Managing hernia. Surgery isn’t the only option for managing inguinal hernia.6 Watchful waiting is safe and acceptable for asymptomatic or minimally symptomatic individuals. Acute complications are rare, and patients who delay surgery don’t have a higher risk of operative or postoperative complications.
What about routine testicular cancer screening?
The US Preventive Services Task Force (USPSTF) hasn’t made a recommendation on hernia screening, but recommends against routine screening for testicular cancer in asymptomatic adolescents and adults.7 The recommendation is based on the low prevalence of testicular cancer and the unknown accuracy of testicular examination in detecting it. Even without screening, current treatments produce very favorable health outcomes.
Although the USPSTF didn’t identify any potential harm from screening for testicular cancer, no evidence suggests that screening provides any benefit over current case-finding practices. Moreover, because some evidence suggests that testicular cancer is often misdiagnosed initially, resources might be better dedicated to proper evaluation of patients with symptoms.
Recommendations
Routine male genitourinary examination during the PPE, including testicular and hernia evaluation, is recommended by the American Academy of Family Physicians (AAFP), American Academy of Pediatrics, American College of Sports Medicine, American Medical Society for Sports Medicine, American Orthopedic Society for Sports Medicine, and American Osteopathic Academy of Sports Medicine.8
The latest AAFP position statement reflects the USPSTF recommendation against routine screening for testicular cancer in asymptomatic adolescents and adults.9