Inguinal Symptoms Not to Be Missed: Inguinal Hernia in Athletes. A Narrative Review

Inguinal hernia (IH) represents one of the potential causes of groin pain in athletes and should be distinguished from sports hernia, which lacks a true fascial defect despite presenting with similar clinical symptoms. This narrative review summarizes the current evidence on IH in athletes, with particular emphasis on epidemiology, risk factors, distinction from sports hernia, treatment strategies and their implications for postoperative recovery and return to sport. The review was based on nearly 60 scientific articles retrieved from PubMed, Scopus, Web of Science and Google Scholar databases, including meta-analyses, systematic reviews, cohort studies, case-control studies and original research. Owing to the heterogeneity of study designs and outcome measures, the available evidence was synthesized qualitatively without meta-analysis. Current evidence indicates that the development of IH is influenced by a combination of individual factors, with potential contribution from external factors such as exposure to increased intra-abdominal pressure. Management strategies range from watchful observation in selected patients to surgical repair using open or laparoscopic techniques. Minimally invasive approaches are generally associated with faster recovery, however, reported outcomes regarding return to sport remain heterogenous, and current technique choice recommendation are largely based on individual surgeon experience rather than standardized guidelines. Overall, IH in athletes requires accurate diagnosis and individualization of management. Although laparoscopic repair appears to facilitate earlier recovery and return to sport compared with open techniques, further high-quality studies are needed to establish uniform, evidence-based recommendations, particularly regarding postoperative activity restriction and return to sport protocols.