperitoneal (TEP) hernia repairs for groin pain in athletes. Electronic databases were searched for literature published from January 1993 to November 2011. There were 10 articles incorporating 196 patients included in this review. Thirty percent of patients were reported to have direct inguinal hernias, 22% had indirect inguinal hernias, and 41% had dilated internal rings. Of note, 30% of cases had no macroscopic abnormality. Four studies reported on an early follow-up ranging between 3 and 6 weeks. Only minimal or mild symptoms were reported. Up to 33% of patients had impaired ability to perform at peak levels. Up to 53% of patients had persistence of symptoms at the early follow-up. Total follow-up time ranged from 3 to 80 months, and most patients were active (90%–100%). At long-term follow-up, 3% to 10% were unable to play, and 5% were reported as being unable to train. Two studies from the same center reported on TEP surgery for osteitis pubis, and most patients returned to sporting activity after 4 to 8 weeks. TEP repair is a good operative intervention in athletes with chronic groin pain not relieved by conservative measures. Athletes recover quickly and return to sport early.

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
Z Hashmi ◽  
R Ahmed ◽  
T Zafar ◽  
M Ahmed ◽  
N Yousaf ◽  
...  

Abstract Objective To prove Inguinal mesh hernioplasty under L/A is safe and acceptable. Helps with post-operative pain and enables rapid recovery as a day case. Method All patients who underwent inguinal hernia repair under local anaesthesia were retrospectively analysed in our hospital between July 2014- July 2017. Clinical judgement was used for inclusion and exclusion parameters. Results From July 2014- July 2017, 260 patients were included in study who underwent Inguinal mesh hernioplasty under L/A. ASA grade for all patients ranged between I-III. The mean age was 37 (20-65). Intraoperatively (9.1) 3.5% patients had problems such as pain, hypotension or sweating. About (86.3%) 224 patients were discharged home the same day and remaining stayed overnight for less than 24 hours. Hematoma was seen in 5 (1.92%) patients, Urinary retention in 2 (0.7%) patients, Wound infection seen in 24(9.2%) patients, Readmission in 10 (3.8%) patients. Chronic groin pain was seen in 10 (3.9%) patients and no recurrence on 6 months follow up. Conclusions Our results showed that this procedure is feasible under L/A and can be performed safely. It showed satisfactory acceptance by the operating surgeon and patient, without significant perioperative issues. It is reliable and showed shorter hospital stay.


2016 ◽  
Vol 10 (6) ◽  
pp. 990-1011 ◽  
Author(s):  
Judith A. Meiklejohn ◽  
Alexander Mimery ◽  
Jennifer H. Martin ◽  
Ross Bailie ◽  
Gail Garvey ◽  
...  

2018 ◽  
Vol 5 (3) ◽  
pp. 1083
Author(s):  
Samrat Sunkar ◽  
Dick B. S. Brashier ◽  
Kiran Bhagwat ◽  
Vipin Sharma ◽  
Piyush Angrish

Background: Residual neuralgia, called as Inguinodynia, is an important complication unique to groin hernia repair. The reported incidence ranges between 9-63%. The symptoms are potentially disabling. Symptoms are often more pronounced on axial twisting of body. Methods for prevention include identification and preservation of all nerves, Ilioinguinal Neurectomy and triple Neurectomy during surgery.Methods: One hundred patients underwent elective unilateral Lichtenstein’s tension free hernioplasty. 50 patients were subjected to elective ilioinguinal neurectomy. The remaining underwent standard Liechtenstein’s mesh hernioplasty, without ilioinguinal neurectomy. Randomization was achieved by allocating alternate patients to each group - prophylactic neurectomy, or nerve preservation. All patients, during each review were asked to fill out a Pain Disability Questionnaire to assess sensory loss and pain disability objectively.Results: At completion of 6 monthly follow up pain at rest (none in group ‘A’ compared with 3 in group ‘B’), after coughing 5 times (none in group ‘A’ compared with 7 in group ‘B’), after climbing 4 flights of stairs(3 in group ‘A’ compared with 16 in group ‘B’) and after cycling for 20 minutes (11 in group ‘A’ compared with 22 in group ‘B’) were all significantly lesser in the neurectomy group as compared with the non neurectomy group. More importantly, exertional chronic pain incidence at 6 months was significantly less in group ‘A’.Conclusions: It was concluded that pain after inguinal mesh hernioplasty is a cause of morbidity, pain was complained of by a significantly larger number of non-neurectomised patients at 6 months of follow-up, prophylactic ilioinguinal neurectomy is associated with reduced exertional chronic groin pain, disability caused by pain after inguinal hernioplasty, is significantly reduced by ilioinguinal neurectomy and an extremely significant reduction in the requirement of medication is brought about by neurectomy compared with controls. 


Brachytherapy ◽  
2020 ◽  
Author(s):  
Raquel Dávila Fajardo ◽  
Bradley R. Pieters ◽  
Jim C.H. Wilde ◽  
Hugo A. Heij ◽  
Rafal Chrzan ◽  
...  

2019 ◽  
Vol 185 (7-8) ◽  
pp. e1298-e1299
Author(s):  
Jackson P Beall ◽  
Joshua J Oliver ◽  
Rachel E Bridwell ◽  
Scott E Young

Abstract Osteitis Pubis (OP) is groin pain caused by overloading stresses on the pubic symphysis. This is often caused by the repetitive stress seen in competitive sports, but can also be caused by rapid acceleration or deceleration. It is a diagnosis of exclusion made after other entities such as fracture or infection are ruled out. It is often treated conservatively with rest, Non-Steroidal Anti-inflammatories (NSAIDS), and Physical Therapy (PT). After these treatment modalities have failed, intra-articular injection with local anesthetics and steroids can be considered. We report a case of a 22-year-old Male Active Duty Army Soldier who presented with OP immediately after landing during a routine Airborne Jump exercise. The Soldier reported landing in such a way that his feet did not impact the ground at the same time, creating a sheering force on his pelvis. Following two months of failed treatment involving NSAIDS and PT, the patient was referred to Sports Medicine where he received an injection of 1 mL of 1% lidocaine and 40 mg of triamcinolone into the pubic symphysis joint space. Shortly afterward the patient endorses complete resolution of his symptoms without return of symptoms at 1-month follow-up. Although injection of the pubic symphysis with local anesthetic and steroids has been previously described, this is the first time it has been described in a jump injury.


Author(s):  
Samarra Mongi Kaabi ◽  
Ahmad Nasser Madkhali ◽  
Naif Hussain Alqahtani ◽  
Ammar Adel Bakhsh ◽  
Yousef Hussain Alharthi ◽  
...  

Computed tomography (CT) of the chest has been previously reported as an efficacious approach for the early diagnosis and suspicion of COVID-19 infection, as diagnosis with other modalities is usually time-consuming and cannot detect the disease within the early stages. Many pulmonary manifestations have been previously observed under CT imaging of the chest. All of them have been linked with the different stages of the disease, indicating their abilities to diagnose and follow-up these patients.This present literature review aims to discuss the role of CT imaging of the chest in COVID-19 infections and it also aims to elaborate the common pulmonary manifestations that can be frequently observed to help with the diagnosis and prognosis of the disease. Moreover, ground-glass opacities (GGOs) have been reported among studies in the literature to be the most common findings as they remain the earliest among other diseases. The literature review also aims to invistagate whether GGOs can fade away or progress to consolidate in order to decide the prognosis of the disease and to identify the severity of cases. Consolidations have also been previously stated among studies in the literature as frequent pulmonary manifestations affecting patients with COVID-19 infections and are estimated to be present in 2-63% of patients with COVID-19 infections. Other pulmonary manifestations might also include bronchiectasis, lymphadenopathy, nodules, pleural effusion or thickening, and halo sign.


2021 ◽  
Vol 8 (3) ◽  
pp. 904
Author(s):  
Ramesh S. Koujalagi ◽  
Vinod Karagi ◽  
Abhijit S. Gogate ◽  
Nikhil M.

Background: Inguinal hernia, the most frequently occurring type of hernia globally, Chronic groin pain could be related to nerve mangling while operating. Mesh repair can lead to an inflammatory reaction over a period of time, though it still needs ground work to find out exact cause of pain. So this study aims to compare the effectiveness of polyglactin versus prolene sutures in reducing the post-operative pain in inguinal hernia repair.Methods: A one year hospital prospective study in KLE hospital. A total of 60 adult patients were divided into two groups of 30 each. Mesh fixation with polyglactin sutures was group A (30) and mesh fixation with polypropylene sutures was group B (30) and then post-operative pain, was assessed. Follow-up was for 3 months. Collected data was analyzed using chi–square tests, Mann-Whitney U tests.Results: Our analysis showed that the incidence of postoperative groin pain with mean severity scores of 1.37±0.49 versus 1.43±0.50; 1.40±0.50 versus 1.57±0.73; 1.03±0.61 versus 1.50±0.057; 0.77±0.63 versus 1.30±0.79; at post-operative day 1, 3 in both groups were similar and statistically not significant whereas the 1 week and 3 months follow up in group A and B respectively, were significant (p<0.05).Conclusions: The post-op chronic groin pain is significantly low, hence routine usage of polyglactin sutures to fix a mesh is a safe and effective alternative to polypropylene sutures in Lichtenstein hernia repair.


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