title: Endoscopic evaluation and treatment of groin pain in the athlete.
abstract: BACKGROUND
  Chronic groin pain in athletes forms a major diagnostic and therapeutic challenge.
  
  
  OBJECTIVE
  Evaluate and treat undiagnosed groin pain in the athlete by endoscopy.
  
  
  METHODS
  Prospective cohort study.
  
  
  METHODS
  Athletes who were referred to the Ikazia Hospital with undiagnosed chronic groin pain between January 1998 and August 2001 were included. Radiography, bone scintigraphy, and ultrasonography were performed. In 14 athletes, groin pain remained undiagnosed. Ten patients complained of unilateral, 4 of bilateral groin pain. Patients underwent a transabdominal or extraperitoneal diagnostic endoscopy.
  
  
  RESULTS
  All patients were operated ambulatory without significant difficulties. Pathology found by endoscopy was hernia inguinalis (n = 9), hernia femoralis (n = 4), preperitoneal lipoma (n = 3), and hernia obturatoria (n = 1). Only once was there no pathology. In 17 groins, a Prolene mesh was placed preperitoneally. Thirteen patients (93%) returned to full activity within 3 months of surgery. One year after surgery, one patient had minor symptoms and one patient had persistent symptoms. All other patients had no complaints.
  
  
  CONCLUSIONS
  An occult hernia should be high on the list of differential diagnoses in undiagnosed chronic groin pain in athletes. Operative treatment can return the patient to his sport within 3 months.
authors.affiliation: Department of General Surgery, Ikazia Hospital, Montessoriweg 1, 3083 AN Rotterdam, the Netherlands.
authors.forename: Jolanda
authors.initials: J
authors.lastname: Kluin
authors.forename: Pieter T
authors.initials: PT
authors.lastname: den Hoed
authors.forename: Robbart
authors.initials: R
authors.lastname: van Linschoten
authors.forename: John C
authors.initials: JC
authors.lastname: IJzerman
authors.forename: Cornelis J
authors.initials: CJ
authors.lastname: van Steensel
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002908:Chronic Disease; D005260:Female; D006119:Groin; D006552:Hernia, Inguinal / Q000175:diagnosis / Q000453:epidemiology* / Q000601:surgery; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000209:etiology*; D059408:Pain Management; D011446:Prospective Studies; D013177:Sports