Letters Section Editor: Robert M. Golub, MD, Senior Editor.
To the Editor: Dr Fitzgibbons and colleagues1 compared watchful waiting with the surgical repair of minimally symptomatic inguinal hernia in men. However, they did not indicate how the outcomes may have differed between patients with direct and indirect inguinal hernias. The anatomy of the inguinal canal is important in this regard. Indirect inguinal hernias present through the internal inguinal ring and carry a significant risk of incarceration and/or strangulation. Direct inguinal hernias present through the floor of the inguinal canal and carry considerably less risk of complications.2
Smith GW. Repair of Inguinal Hernia vs Watchful Waiting. JAMA. 2006;295(23):2724-2725. doi:10.1001/jama.295.23.2724-b