Marshfield Clinic is one of only five medical centers in the country participating in a study to determine whether "watchful waiting" can be a satisfactory long-term treatment for men with groin hernias, called inguinal hernias, with few or no symptoms.

In an inguinal hernia, a loop of intestine pushes through an opening in the abdominal wall into the inguinal canal, the passageway through which the testes descend into the scrotum.

Each year, about 700,000 men in the United States undergo surgical repair for inguinal hernia. This results in large direct costs due to surgical care and indirect costs to the economy because of the patient's time off from work, school, and other daily activities, according to Marshfield Clinic Surgeon James L. Hoehn, M.D., coordinating physician for the study at Marshfield Clinic. Yet, it is not known whether patients with inguinal hernias can safely delay treatment, or if watchful waiting is an acceptable and safe method of managing their hernias.

"Inguinal hernia is one of the most common worldwide afflictions of men," said Robert J. Fitzgibbons, Jr., M.D., project principal investigator. Dr. Fitzgibbons is the Dr. Harry E. Stuckenhoff Endowed Chair in Surgery at Creighton University in Omaha, Nebraska, and a consultant to the Veterans Administration Medical Center. "Because presence of an inguinal hernia is usually considered an indication for its repair, little is known about the natural history of this abnormality in minimally symptomatic patients. The study will compare the use of watchful waiting with tension-free open repair and will substantially increase knowledge of the natural history in inguinal hernia in men," he said.

Dr. Hoehn said, "The study will also provide useful information on medical, patient-centered, and cost outcomes of treatment options and guide selection of appropriate treatment for this common surgical disease."

Researchers in five areas of the nation, including Marshfield Clinic, will enroll 753 men with inguinal hernias that are causing no or minor symptoms. Other study locations are in Omaha, Nebraska; Dallas; Los Angeles; and Albuquerque, New Mexico.