Helpful Links & Research
Helpful Links & Hernia Research
We have brought together a selection of resources for people who would like to learn more about inguinal hernias, their management and the research surrounding different approaches to treatment.
This page includes research papers, articles, books and links that have been collected by The Support Company over many years.
Some of the research listed here is historical and medical understanding continues to develop. These resources are provided for further reading and should not be considered a substitute for advice from your doctor, surgeon or other qualified healthcare professional.
Free Hernia E-books
The Hernia Bible: A Non-Surgical Approach to Hernia Treatment - Craig Sams
The Hernia Bible was written by Craig Sams, a former hernia sufferer, and explores his personal experience and approach to managing an inguinal hernia without surgery.
The book represents the author's own experiences and views and should be read as such rather than as medical advice.
Download The Hernia Bible (PDF)
Cluthe's Advice to the Ruptured
Originally published in 1912, this historical book describes the use of early trusses and presents numerous accounts of people with hernias using the devices available at the time.
It provides an interesting historical perspective on hernia support before modern surgical techniques became commonplace.
Download Cluthe's Advice to the Ruptured (PDF)
Inguinal Hernia Research
The following papers and articles explore different aspects of inguinal hernia management, including watchful waiting, surgical repair, postoperative pain, recurrence and mesh repair.
Research findings should always be considered in context. The most appropriate approach to an inguinal hernia depends on the individual patient and should be discussed with an appropriate healthcare professional.
Watchful Waiting and Surgery
Watchful waiting has been studied as an approach for some men with asymptomatic or minimally symptomatic inguinal hernias.
Watchful Waiting vs Repair of Inguinal Hernia in Minimally Symptomatic Men
Fitzgibbons RJ Jr, Giobbie-Hurder A et al.
JAMA. 2006;295(3):285–292.
A randomised clinical trial involving 720 men comparing watchful waiting with surgical repair for minimally symptomatic inguinal hernias.
Observation or Operation for Patients with an Asymptomatic Inguinal Hernia
O'Dwyer PJ, Norrie J, Alani A et al.
Annals of Surgery. 2006;244(2):167–173.
A randomised clinical trial examining observation compared with surgical treatment for asymptomatic inguinal hernias.
Management of Asymptomatic Inguinal Hernia: A Systematic Review
Mizrahi H, Parker MC.
A systematic review examining the available evidence surrounding management of asymptomatic inguinal hernias.
A Clinician's Guide to Patient Selection for Watchful Waiting
Sarosi GA, Wei Y, Gibbs JO et al.
Research examining patient selection for watchful waiting as an approach to inguinal hernia management.
Does Delaying Repair of an Asymptomatic Hernia Have a Penalty?
Thompson JS, Gibbs JO, Reda DJ et al.
American Journal of Surgery. 2008;195(1):89–93.
Research comparing outcomes between patients undergoing repair after diagnosis and those whose surgery was delayed.
Research into Pain Following Hernia Repair
Persistent pain following inguinal hernia surgery has been investigated in a number of studies.
The studies below are included for readers interested in exploring this area of research. They should not be interpreted as suggesting that surgery is unsuitable or unnecessary for an individual patient.
Pain and Functional Impairment One Year After Inguinal Herniorrhaphy
Bay-Nielsen M, Perkins FM, Kehlet H.
Annals of Surgery. 2001;233.
A nationwide questionnaire study investigating pain and functional impairment following inguinal hernia repair.
Pain and Functional Impairment Six Years After Inguinal Herniorrhaphy
Aasvang EK, Bay-Nielsen M, Kehlet H.
Hernia. 2006;10(4):316–321.
A longer-term follow-up examining persistent pain following inguinal hernia repair.
Risk Factors for Long-Term Pain After Hernia Surgery
Fränneby U, Sandblom G, Nordin P et al.
Annals of Surgery. 2006;244(2):212–219.
Research examining factors associated with persistent pain following hernia surgery.
Chronic Pain and Quality of Life Following Open Inguinal Hernia Repair
Poobalan AS, Bruce J, King PM et al.
British Journal of Surgery. 2001;88(8):1122–1126.
A study examining persistent pain and quality of life following open inguinal hernia repair.
A Review of Chronic Pain After Inguinal Herniorrhaphy
Poobalan AS, Bruce J, Cairns W et al.
Clinical Journal of Pain. 2003;19(1):48–54.
A review of published research into chronic postoperative pain following inguinal hernia repair.
Research into Hernia Mesh
Surgical mesh is commonly used in modern hernia repair. The following research looks at areas including recurrence, pain, foreign-body response and complications associated with mesh repair.
These links are provided for further reading and do not constitute a recommendation for or against mesh repair.
Open Mesh versus Laparoscopic Mesh Repair of Inguinal Hernia
Neumayer L, Giobbie-Hurder A, Jonasson O et al.
New England Journal of Medicine. 2004;350:1819–1827.
A major study comparing open and laparoscopic mesh repair techniques.
Foreign Body Reaction to Meshes Used for Abdominal Wall Hernias
Klinge U, Klosterhalfen B, Müller M, Schumpelick V.
European Journal of Surgery. 1999;165(7):665–673.
Research examining the tissue response to materials used in hernia mesh.
Late-Onset Deep Mesh Infection After Inguinal Hernia Repair
Delikoukos S, Tzovaras G, Liakou P et al.
Hernia. 2007;11(1):15–17.
A study examining late-onset mesh infection following inguinal hernia repair.
Three-Year Results of Lightweight or Standard Polypropylene Mesh
Bringman S, Wollert S, Osterberg J et al.
British Journal of Surgery. 2006;93(9):1056–1059.
Research comparing different polypropylene meshes used for inguinal hernia repair.
Exercise & Movement Resources
Appropriate activity will depend on your individual circumstances. If you have been diagnosed with an inguinal hernia, speak to your healthcare professional about which forms of exercise are appropriate for you.
For people interested in learning more about Pilates:
Nutrition Resources
For people interested in finding out more about nutrition and nutritional therapy:
British Association for Nutrition and Lifestyle Medicine (BANT)
Nutrition and supplements should not be considered a treatment for an inguinal hernia. Speak to an appropriate healthcare professional before making significant dietary changes or taking supplements, particularly if you have an existing medical condition or take medication.
Further Reading
We continue to review and update the resources on this page.
Medical research changes over time, and some of the studies and books listed above are included because of their historical relevance to the development of thinking around inguinal hernia management.
If you have been diagnosed with an inguinal hernia and are considering your options, we recommend discussing them with your doctor or surgeon.
For information specifically about using a support garment, you can also explore our guides to inguinal hernia supports, sizing and the Flat Pad design.