From the Guidelines
Adolescent males are screened for inguinal hernias during pre-participation sports physicals to identify and manage potential abdominal wall weaknesses that could worsen with physical activity, thereby preventing morbidity and improving quality of life. The examination for inguinal hernias is crucial as it helps detect any abnormal protrusion of abdominal contents through the inguinal canal, which can become painful or even dangerous if left untreated 1. Key aspects of this screening include:
- Having the adolescent male stand while the healthcare provider places a finger into the scrotum and asks him to cough to detect any hernia
- Early detection allows for appropriate management, which may include activity modification, monitoring, or surgical repair depending on severity
- Inguinal hernias are relatively common in adolescent males due to the natural passage of the testicles through the inguinal canal during fetal development, leaving a potential weakness
- Sports that involve straining, lifting, or sudden movements can increase intra-abdominal pressure and potentially worsen an existing hernia, making this assessment particularly relevant before athletic participation. Although the study by 1 emphasizes the importance of comprehensive care and preventive health assessments, it indirectly supports the need for targeted screenings like inguinal hernia checks during sports physicals to ensure the health and safety of adolescent males engaging in athletic activities.
From the Research
Screening for Inguinal Hernias in Adolescent Males
Adolescent males are screened for inguinal hernias during pre-participation sports physicals due to several reasons:
- Inguinal hernias are a common condition that can occur in males, with one third of males being diagnosed with an inguinal hernia during their lifetime 2
- The condition can cause chronic pain and discomfort, particularly in athletes who participate in sports that involve kicking and twisting movements, such as rugby, football, soccer, and ice hockey 3
- Early detection and treatment of inguinal hernias can help prevent complications, such as intestinal obstruction, and improve treatment outcomes 2
- Screening for inguinal hernias during pre-participation sports physicals can help identify athletes who may be at risk of developing the condition, allowing for early intervention and treatment 4, 5
Diagnosis and Treatment of Inguinal Hernias
Diagnosis of inguinal hernias can be challenging, but dynamic ultrasound and physical examination can be effective tools in identifying the condition 6
- Treatment options for inguinal hernias include surgical repair, which can be performed using an open anterior approach or posteriorly from within the abdomen with laparoscopy 2
- Percutaneous internal ring suturing (PIRS) is a laparoscopic procedure that has been shown to be safe and effective for inguinal hernia repair in adolescents 4
- A selective approach to inguinal hernia repair in adolescents, based on the size and nature of the presenting pathology, may be recommended 5