Groin Hernias in Adults

Abstract

Key Clinical Points Groin Hernias in Adults Groin hernias are much more common in men than in women. Patients with symptoms of acute incarceration and strangulation require emergency surgery. Watchful waiting is a safe approach for asymptomatic male patients with inguinal hernia, but data from randomized trials suggest that the majority of men will ultimately be referred for surgery, primarily because of pain, within 10 years. For an uncomplicated unilateral inguinal hernia, open repair has the advantages of potentially being performed under local anesthesia and incurring lower initial costs; laparoscopic repair results in less postoperative pain and an earlier return to normal activities, but it requires general anesthesia routinely and carries a small risk of major intraabdominal injury. Femoral hernias occur more often in women than in men, are associated with much higher risk of strangulation, and can be difficult to distinguish from inguinal hernias; watchful waiting is not recommended in women.