Epidemiology and Etiology of Primary Groin Hernias

  • Brian M. StephensonEmail author


The population prevalence (the percentage of a population being studied that is affected with a particular disease at any given time) and the incidence (the rate of occurrence of new cases of a particular disease in a population being studied) of groin hernias have been studied extensively by a variety of authors in the last 100 years [1]. In developed countries the incidence of operations for groin hernia is approximately 2000 operations per million population per year [2]. Nationwide information on the relation between the number of procedures performed per year and the rates of incidence of groin hernia have been more difficult to establish. However, the 1981/1982 morbidity statistics from general practice (third national study) estimated that approximately the same number of new hernias was diagnosed annually by general practitioners as the number of patients consulting their doctors with existing hernias [3]. This clearly suggests that a large number of groin hernias are not referred for definitive surgical treatment and that the prevalence is far higher than the annual incidence of operation. A survey in Somerset and Avon Health Authority in the UK of a stratified random sample of 28,000 adults aged over 35 enquired about lumps in the groin and invited those indicating positive replies to attend for interview and examination. The results revealed that of the hernias discovered, one third of patients had not consulted their primary care physician and of the two thirds that had seen their primary care physician, less than half had been referred to a surgeon for a decision on definitive management. Interestingly of the third of patients who had not consulted their general practitioner, two thirds said they would accept an operation if this was advised. Of the patients who eventually reached a surgeon, 20% were advised that operation was not required. These findings suggest that there is an unmet need for groin hernia surgery with many patients being denied access by their family doctor. Once referred, surgeons seem to act as gatekeepers and may indeed “cherry-pick.” Finally, there certainly appears to be a need for patient education in terms of the potential dangers of having a groin lump. Nevertheless, it is estimated that the number of groin herniorrhaphies done worldwide annually exceeds 20 million [4] and the lifetime risk of groin hernia is 27% for men and 3% for women [5].


  1. 1.
    Rutkow IM. Epidemiologic, economic, and sociologic aspects of hernia surgery in the United States in the 1990s. Surg Clin N Am. 1998;78:941–51.PubMedPubMedCentralCrossRefGoogle Scholar
  2. 2.
    Bay-Nielsen M, Kehlet H. Establishment of a national Danish Hernia data-base: preliminary report. Hernia. 1999;3:81–3.CrossRefGoogle Scholar
  3. 3.
    Royal College of General Practitioners, OPCS 1981–82. Morbidity statistics from general practice. Third national study. London: HMSO; 1986.Google Scholar
  4. 4.
    Bay-Nielsen M, Kehlet H, Strand L, Malmstrom J, Andersen FH, Wara P, Juul P, Callesen T. Prospective nationwide quality assessment of 26,304 herniorrhaphies in Denmark. Lancet. 2001;358:1124–8.PubMedPubMedCentralCrossRefGoogle Scholar
  5. 5.
    Primatesta P, Goldacre MJ. Inguinal hernia repair: incidence of elective and emergency surgery, readmission and mortality. Int J Epidemiol. 1996;25:835–9.PubMedPubMedCentralCrossRefGoogle Scholar
  6. 6.
    Williams BT, Nicholl JP, Thomas KJ, Knowlenden J. Differences in duration of stay for surgery in the NHS and private hospitals in England and Wales. Br Med J. 1985;290:978–80.CrossRefGoogle Scholar
  7. 7.
    Cheek C, Black NA, Devlin HB, Kingsnorth AN, Taylor RS, Watkins D. Systematic review on groin hernia surgery. Ann R Coll Surg Engl. 1998;80(Suppl 1):S1–80.PubMedPubMedCentralGoogle Scholar
  8. 8.
    Law NW, Trapnell JE. Does a truss benefit a patient with inguinal hernia. Br Med J. 1992;304:1092.CrossRefGoogle Scholar
  9. 9.
    Williams M, Frankel S, Nanchalal K, Coast J, Donovan J. Hernia repair: epidemiologically based needs assessment. Bristol: Health Care Evaluation Unit, University of Bristol Print Services; 1992.Google Scholar
  10. 10.
    Andrews NJ. Presentation and outcome of strangulated external hernia in a district general hospital. Br J Surg. 1981;68:329–32.PubMedPubMedCentralCrossRefGoogle Scholar
  11. 11.
    Coulter A, McPherson K. Socioeconomic variations in the use of common surgical operations. Br Med J. 1985;291:183–7.CrossRefGoogle Scholar
  12. 12.
    Barwell NJ, Schumpelick V, Wantz GE, editors. Inguinal Hernia Repair. Basel: Karger; 1995.Google Scholar
  13. 13.
    Nilsson F, Anderberg B, Bragmark M, Eriksson T, Fordell R, Happaniemi S, Heuman R, Kald A, Stubberod A, Svensson P. Hernia surgery in a defined population: improvements possible in outcome and cost-effectiveness. Ambul Surg. 1993;1:150–3.CrossRefGoogle Scholar
  14. 14.
    Schumpelick V, Treutner KH, Arit G. Inguinal hernia repair in adults. Lancet. 1994;344:375–9.PubMedPubMedCentralCrossRefGoogle Scholar
  15. 15.
    Hair A, Duffy K, McLean J, Taylor S, Smith H, Walker A, Macintyre IMC, O’Dwyer PJ. Groin hernia repair in Scotland. Br J Surg. 2000;87:1722–6.PubMedPubMedCentralCrossRefGoogle Scholar
  16. 16.
    Schoots IG, van Dijkman D, Butzelaar RMJM, van Geldere D, Simons MP. Inguinal hernia repair in the Amsterdam region 1994–1996. Hernia. 2001;5:37–40.PubMedPubMedCentralCrossRefGoogle Scholar
  17. 17.
    Penttinen R, Grunroos JM. Mesh repair of common abdominal hernias: a review on experimental and clinical studies. Hernia. 2008;12:337–44.PubMedPubMedCentralCrossRefGoogle Scholar
  18. 18.
    Rutkow IM, Robbins AW. Demographic, classificatory, and socio-economic aspects of hernia repair in the United States. Surg Clin N Am. 1993;73:413–26.PubMedPubMedCentralCrossRefGoogle Scholar
  19. 19.
    Seymour DG, Garthwaite PH. Age deprivation and rates of inguinal hernia surgery in men. Age Aging. 1999;28:485–90.CrossRefGoogle Scholar
  20. 20.
    Sanders DL, Porter CS, Mitchell KC, Kingsnorth AN. A prospective cohort study comparing the African and European hernia. Hernia. 2008;12:527–9.PubMedPubMedCentralCrossRefGoogle Scholar
  21. 21.
    Milamed DR, Hedley-White J. Contributions of the surgical sciences to a reduction of the mortality rate in the United States for the period 1968 to 1988. Ann Surg. 1994;219:94–102.PubMedPubMedCentralCrossRefGoogle Scholar
  22. 22.
    London JA, Utter GH, Sena MJ, Chen SL, Romano PS. Lack of insurance is associated with increased risk for hernia complications. Ann Surg. 2009;250:331–7.PubMedPubMedCentralCrossRefGoogle Scholar
  23. 23.
    Keith A. On the origin and nature of hernia. Br J Surg. 1924;11:455–75.CrossRefGoogle Scholar
  24. 24.
    Zimmerman LM, Anson BJ. Anatomy and surgery of hernia. 2nd ed. Baltimore: Williams and Wilkins; 1967. p. 216–27.Google Scholar
  25. 25.
    Iles JDH. Specialisation in elective herniorrhaphy. Lancet. 1965;1:751–5.PubMedPubMedCentralCrossRefGoogle Scholar
  26. 26.
    Harvald B. Genetic epidemiology of Greenland. Clin Genet. 1989;36:364–7.PubMedPubMedCentralCrossRefGoogle Scholar
  27. 27.
    Belcher DW, Nyame DK, Wurapa FJ. The prevalence of inguinal hernia in adult Ghanaian males. Trop Geogr Med. 1978;30:39–43.PubMedPubMedCentralGoogle Scholar
  28. 28.
    Abramson JH, Gofin J, Hoppe C, Makler A. The epidemiology of inguinal hernia. A survey in Western Jerusalem. J Epidemiol Community Health. 1978;32:59–67.PubMedPubMedCentralCrossRefGoogle Scholar
  29. 29.
    National Centre for Health Statistics. Health interview responses compared with medical records. Health statistics form the US, National health survey series D. Washington, DC: US Department of Health, Education and Welfare; 1961.Google Scholar
  30. 30.
    Maingot R. Abdominal operations. 4th ed. New York: Appleton-Century-Crofts; 1961. p. 939.Google Scholar
  31. 31.
    Glassow F. Femoral hernia in men. Am J Surg. 1971;121:637–40.PubMedPubMedCentralCrossRefGoogle Scholar
  32. 32.
    Quill DS, Devlin HB, Plant JA, Denham KR, McNay RA, Morris D. Surgical operation rates: a twelve year experience in Stockton-on-Tees. Ann R Coll Surg Engl. 1983;65:248–53.PubMedPubMedCentralGoogle Scholar
  33. 33.
    Suppiah A, Gatt M, Barandiaran J, Heng MS, Perry EP. Outcomes of emergency and elective femoral hernia surgery in four district general hospitals: a 4-year study. Hernia. 2007;11:509–12.PubMedPubMedCentralCrossRefGoogle Scholar
  34. 34.
    Dahistrand U, Wollert S, Nordin P, Sandblom G, Gunnarsson U. Emergency femoral hernia repair: a study based on a national register. Ann Surg. 2009;249:672–6.CrossRefGoogle Scholar
  35. 35.
    Ashley GT. Hernia in East Africa – an anatomical analysis of 700 cases. East Afr Med J. 1954;31:315–9.PubMedPubMedCentralGoogle Scholar
  36. 36.
    Badoe EA. External hernia in Accra-some epidemiological aspects. Afr J Med Sci. 1973;4:51–8.PubMedPubMedCentralGoogle Scholar
  37. 37.
    Kreymer M. Inguinal hernien bei centralafrikan-ern. Munch Med Wochenschr. 1968;110:1750–5.Google Scholar
  38. 38.
    Onukak EE, Grundy DJ, Lawrie JH. Hernia in Northern Nigeria. J R Coll Surg Edinb. 1983;28:147–50.PubMedPubMedCentralGoogle Scholar
  39. 39.
    Yordanov YS, Stroyanov SK. The incidence of hernia on the Island of Pemba. East Afr Med J. 1969;46:687–91.PubMedPubMedCentralGoogle Scholar
  40. 40.
    Hunter J. Palmer’s edition of Hunter’s works, vol. iv. London: Longman, Rees, Orme, Brown, Green, and Longman; 1837. p. 1.Google Scholar
  41. 41.
    Cloquet J. Recherches anatomiques sur les hernies de l’abdomen. Thesis, Paris, 1817, 133: 129.Google Scholar
  42. 42.
    Hughson W. The persistent or preformed sac in relation to oblique inguinal hernia. Surg Gynecol Obstet. 1925;41:610–4.Google Scholar
  43. 43.
    Grover VK, Nur AMA, Usha R, Farag TI, Sabry MA. Indirect inguinal hernia among Bedouins. J Med Genet. 1996;33:887.PubMedPubMedCentralCrossRefGoogle Scholar
  44. 44.
    Ando H, Kaneko K, Ito F, Seo T, Ito T. Anatomy of the round ligament in female infants and children with an inguinal hernia. Br J Surg. 1997;84:404–5.PubMedPubMedCentralCrossRefGoogle Scholar
  45. 45.
    Ron O, Eaton S, Pierro A. Systematic review of the risk of developing a metachronous contralateral inguinal hernia in children. Br J Surg. 2007;94:804–11.PubMedPubMedCentralCrossRefGoogle Scholar
  46. 46.
    Zamakhshardy M, Ein A, Ein SH, Wales PW. Predictors of metachronous inguinal hernias in children. Pediatr Surg Int. 2009;25:69–71.PubMedPubMedCentralCrossRefGoogle Scholar
  47. 47.
    Chan MK, Baillod RA, Tanner RA, et al. Abdominal hernias in patients receiving continuous ambulatory peritoneal dialysis. Br Med J. 1981;283:826.CrossRefGoogle Scholar
  48. 48.
    Engeset J, Youngson GG. Ambulatory peritoneal dialysis and hernial complications. Surg Clin N Am. 1984;64:385–92.PubMedPubMedCentralCrossRefGoogle Scholar
  49. 49.
    Schurgers ML, Boelaert JRO, Daneels RF, Robbens EJ, Vandelanotte MM. Genital oedema in patients treated by continuous ambulatory peritoneal dialysis: an unusual presentation of inguinal hernia. Br Med J. 1983;388:358–9.CrossRefGoogle Scholar
  50. 50.
    Cooper JL, Nicholls AJ, Simms IM. Genital oedema in patients treated by continuous ambulatory peritoneal dialysis: an unusual presentation of inguinal hernia. Br Med J. 1983;286:1923–4.CrossRefGoogle Scholar
  51. 51.
    Herlock DJ, Smith S. Complications resulting from a patent processus vaginalis in two patients on continuous Marlex hernia repair. Br J Surg. 1984;71:477.CrossRefGoogle Scholar
  52. 52.
    Russell H. The saccular theory of hernia and the radical operation. Lancet. 1906;3:1197–203.CrossRefGoogle Scholar
  53. 53.
    van Wessem KJ, Simons MP, Plaisier PW, Lange JF. The aetiology of indirect inguinal hernias: congenital and/or acquired? Hernia. 2003;7:76–9.PubMedPubMedCentralCrossRefGoogle Scholar
  54. 54.
    Van Veen RN, van Wessem KJ, Halm JA, Simons MP, Plaisier PW, Jeekel J, Lange JF. Patent processus vaginalis in the adult as a risk factor for the occurrence of indirect inguinal hernia. Surg Endosc. 2007;21:202–5.PubMedPubMedCentralCrossRefGoogle Scholar
  55. 55.
    Edwards H. Discussion on hernia. Proc R Soc Med. 1943;36:186–9.Google Scholar
  56. 56.
    Read RC. Attentuation of the rectus sheath in inguinal herniation. Am J Surg. 1970;120:610–4.PubMedPubMedCentralCrossRefGoogle Scholar
  57. 57.
    McVay CB. The normal and pathologic anatomy of the transversus abdominis muscle in inguinal and femoral hernia. Surg Clin N Am. 1971;51:1251–61.PubMedPubMedCentralCrossRefGoogle Scholar
  58. 58.
    McVay CB. The anatomic basis for inguinal and femoral hernioplasty. Surg Gynecol Obstet. 1974;139:931–45.PubMedPubMedCentralGoogle Scholar
  59. 59.
    Dutta CR, Katzarski M. The anatomical basis for the inguinal hernia in Ghana. Ghana Med J. 1969;8:185–6.Google Scholar
  60. 60.
    Zinanovic S. The anatomical basis for the high frequency of inguinal and femoral hernia in Uganda. East Afr Med J. 1968;45:41–6.Google Scholar
  61. 61.
    Peacock EE, Madden JW. Studies on the biology and treatment of recurrent inguinal hernia: 11 morphological changes. Ann Surg. 1974;179:567–71.PubMedPubMedCentralCrossRefGoogle Scholar
  62. 62.
    Lichtenstein IL, Shore JM. Exploding the myths of hernia repair. Am J Surg. 1976;132:307–15.PubMedPubMedCentralCrossRefGoogle Scholar
  63. 63.
    Wagh PV, Read RC. Defective collagen synthesis in inguinal herniation. Am J Surg. 1972;124:819–22.PubMedPubMedCentralCrossRefGoogle Scholar
  64. 64.
    Wagh PV, Leverich AP, Read RC, Sun CN, White JH. Direct inguinal herniation in man: a disease of collagen. J Surg Res. 1974;17:425–33.PubMedPubMedCentralCrossRefGoogle Scholar
  65. 65.
    White HJ, Sun CN, Read RC. Inguinal hernia: a true collagen disease. Lab Investig. 1977;36:359.Google Scholar
  66. 66.
    Allegra SR, Broderick PA. Desmoid fibroblastoma. Intracytoplasmic collagen synthesis in a peculiar fibroblastic tumour: light and ultrastructural study of a case. Hum Pathol. 1973;4:419–29.PubMedPubMedCentralCrossRefGoogle Scholar
  67. 67.
    Cannon DJ, Read RC. Metastatic emphysema. A mechanism for acquiring inguinal herniation. Ann Surg. 1981;194:270–6.PubMedPubMedCentralCrossRefGoogle Scholar
  68. 68.
    Levene CL, Ockleford CD, Harber CL. Scurvy: a comparison between ultrastructural and biochemical changes observed in cultural fibroblasts and the collagen they synthesize. Virchows Arch B Cell Pathol. 1977;23:325–38.PubMedPubMedCentralGoogle Scholar
  69. 69.
    Pans A, Pierard GE, Albert A. Adult groin hernias: new insight into their biomechanical characteristics. Eur J Clin Investig. 1997;27:863–8.CrossRefGoogle Scholar
  70. 70.
    Berliner SD. An approach to groin hernia. Surg Clin N Am. 1984;64:197–213.PubMedPubMedCentralCrossRefGoogle Scholar
  71. 71.
    Friedman DW, Boyd CD, Norton P, Greco RS, Boyarsky AH, Mackenzie JW, Deak SB. Increases in Type III collagen gene expression and protein expression in patients with inguinal hernias. Ann Surg. 1993;218:754–60.PubMedPubMedCentralCrossRefGoogle Scholar
  72. 72.
    Casanova AB, Trindade EN, Trindade MRM. Collagen in the tranversalis fascia of patients with indirect inguinal hernia: a case-control study. Am J Surg. 2009;198:1–5.PubMedPubMedCentralCrossRefGoogle Scholar
  73. 73.
    Henriksen NA, Mortensen JH, Lorentzen L, Agren MS, Bay-Jensen AC, Jorgensen LN, Karsdal MA. Abdominal wall hernias-A local manifestation of systemically impaired quality of extracellular matrix. Surgery. 2016;160:220–7.PubMedPubMedCentralCrossRefGoogle Scholar
  74. 74.
    Laurell CB, Ericksson S. The electrophoretic alpha-1-globulin pattern of serum alpha-1-anti trypsin deficiency. Scand J Clin Lab Invest. 1963;15:132–40.CrossRefGoogle Scholar
  75. 75.
    Bellon JM, Bajo A, Ga-Honduvilla N, Gimeno MJ, Pascual G, Guerrero A, Bujan J. Fibroblasts from the transversalis fascia of young patients with direct inguinal hernias show constitutive MMP-2 overexpression. Ann Surg. 2001;233:287–91.PubMedPubMedCentralCrossRefGoogle Scholar
  76. 76.
    Zheng H, Si Z, Kasperk R, Bhardwaj RS, Schumpelick V, Klinge U, Klosterhalfen B. Recurrent inguinal hernia: disease of the collagen matrix? World J Surg. 2002;26:401–8.PubMedPubMedCentralCrossRefGoogle Scholar
  77. 77.
    Pascual G, Corrales C, Gomez-Gil V, Bujan J, Bellon JM. TGF-beta1 overexpression in the transversalis fascia of patients with direct inguinal hernia. Eur J Clin Investig. 2007;37:516–21.CrossRefGoogle Scholar
  78. 78.
    Lehnert B, Wadouh F. High coincidence of inguinal hernias and abdominal aortic aneurysms. Ann Vasc Surg. 1992;6:134–7.PubMedPubMedCentralCrossRefGoogle Scholar
  79. 79.
    Adye B, Luna G. Incidence of abdominal wall hernia in aortic surgery. Am J Surg. 1998;175:400–2.PubMedPubMedCentralGoogle Scholar
  80. 80.
    Cannon DJ, Casteel L, Read RC. Abdominal aortic aneurysm, Leriche’s syndrome, inguinal herniation and smoking. Arch Surg. 1984;119:387–9.PubMedPubMedCentralCrossRefGoogle Scholar
  81. 81.
    Liapis CD, Dimitroulis DA, Kakisis JD, Nikolaou AN, Skandalakis P, Daskalopoulos M, Kostakis AG. Incidence of incisional hernias in patients operated on for aneurysm or occlusive disease. Am Surg. 2004;70:550–2.PubMedPubMedCentralGoogle Scholar
  82. 82.
    Takagi H, Sugimoto M, Kato T, Matsuno Y, Umemoto T. Postoperative incision hernia in patients with abdominal aortic aneurysm and aortoiliac occlusive disease: a systematic review. Eur J Vasc Endovasc Surg. 2007;33:177–81.PubMedPubMedCentralCrossRefGoogle Scholar
  83. 83.
    Musella M, Milone F, Chello M, Angelini P, Jovino R. Magnetic resonance imaging and abdominal wall hernias in aortic surgery. J Am Coll Surg. 1993;2001:392–5.Google Scholar
  84. 84.
    Pleumeekers HJ, De Gruijl A, Hofman A, Van Beek AJ, Hoes AW. Prevalence of aortic aneursym in men with a history of inguinal hernia. Br J Surg. 1999;86:1155–8.PubMedPubMedCentralCrossRefGoogle Scholar
  85. 85.
    Anderson O, Shiralkar S. Prevalence of abdominal aortic aneursyms in over 65-year-old men with inguinal hernias. Ann R Coll Surg Engl. 2008;90:386–8.PubMedPubMedCentralCrossRefGoogle Scholar
  86. 86.
    Read RC. Metabolic factors contributing to herniation: a review. Hernia. 1998;2:51–5.CrossRefGoogle Scholar
  87. 87.
    Klinge U, Zheng H, Si ZY, Bhardwaj R, Klosterhalfen B, Schumpelick V. Altered collagen synthesis in fascia transversalis of patients with inguinal hernia. Hernia. 1999;4:181–7.CrossRefGoogle Scholar
  88. 88.
    Hunt DM. Primary defect in copper transport underlies mottled mutant in mouse. Nature. 1974;249:852–4.PubMedPubMedCentralCrossRefGoogle Scholar
  89. 89.
    Tilson MD, Davis G. Deficiencies of copper and a compound with iron exchange characteristics of pyridinoline in skin from patients with abdominal aortic aneurysms. Surgery. 1983;94:134–41.PubMedPubMedCentralGoogle Scholar
  90. 90.
    Bendavid R. The unified theory of hernia formation. Hernia. 2004;8:171–6.PubMedPubMedCentralGoogle Scholar
  91. 91.
    Klinge U, Binnebosel M, Mertens PR. Are collagens the culprits in the development of incisional and inguinal hernia disease? Hernia. 2006;10:472–7.PubMedPubMedCentralCrossRefGoogle Scholar
  92. 92.
    Franz MG. The biology of hernia formation. Surg Clin N Am. 2008;88:1–15.PubMedPubMedCentralCrossRefGoogle Scholar
  93. 93.
    Hiles M, Record Ritchie RD, Altizer AM. Are biologic grafts effective for hernia repair: a systematic review of the literature. Surg Innov. 2009;16:26–37.PubMedPubMedCentralCrossRefGoogle Scholar
  94. 94.
    Fang Z, Ren F, Zhou J, Tian J. Biologic mesh versus synthetic mesh in open inguinal hernia repair: system review and meta-analysis. ANZ J Surg. 2015;85:910–6.PubMedPubMedCentralCrossRefGoogle Scholar
  95. 95.
    Beighton P, De Paepe A, Steinmann B, Tsipouras P, Wenstrup RJ. Ehlers-Danlos syndromes; revised nosology. Am J Med Genet. 1998;77:31–7.PubMedPubMedCentralCrossRefGoogle Scholar
  96. 96.
    Barnett C, Langer JC, Hinek A, Bradley TJ, Chitayat D. Looking past the lump: genetic aspects of inguinal hernia in children. J Pediatr Surg. 2009;44:1423–31.PubMedPubMedCentralCrossRefGoogle Scholar
  97. 97.
    West LS. Two pedigrees showing inherited predisposition to hernia. J Hered. 1936;27:449–55.CrossRefGoogle Scholar
  98. 98.
    Smith MP, Sparkes RS. Familial inguinal hernia. Surgery. 1965;57:807–12.Google Scholar
  99. 99.
    Morris-Stiff G, Coles G, Moore R, Jurewicz LR. Abdominal wall hernia in autosomal dominant polycystic kidney disease. Br J Surg. 1997;84:615–7.PubMedPubMedCentralCrossRefGoogle Scholar
  100. 100.
    Weimer BR. Congenital inheritance of inguinal hernia. J Hered. 1949;40:219–20.PubMedPubMedCentralCrossRefGoogle Scholar
  101. 101.
    Montagu AMF. A case of familial inheritance of oblique inguinal hernia. J Hered. 1942;33:355–6.CrossRefGoogle Scholar
  102. 102.
    Czeizel A, Gardonyi J. A family study of congenital inguinal hernia. Am J Med Genet. 1979;4:247–54.PubMedPubMedCentralCrossRefGoogle Scholar
  103. 103.
    Savatguchi S, Matsunaga E, Honna T. A genetic study on indirect inguinal hernia. Jpn J Hum Genet. 1975;20:187–95.Google Scholar
  104. 104.
    Gong Y, Shao C, Sun Q, et al. Genetic study of indirect inguinal hernia. J Med Genet. 1994;31:187–92.PubMedPubMedCentralCrossRefGoogle Scholar
  105. 105.
    Jones ME, Swerdlow AJ, Griffith M, Goldacre MJ. Risk of congenital inguinal hernia in siblings: a record linkage study. Paediatr Perinat Epidemiol. 1998;12:288–96.PubMedPubMedCentralCrossRefGoogle Scholar
  106. 106.
    Lau H, Fang C, Yuen WK, Patil NG. Risk factors for inguinal hernia in adult males: a case-control study. Surgery. 2007;141:262–6.PubMedPubMedCentralCrossRefGoogle Scholar
  107. 107.
    Grindflek E, Moe M, Taubert H, Simianer H, Lien S, Moen T. Genome-wide linkage analysis of inguinal hernia in pigs using affected sib pairs. BMC Genet. 2006;7:25.PubMedPubMedCentralCrossRefGoogle Scholar
  108. 108.
    Jorgenson E, Makki N, Shen L, Chen DC, Tian C, Eckalbar WL, Hinds D, Ahituv N, Avins A. A genome-wide association study identifies four novel susceptibility loci underlying inguinal hernia. Nat Commun. 2015;6:10130.PubMedPubMedCentralCrossRefGoogle Scholar
  109. 109.
    Kasson MA, Munoz E, Laughlin A, Margolis IB, Wise L. Value of routine pathology in herniorraphy performed upon adults. Surg Gynecol Obstet. 1986;163:518–22.Google Scholar
  110. 110.
    Tanyel FC, Dagdeviren A, Muftuoglu S, Gursoy MH, Yuruker S, Buyukpamukcu N. Inguinal hernia revisited through comparative evaluation of peritoneum, processus vaginalis and sacs obtained from children with hernia, hydrocel, and undescended. J Paediatr Surg. 1999;34:552–5.CrossRefGoogle Scholar
  111. 111.
    Rosai J, Dehner LP. Nodular mesothelial hyerplasia in hernia sacs. A benign reactive condition simulating a neoplastic process. Cancer. 1975;35:165–75.PubMedPubMedCentralCrossRefGoogle Scholar
  112. 112.
    Leonetti JP, Aranha GV, Wilkinson WA, Stanley M, Greenlee HB. Umbilical herniorrhaphy in cirrhotic patients. Arch Surg. 1984;119:442–5.PubMedPubMedCentralCrossRefGoogle Scholar
  113. 113.
    Carbonell AM, Wolfe LG, DeMaria EJ. Poor outcomes in cirrhosis-associated hernia repair: a nationwide cohort study of 32,033 patients. Hernia. 2005;9:353–7.PubMedPubMedCentralCrossRefGoogle Scholar
  114. 114.
    Gray SH, Vick CC, Graham LA, Finan KR, Neumayer LA, Hawn MT. Umbilical herniorrhapy in cirrhosis: improved outcomes with elective repair. J Gastrointest Surg. 2008;12:675–81.PubMedPubMedCentralCrossRefGoogle Scholar
  115. 115.
    Patti R, Almasio PL, Buscemi S, Fama F, Craxi A, Di Vita G. Inguinal hernioplasty improves the quality of life in patients with cirrhosis. Am J Surg. 2008;196:373–8.PubMedPubMedCentralCrossRefGoogle Scholar
  116. 116.
    Ammar SA. Management of complicated umbilical hernias in cirrhotic patients using permanent mesh: a randomized trial. Hernia. 2010;14:35–8.PubMedPubMedCentralCrossRefGoogle Scholar
  117. 117.
    Cronin K, Ellis H. Pus collections in hernial sacs. Br J Surg. 1959;46:364–7.PubMedPubMedCentralCrossRefGoogle Scholar
  118. 118.
    Thomas WEG, Vowles KDL, Williamson RCN. Appendicitis in external herniae. Ann R Coll Surg Engl. 1982;64:121–2.PubMedPubMedCentralGoogle Scholar
  119. 119.
    Greenberg J, Arnell TD. Diverticular disease presenting as an incarcerated inguinal hernia. Am Surg. 2005;71:208–9.PubMedPubMedCentralGoogle Scholar
  120. 120.
    Bunting D, Harshen R, Ravichandra M, Ridings P. Unusual diagnoses presenting as incarcerated inguinal hernia: a case report and review of the literature. Int J Clin Pract. 2006;60:1681–2.PubMedPubMedCentralCrossRefGoogle Scholar
  121. 121.
    Hoguet JP. Right inguinal hernia following appendectomy. Ann Surg. 1911;54:673–6.PubMedPubMedCentralCrossRefGoogle Scholar
  122. 122.
    Arnbjornsson E. Development of right inguinal hernia after appendectomy. Am J Surg. 1982b;143:174–5.PubMedPubMedCentralCrossRefGoogle Scholar
  123. 123.
    Gue S. Development of right inguinal hernia following appendiectomy. Br J Surg. 1972;59:352–3.PubMedPubMedCentralCrossRefGoogle Scholar
  124. 124.
    Arnbjornsson E. A neuromuscular basis for the development of right inguinal hernia after appendicectomy. Am J Surg. 1982a;143:367–9.PubMedPubMedCentralCrossRefGoogle Scholar
  125. 125.
    Gilsdorf JR, Friedman RH, Shapiro P. Electromyographic evaluation of the inguinal region in patients with hernia of the groin. Surg Gynecol Obstet. 1988;167:466–8.PubMedPubMedCentralGoogle Scholar
  126. 126.
    Leech P, Waddell G, Main RG. The incidence of right inguinal hernia following appendicectomy. Br J Surg. 1972;59:623.PubMedPubMedCentralCrossRefGoogle Scholar
  127. 127.
    Jorgensen LN, Wille-Jorgensen P. Open or laparoscopic appendicectomy? Color Dis. 2009;11:795–6.CrossRefGoogle Scholar
  128. 128.
    Ukai T, Shikata S, Takeda H, Dawes L, Noguchi Y, Nakayama T, Takemura YC. Evidence of surgical outcomes fluctuates over time: results from a cumulative meta-analysis of laparoscopic versus open appendectomy for acute appendicitis. BMC Gastroenterol. 2016;16:37. Scholar
  129. 129.
    Nilsson H, Stranne J, Stattin P, Nordin P. Incidence of groin hernia repair after radical prostatectomy: a population-based nationwide study. Ann Surg. 2014;259:1223–7.PubMedPubMedCentralCrossRefGoogle Scholar
  130. 130.
    Lee DH, Jung HB, Chung MS, Lee SH, Chung BH. Patent processus vaginalis in adults who underwent robot-assisted laparoscopic radical prostatectomy: predictive signs of postoperative inguinal hernia in the internal inguinal floor. Int J Urol. 2013;20:177–82.PubMedPubMedCentralCrossRefGoogle Scholar
  131. 131.
    Teber D, Erdogru T, Zukosky D, Frede T, Rassweiler J. Prosthetic mesh hernioplasty during laparoscopic radical prostatectomy. Urology. 2005;65:1173–8.PubMedPubMedCentralCrossRefGoogle Scholar
  132. 132.
    Savetsky IL, Rabbani F, Singh K, Brady MS. Preperitoneal repair of inguinal hernia at open prostatectomy. Hernia. 2009;13:517–22.PubMedPubMedCentralCrossRefGoogle Scholar
  133. 133.
    Lee DK, Mongomery DP, Porter JR. Concurrent transperitoneal repair for incidentally detected inguinal hernias during robotically assisted radical prostatectomy. Urology. 2013;82:1320–2.PubMedPubMedCentralCrossRefGoogle Scholar
  134. 134.
    Fujii Y, Yamamoto S, Yonese J, Masuda H, Urakami S, Kitsukawa S, Sakura M, Yuasa T, Kihara K, Fukui I. The processus vaginalis transection method to prevent postradical prostatectomy inguinal hernia: long-term results. Urology. 2014;83:247–52.PubMedPubMedCentralCrossRefGoogle Scholar
  135. 135.
    Kanda T, Fukuda S, Kohno Y, Fukui N, Kageyama Y. The processus vaginalis transection method is superior to the simple prophylactic procedure for prevention of inguinal hernia after radical prostatectomy. Int J Clin Oncol. 2016;21:384–8.PubMedPubMedCentralCrossRefGoogle Scholar
  136. 136.
    Clain A. Traumatic hernia. Br J Surg. 1964;51:549–50.PubMedPubMedCentralCrossRefGoogle Scholar
  137. 137.
    Ryan EA. Hernias related to pelvic fractures. Surg Gynecol Obstet. 1971;133:440–6.PubMedPubMedCentralGoogle Scholar
  138. 138.
    Narath A. Ueber eine eigenartige form von hernia cruralis (prevascularis) in Anschlusse an die umblitige Behandlung angeborener Huftgelenskverrenkung. Arch Klin Chir. 1899;59:396–424.Google Scholar
  139. 139.
    Salter RB. Innominate osteotomy in the treatment of dislocation and subluxation of the hip. J Bone Joint Surg. 1961;43-B:518–39.CrossRefGoogle Scholar
  140. 140.
    Castelein RM, Saunter AJM. Lumbar hernia in an iliac bone graft defect. Acta Orhtopaedica Scand. 1985;56:273–4.CrossRefGoogle Scholar
  141. 141.
    Dennis RW, Marshall A, Deshmukh H, Bender JS, Kulvatunyou N, Lees JS, Albrecht RM. Abdominal wall injuries occurring after blunt trauma: incidence and grading system. Am J Surg. 2009;197:413–7.PubMedPubMedCentralCrossRefGoogle Scholar
  142. 142.
    Davis PR. The causation of herniae by weight lifting. Lancet. 1969;2:155–7.Google Scholar
  143. 143.
    Smith GD, Crosby DL, Lewis PA. Inguinal hernia and a single strenuous event. Ann R Coll Surg Engl. 1996;78:367–8.PubMedPubMedCentralGoogle Scholar
  144. 144.
    Sanjay P, Woodward A. Single strenuous event: does it predispose to inguinal herniation? Hernia. 2007;11:493–6.PubMedPubMedCentralCrossRefGoogle Scholar
  145. 145.
    Pathak S, Poston GJ. It is unlikely that the development of an abdominal wall hernia can be attributable to a single strenuous event. Ann R Coll Surg Engl. 2006;88:168–71.PubMedPubMedCentralCrossRefGoogle Scholar
  146. 146.
    Vad MV, Frost P, Svendsen SW. Occupational mechanical exposure and reoperation after first-time inguinal hernia repair: a prognosis study in a male cohort. Hernia. 2015;19:893–900.PubMedPubMedCentralCrossRefGoogle Scholar
  147. 147.
    Carbonell JF, Sanchez JLA, Peris RT, Ivorra JC, Delbano MJP, Sanchez C, Araez JIG, Greus PC. Risk factors associated with inguinal hernias: a case control study. Eur J Surg. 1993;159:481–6.PubMedPubMedCentralGoogle Scholar
  148. 148.
    Flich J, Alfonso JL, Delgrado F, Prado MJ, Cortina P. Inguinal hernias and certain risk factors. Eur J Epidemiol. 1992;8:277–82.PubMedPubMedCentralCrossRefGoogle Scholar
  149. 149.
    McArdle G. Is inguinal hernia a defect in human evolution and would this insight improve concepts for methods of surgical repair. Clin Anat. 1997;10:47–55.PubMedPubMedCentralCrossRefGoogle Scholar
  150. 150.
    Liem MS, van der Graaf Y, Zwart RC, Geurts I, van Vroonhoven TJ. Risk factors for inguinal hernia in women: a case-control study. The Coala Trial Group. Am J Epidemiol. 1997;146:721–6.PubMedPubMedCentralCrossRefGoogle Scholar
  151. 151.
    Kemp DA. Kemp and Kemp. The quantum of damages. Revised edn, vol. 1. London: Sweet and Maxwell; 1975.Google Scholar
  152. 152.
    Hendry PO, Paterson-Brown S, de Beaux A. Work related aspects of inguinal hernia: a literature review. Surgeon. 2008;6:361–5.PubMedPubMedCentralCrossRefGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of General SurgeryRoyal Gwent Hospital, Aneurin Bevan University Health BoardNewportUK

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