Current status of inguinal hernia management: A review

Groin hernias are the most common reason for primary care physicians to refer patients for surgical management. Patients often present with a bulge in the groin that is associated with pain in two-thirds of cases. Diagnosis is usually clinical, with physical exam and history being sufficient enough to confirm diagnosis without imaging. Groin hernias may be associated with morbidity and can become complicated by incarceration or strangulation, requiring emergent surgical repair. However, the risk of strangulation is sufficiently low in asymptomatic or minimally symptomatic patients with inguinal hernias that an initial approach of watchful waiting is safe and appropriate. Chronic pain and hernia recurrence are other potential complications that support a watchful waiting approach in asymptomatic patients. Patients with symptomatic hernias should be offered surgical repair. The objective of this paper is to review the current status of the clinical diagnosis and management of patients with inguinal hernias.