Groin hernia pathway (Guidelines)



Highland HSCP and Argyll & Bute HSCP
Primary and Secondary Care

Quick reference guide


* In a symptomatic patient not fit for / not wishing to consider surgery, conservative management could include:

  • Advice
  • Analgesia
  • Consideration of a truss.
    Some patients find these very helpful for symptom 
    management (can also be used while awaiting surgery), while others find they are too uncomfortable to wear. A referral can be made through Orthotics for the patient to be measured for a truss but many patients are happy to purchase these online and some patients find purchased sports style support garments more comfortable to wear

** Unilateral groin pain is common, particularly in men, and it is frequently not possible to make a clear diagnosis. 

  • The most common causes are musculo-ligamentous strain or referred pain from the hip.
  • Hernias rarely present with pain alone.
  • Ultrasound is generally unhelpful and tends to lead to the over diagnosis of hernias (can detect fat moving up and down the inguinal canal which may be labelled as a “hernia” but is a normal finding). As such referral for ultrasound scans from primary care exclusively to look for a hernia are unlikely to be accepted by the Radiology Department.

Last reviewed: 27/10/2022

Next review date: 31/10/2025

Author(s): Department of General Surgery .

Version: 1

Approved By: TAM Subgroup of ADTC

Reviewer name(s): Cherith Sutton Speciality Doctor in General Surgery .

Document Id: TAM531

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