Our Summary
This paper is about guidelines for treating groin hernias, a common condition where part of the intestine or fat pushes through a weak spot in the abdominal wall. These guidelines were created by a group of top surgeons from around the world, who worked together to review all the best research on groin hernia treatment up to mid-2015. The group’s goal was to standardize care, decrease the rate of hernias returning, and reduce chronic pain, which are the most common issues after hernia repair.
The research team found that risk factors for groin hernias include family history, being male, getting older, having abnormal collagen metabolism, having a prostatectomy, and having a low body mass index. Poor surgical techniques and inexperienced surgeons can also increase the risk of hernias returning after surgery.
For most people, a physical examination is enough to diagnose a hernia. However, in some cases, an ultrasound, a dynamic MRI or CT scan, or a herniogram might be needed.
The best treatment for groin hernias is surgery, but for men who have no or only mild symptoms, a “watchful waiting” approach could be taken, where the hernia is carefully monitored but not immediately operated on.
The type of surgery should depend on the surgeon’s expertise, the patient’s and hernia’s characteristics, and available resources. The use of mesh in repair is recommended as it has been found to be effective. However, the use of so-called low-weight mesh is not advised as it doesn’t improve long-term outcomes.
After surgery, patients should return to their normal activities as soon as they feel comfortable.
The guidelines also include recommendations for treating hernias in women, who should ideally undergo laparo-endoscopic repair to decrease the risk of chronic pain.
For patients who experience chronic pain after surgery, it is suggested that their pain be managed by a team of specialists and treated with a combination of drugs and interventional measures.
The paper concludes by emphasizing the importance of ongoing research, national registries of hernia cases, and the development of simple guidelines and sustainable strategies for treating hernias in low-resource settings. It is hoped that the guidelines will improve outcomes for patients with groin hernias worldwide.
FAQs
- What are the risk factors for developing a groin hernia?
- What is the recommended treatment for groin hernias and how does it vary based on the patient’s condition and available resources?
- What measures are suggested for managing chronic pain after hernia surgery?
Doctor’s Tip
One helpful tip a doctor might give a patient about hernia repair is to follow post-operative instructions carefully, including avoiding heavy lifting and strenuous activities for a certain period of time to allow for proper healing. It is important to listen to your body and not push yourself too hard too soon after surgery. Additionally, maintaining a healthy weight and overall lifestyle can help prevent hernias from recurring in the future.
Suitable For
Patients who are typically recommended hernia repair are those who have symptomatic hernias, meaning they experience pain, discomfort, or other symptoms related to the hernia. These patients may also have risk factors such as a family history of hernias, being male, getting older, having abnormal collagen metabolism, or having had a prostatectomy. Patients with a low body mass index may also be at higher risk for hernias.
It is important for patients to undergo a thorough evaluation by a healthcare provider to determine the best course of treatment. In some cases, a “watchful waiting” approach may be recommended for patients with no or mild symptoms. However, for most patients, surgery is the best option to repair the hernia and prevent complications.
Patients who experience chronic pain after hernia repair may also benefit from additional interventions to manage their pain. A team of specialists may be involved in the treatment of chronic pain, and a combination of drugs and interventional measures may be used to provide relief.
Overall, the guidelines recommend individualized treatment plans for patients based on their specific circumstances and risk factors. By following these guidelines, healthcare providers can improve outcomes for patients with groin hernias and reduce the risk of complications.
Timeline
In summary, before hernia repair, a patient may experience symptoms such as a bulge or pain in the groin area. They may undergo a physical examination or imaging tests to diagnose the hernia. After surgery, patients are encouraged to return to normal activities as soon as possible. For those who experience chronic pain post-surgery, a multidisciplinary approach to pain management is recommended. Ongoing research and the development of guidelines are crucial for improving outcomes for patients with groin hernias.
What to Ask Your Doctor
Some questions a patient should ask their doctor about hernia repair include:
- What type of hernia do I have and what are the potential risks associated with it?
- What are the different treatment options available for my hernia?
- How experienced are you in performing hernia repair surgeries?
- What type of surgery do you recommend for my specific case and why?
- What are the potential complications of the surgery and how likely are they to occur?
- Will I need to have mesh placed during the surgery and what are the potential risks or benefits of using mesh?
- How long will the recovery process take and when can I expect to return to my normal activities?
- What should I do if I experience chronic pain after the surgery?
- Are there any lifestyle changes I should make to reduce the risk of hernia recurrence?
- Are there any specific follow-up appointments or care instructions I should be aware of post-surgery?
Reference
Authors: HerniaSurge Group. Journal: Hernia. 2018 Feb;22(1):1-165. doi: 10.1007/s10029-017-1668-x. Epub 2018 Jan 12. PMID: 29330835