Study | Type | Patient (M/F) | Primary sport | Repair | Mesh | Operative findings | Follow-up | Clinical outcomes |
Kluin et al3 | P | 14 (13/1) | Soccer and triathletes | Transabdominal preperitoneal or extraperitoneal approach, 4 bilateral repairs | Yes | 50% hernia inguinalis; 22% hernia femoralis; 16.7% preperitoneal lipoma, 5.6% hernia obturatoria; 5.6% no obvious pathology | 1 year | 93% returned to full activity in 12 weeks |
Edelman & Selesnick29 | R | 10 (9/1) | Soccer n = 2, Basketball n = 2, other sports n = 6) | Laparoscopic repair using extraperitoneal technique with balloon peritoneum dissection | Yes | Tear or laxity of transversalis fascia | 1 year | 100% returned to full activity in 4 weeks. One patient did not improve after surgery |
Srinivasan & Schuricht103 | R | 15 (15/0) | Soccer n = 6, football n = 4, hockey n = 4, body builder n = 1 | Totally extraperitoneal procedure | Yes | Small indirect hernias | 6–8 months | 87% to full activity in 3–6 weeks |
Paajanen et al99 | R | 41 (41/0) | Soccer n = 58%, ice hockey n = 27% | Totally extraperitoneal procedure | Yes | (1) No macroscopic abnormality (59%); (2) rupture of conjoined tendon near public ramus (24%); (3) muscle asymmetry (17%) | 48 months | 94% to full activity in 4 weeks |
van Veen et al54 | P | 55 (53/2) | Soccer | Totally extraperitoneal procedure | Yes, occasional adductor release | 1) Weakness of posterior wall (63%, 7% with lymph node near internal ring and 9% with lipoma); (2) direct inguinal hernia (6%); (3) indirect inguinal hernia (31%) | 3 months | 100% to full activity at 3 months |
Susmallian et al100 | P | 35 (35/0) | Soccer | Totally extraperitoneal procedure | Yes | 1) Wide internal ring and peritoneal dimple (80%); (2) indirect hernia (11%); (3) no obvious abnormality (9%) | 15 months | 97% to full activity. Average time to return to full play was not reported |
Genitsaris et al31 | R | 131 (131/0) | Soccer | Transabdominal preperitoneal procedure | Yes | Direct hernia (62%); bilateral (31%) | Mean 5 years (range 4 months to 10 years) | 96.9% returned to full activity within 2–3 weeks |
Azurin et al36 | R | 8 (8/0) | Hockey n = 3, football n = 3, soccer n = 1, body- building n = 1 | Endoscopic preperitoneal | Yes | 100% subtle hernia; bilateral in 7 patients | 4 weeks | 100% return to full activity in 2–3 weeks |
F, female; M, male; NR, not reported; P, prospective; R, retrospective.