Scripties UMCG - Rijksuniversiteit Groningen
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Athletes with inguinal disruption benefit from endoscopic totally extraperitoneal (TEP) repair

(2017) Bakker, W.J. (Wouter)

Inguinal disruption, a common condition in athletes, is a diagnostic and therapeutic challenge. The aim of this study was to evaluate the effect of endoscopic totally extraperitoneal (TEP) repair in athletes with inguinal disruption, selected through a multidisciplinary, systematic work-up.
An observational, prospective cohort study was conducted in 32 athletes (median age 22) with inguinal disruption. Athletes were assessed by a sports medicine physician, radiologist and hernia surgeon. An endoscopic TEP repair with placement of a polypropylene mesh was performed. The primary outcome was pain reduction 3 months postoperatively. Secondary outcomes were the resumption of sport, physical functioning and long-term pain intensity. Patients were assessed preoperatively, 3 months postoperatively and after a median long-term follow-up of 19 months.
Follow-up was completed in 30 patients. The median pain score (NRS) decreased from 8 [interquartile range (IQR) 7-8] preoperatively to 2 [IQR 0-5] 3 months postoperatively (p<0.001). At long-term follow-up the median pain score was 0 [IQR 0-3] (p<0.001). At 3 months postoperatively 60% of patients were able to complete a full training and match. The median maximum intensity of sport was 40% [IQR 20-65] preoperatively, 95% [IQR 70-100] 3 months postoperatively (p<0.001), and 100% [IQR 90-100] at long-term follow-up (p<0.001). The median frequency of sport was 4 [IQR 3-5] times per week before patients developed symptoms and 3 [IQR 3-4] times per week 3 months postoperatively (p=0.025). Three months postoperatively improvement was shown on all subscales of physical functioning.
Athletes with inguinal disruption, selected through a systematic work-up executed by a multidisciplinary team, benefit from TEP repair

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