Suggested Pre-Referral Evaluation and Management Guidelines
Groin pain, particularly in muscular young males and in conjunction with work-related injury, is a vexing and difficult problem. Patients commonly report that they "felt something pop" while straining or lifting, and have had since then continuous pain in the groin region, usually along the posterior insertion of the adductor muscles into the pubic ramus, deep to the upper scrotum. The vast majority of patients with these symptoms have musculo-fascial groin pain and not inguinal hernia. (Hernias do not cause continuous groin pain; groin muscle injury does.)
Patients who have an actual hernia and who also have continuous groin pain are particularly problematic, because repair of the hernia rarely leads to improvement of the groin pain, but can result in having the continued pain attributed to the hernia repair. (Persistent groin pain after inguinal hernia repair is said to occur in 1-5% of patients, but almost never occurs in patients who do not have groin pain pre-operatively.)
Groin pain is usually not a surgical or surgically remediable condition.
Suggested Additional Test/Management Prior to Specialty Visit
Ultrasound (inguinal and testicular) MRI and CT may be requested but are usually not helpful. Ultrasound in particular may be misleading by detecting small amounts of fat in the inguinal canal, which are reported as being a hernia.
Patient Education/Information (includes preps)
How to Get Results to Consultant
UMHS Patients: See CareWeb
External Patients: Hand carry Non-UM records to visit