Early recovery after endoscopic totally extraperitoneal (TEP) hernia repair in athletes with inguinal disruption: A prospective cohort study

Autoři: Erwin Brans aff001;  Inge H. F. Reininga aff003;  Hans Balink aff004;  Arvid V. E. Munzebrock aff001;  Bram Bessem aff002;  Joost S. de Graaf aff001
Působiště autorů: Department of Surgery, Medical Center Leeuwarden, Leeuwarden, The Netherlands aff001;  University of Groningen, University Medical Center Groningen, Center for Sports Medicine, Groningen, The Netherlands aff002;  University of Groningen, University Medical Center Groningen, Department of Trauma Surgery, Groningen, The Netherlands aff003;  Department of Nuclear Medicine, Medical Center Leeuwarden, Leeuwarden, The Netherlands aff004
Vyšlo v časopise: PLoS ONE 14(12)
Kategorie: Research Article
doi: https://doi.org/10.1371/journal.pone.0226011



Groin pain is a common problem in athletes which results in loss of playing time. Moreover, it can be for the cause of athletic career termination. A common cause of groin pain in athletes is inguinal disruption; pain in the groin area near the pubic tubercle were no obvious other pathology exists to explain the symptoms. Aim of this study was to evaluate the effect of endoscopic totally extraperitoneal (TEP) hernia repair in athletes with inguinal disruption.


Thirty-one athletes with chronic groin pain due to inguinal disruption, who had undergone conservative therapy without any effect, were included in this prospective cohort study. Prior to surgery patients were assessed by clinical examination, ultrasound of the inguinal region, x-ray and a radionuclide bone scan with single photon-emission computed tomography and CT (SPECT-CT). TEP hernia repair was performed and a lightweight polypropylene mesh was placed pre-peritoneally. Additionally the athletes’ perception about their groin disability was assessed preoperatively and 6 weeks postoperatively by means of the Hip and Groin Outcome Score (HAGOS). The HAGOS consists of six subscales: Pain, Symptoms, Physical function in daily living, Physical function in Sport and Recreation, Participation in Physical Activities, and hip and/or groin-related Quality of Life.


No complications occurred during and after surgery. After six weeks patients improved in all the separate subscales of the Hip and Groin Outcome Score (HAGOS). Within 6 weeks of surgery, 26 patients (84%) returned to sports activities with no or less groin pain.


This study showed that endoscopic totally extraperitoneal (TEP) hernia repair is an effective surgical treatment of inguinal disruption in athletes with chronic groin pain.

Klíčová slova:

Endoscopy – Hernia – Magnetic resonance imaging – Quality of life – Sports – Surgical and invasive medical procedures – Surgical repair – Ultrasound imaging


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