Brian P. Jacob, David C. Chen, Bruce Ramshaw, Shirin Towfigh (eds.) - The SAGES Manual of Groin Pain-Springer International Publishing (2016)

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488 N.A. Al-Enazi and B.P. Jacob pubalgia pain. We therefore recommend initiating treatment for pubalgia first and delaying a hernia repair until the pubalgia pain is better controlled and the patient understands the difference between the hernia pain and the pubalgia pains. The main goal of physical rehabilitation is to strengthen and stabilize the pelvis and pubic symphysis. Physical rehabilitation, usually for 6–8 weeks, has been found in multiple observational studies to be effective in reducing pain among patients with osteitis pubis [ 14 ]. Conservative measures have been shown to be effective in treating osteitis pubis, and the expected duration of treatment before resolution should be around 2–3 months. A majority of the patients with osteitis pubis respond very well to this modality of treatment. After the osteitis is improved or resolved, the hernia repair can then be sought. Conclusion Osteitis pubis can be easily missed when patients complain of groin pain and present with a simultaneous inguinal hernia. History and physical examination should include a high index of suspicion. If the diagnosis is suspected, the potential to make the diagnosis will increase, and thus the surgeon and the patient may be able to prevent a case of chronic groin pain that would otherwise be at risk for being associated with an inguinal hernia repair. Usually, the treatment of choice for patients with osteitis pubis is conservative, with rest, painkillers, and physiotherapy or steroid injection. The healing process for most patients is 6–8 weeks. In patients who have an obvious inguinal hernia and osteitis, it is important to educate the patients about the osteitis and its associated symptoms, treatment options, and outcomes before repairing the inguinal hernia. References 1. Hölmich P. Adductor-related groin pain in athletes. Sports Med Arthrosc Rev. 1997;5:285–91. 2. Fricker PA. Osteitis pubis. Sports Med Arthrosc Rev. 1997;5:305–12. 3. Ruane JJ, Rossi TA. When groin pain is more than ‘just a strain’: navigating a broad differential. Phys Sportsmed. 1998;26(4):78–103. 4. Holt MA, Keene JS, Graf BK, Helwig DC. Treatment of osteitis pubis in athletes. Results of corticosteroid injections. Am J Sports Med. 1995;23(5):601–6.
41. Right Inguinal Hernia with Osteitis Pubis… 489 5. Pauli S, Willemsen P, Declerck K, Chappel R, Vanderveken M. Osteomyelitis pubis versus osteitis pubis: a case presentation and review of the literature. Br J Sports Med. 2002;36(1):71–3. 6. Rodriguez C, Miguel A, Lima H, Heinrichs K. Osteitis pubis syndrome in the professional soccer athlete: a case report. J Athl Train. 2001;36(4):437–40. 7. Gilmore J. Groin pain in the soccer athlete: fact, fiction and treatment. Clin Sports Med. 1998;17(4):787–93. 8. Batt ME, McShane JM, Dillingham MF. Osteitis pubis in collegiate football players. Med Sci Sports Exerc. 1995;27(5):629–33. 9. Johnson R. Osteitis pubis. Curr Sports Med Rep. 2003;2(2):98–102. 10. Radic R, Annear P. Use of pubic symphysis curettage for treatment- resistant osteitis pubis in athletes. Am J Sports Med. 2008;36(1):122–8. 11. Meyers WC, Foley DP, Garrett WE, Lohnes JH, Mandelbaum BR. Management of severe lower abdominal or inguinal pain in high-performance athletes. PAIN (Performing athletes with abdominal or inguinal neuromuscular pain study group). Am J Sports Med. 2000;28(1):2–8. 12. O’Connell MJ, Powell T, McCaffrey NM, O’Connell D, Eustace SJ. Symphyseal cleft injection in the diagnosis and treatment of osteitis pubis in athletes. AJR Am J Roentgenol. 2002;179(4):955–9. 13. King JB. Treatment of osteitis pubis in athletes: results of corticosteroid injections. Am J Sports Med. 1996;24(2):248. 14. Choi H, McCartney M, Best TM. Treatment of osteitis pubis and osteomyelitis of the pubic symphysis in athletes: a systematic review. Br J Sports Med. 2011;45(1):57–64.
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Brian P. Jacob · David C. Chen Bru
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The SAGES Manual of Groin Pain Bria
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Foreword Inguinal hernia repair is
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Contents Part I Primary Groin Pain
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Contents ix 22 Management of Inguin
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Contents xi 45 Value-Based Clinical
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xiv Editors and Contributors Jeffre
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xvi Editors and Contributors David
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xviii Editors and Contributors Greg
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xx Editors and Contributors David S
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1. Introduction to Primary and Seco
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10 I.A. Gawlas and W.J. Peacock Ili
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12 I.A. Gawlas and W.J. Peacock Tra
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14 I.A. Gawlas and W.J. Peacock Var
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3. Complex Regional Pain Syndrome T
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4. Chief Complaint of Groin Pain: H
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4. Chief Complaint of Groin Pain…
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42 C. Ma and A. Ramaswamy inguinal
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44 C. Ma and A. Ramaswamy Categoriz
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46 C. Ma and A. Ramaswamy with no s
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48 C. Ma and A. Ramaswamy 26. Aasva
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50 I.M. Daoud and K. Dunn Other per
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52 I.M. Daoud and K. Dunn low herni
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54 I.M. Daoud and K. Dunn In the po
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56 I.M. Daoud and K. Dunn with a he
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58 I.M. Daoud and K. Dunn 13. O’C
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60 G.J. Mancini Occult Hernia Backg
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62 G.J. Mancini Magnetic resonance
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64 G.J. Mancini rocking motion can
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66 G.J. Mancini Unique to the adduc
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68 G.J. Mancini two nerve injuries
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70 G.J. Mancini abdominis has a rep
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72 G.J. Mancini 5. Light D, Ratnasi
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74 J.C. Campbell and G.D. Paiement
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9. Groin Pain Etiology: Spine and B
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10. Groin Pain Etiology: Spermatic
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Table 10.2. European Association of
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138 M. Hibner and C. Coyne Piriform
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140 M. Hibner and C. Coyne Fig. 11.
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142 M. Hibner and C. Coyne Table 11
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144 M. Hibner and C. Coyne present
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146 M. Hibner and C. Coyne Table 11
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148 M. Hibner and C. Coyne Once the
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150 M. Hibner and C. Coyne 3. Hibne
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12. Chronic Pelvic Pain in Women M.
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12. Chronic Pelvic Pain in Women 15
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174 J.M. Miller et al. Knowing the
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176 J.M. Miller et al. Fig. 13.2. A
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182 J.M. Miller et al. Fig. 13.9. C
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184 J.M. Miller et al. Fig. 13.14.
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192 J.M. Miller et al. Cardiac Cath
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194 B.J. Dunkin Noxious peripheral
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196 B.J. Dunkin Table 14.1. Summary
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198 B.J. Dunkin Rectus abdominis Ex
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200 B.J. Dunkin COX-1 COX-2 Celecpx
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202 B.J. Dunkin Table 14.2. Common
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204 B.J. Dunkin Possible Preoperati
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206 B.J. Dunkin Postoperative Pain
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208 B.J. Dunkin Summary Understandi
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15. Chronic Groin Pain Following An
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222 E.L. Felix not seem to alter th
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224 E.L. Felix nerves from the surg
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226 E.L. Felix Fig. 16.2. Lateral f
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228 E.L. Felix It has been establis
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230 E.L. Felix 18. Pollak R, Nyhus
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17. The Orthopedic Perspective on G
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246 J.F.M. Lange Jr. examination an
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248 J.F.M. Lange Jr. and remedial s
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250 J.F.M. Lange Jr. Best available
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252 J.F.M. Lange Jr. Neuropathic pa
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254 J.F.M. Lange Jr. This algorithm
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19. Radiologic Evaluation for Posto
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19 Radiologic Evaluation for Postop
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268 A. Malhotra extended variant of
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270 A. Malhotra steroid injections,
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272 A. Malhotra located just below
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274 A. Malhotra Nociceptive Acute N
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276 A. Malhotra 20. Rozen D, Parvez
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278 R. Álvarez intentionally or in
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Fig. 21.1. Material: A ballpoint pe
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Fig. 21.5. Dermatome mapping compat
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Fig. 21.9. Dermatome mapping compat
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286 R. Álvarez Subsequently, we mu
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288 R. Álvarez G : Granuloma H : H
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290 R. Álvarez Fig. 21.14. Same pa
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292 R. Álvarez 6. Lermite E, Arnau
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294 K.A. Seymour and J.S. Yoo Table
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296 K.A. Seymour and J.S. Yoo repro
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298 K.A. Seymour and J.S. Yoo Recur
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23. Mesh Removal for Chronic Pain:
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23. Mesh Removal for Chronic Pain
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320 I.T. MacQueen et al. inguinodyn
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322 I.T. MacQueen et al. Fig. 24.2.
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324 I.T. MacQueen et al. Timing and
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326 I.T. MacQueen et al. Fig. 24.4.
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328 I.T. MacQueen et al. Posthernio
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330 I.T. MacQueen et al. never be e
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25. Laparoscopic Triple Neurectomy
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26. Chronic Orchialgia: Workup and
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27. The Role of Bioactive Prostheti
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376 G. Campanelli et al. affecting
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378 G. Campanelli et al. into the w
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380 G. Campanelli et al. chronic gr
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382 G. Campanelli et al. A prospect
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384 G. Campanelli et al. open mesh
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386 G. Campanelli et al. 38. Alfier
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29. Prevention of Pain: Optimizing
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30. Prophylactic Neurectomy Versus
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Table 31.1. Selective neurectomy wi
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408 W.M.J. Reinpold and A.D. Schroe
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32. Chronic Groin Pain: Mesh or No
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Part IV Case Reports and Patients
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430 S. Towfigh were irregular and s
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432 S. Towfigh in addressing her sy
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434 S. Towfigh Conclusion We have y
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Page 478 and 479: 482 S. Towfigh References 1. Matthi
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Page 486 and 487: 42. Patient with Chronic Pelvic Pai
Page 488 and 489: 42. Patient with Chronic Pelvic Pai
Page 490 and 491: 43. Thoracolumbar Syndrome James A.
Page 492 and 493: 43. Thoracolumbar Syndrome 497 The
Page 494 and 495: 43. Thoracolumbar Syndrome 499 Groi
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Page 500 and 501: 45. Value-Based Clinical Quality Im
Page 510 and 511: 46. Patient Care Manager Perspectiv
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Page 526 and 527: 532 Index Athletic pubalgia (cont.)
Page 528 and 529: 534 Index Chronic post-herniorrhaph
Page 530 and 531: 536 Index Groin pain (cont.) magnet
Page 532 and 533: 538 Index Ilioinguinal nerve (IIN)
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540 Index Local anesthetics (cont.)
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542 Index Peripheral nerve entrapme
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544 Index S Sacroiliac (SI) joint d
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546 Index Transperineal pudendal ne
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Brian P. Jacob, David C. Chen, Bruce Ramshaw, Shirin Towfigh (eds.) - The SAGES Manual of Groin Pain-Springer International Publishing (2016)

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