ENDOSCOPIC PREPERITONEAL HERNIORRHAPHY IN PROFESSIONAL ATHLETES WITH GROIN PAIN

Introduction: Surgical exploration of the groin with subsequent hernio rrhaphy has been recommended for obscure groin pain in athletes. The p urpose of this study was to evaluate the efficacy of endoscopic preper itoneal herniorrhaphy and, if indicated, contralateral groin explorati on in professional athletes with groin pain. Patients and Methods: Eig ht professional athletes presented with groin pain and underwent endos copic preperitoneal herniorrhaphy between February 1994 and May 1996. All athletes were male with a median age of 25.1 years (range: 22-30). Seven of the athletes complained of unilateral groin pain,while one p atient had bilateral pain. Seven had undergone previous conservative t reatment without success. Despite multiple examinations, only two pati ents had been diagnosed with hernias prior to referral to the surgeon. Of the remaining six patients, all were found to have small inguinal hernias in the symptomatic groin. Seven of the patients were noted to have bilateral pathology. Results: Operative time averaged 55.3 min. A ll patients were ambulatory without significant difficulty within the first 24 h, discontinued oral narcotic use within 72 h of surgery, and were back to recreational activities within 1 week. Aerobic condition ing was resumed within a maximum of 2 weeks. Full conditioning and/or return to full competition occurred within a 2- to 3-week period. At t he time of 4 week follow-up, all athletes reported no more than minima l postexertional discomfort, with near total relief of early postopera tive symptoms. No athletes noted any impairment in their ability to pe rform at peak levels. Conclusions: Groin pain in athletes is a difficu lt problem requiring a multidisciplinary approach to diagnosis and tre atment planning. Endoscopic preperitoneal herniorrhaphy is an effectiv e treatment for obscure groin pain when the pain is associated with an inguinal hernia and allows for a short recovery time back to full. at hletic activity.