Köckerling F, et al. - Researchers analyzed data of 15,601 female patients from the Herniamed Registry in order to recognize factors influencing the outcome in female groin hernia repair. These patients had undergone primary unilateral groin hernia repair with the Lichtenstein, Shouldice, totally extraperitoneal patch plasty (TEP) and transabdominal preperitoneal patch plasty (TAPP) technique, and had 1-year follow-up available. Multivariable analysis revealed a significantly higher risk of postoperative complications, complication-related reoperations, recurrences, and pain on exertion, only for the Lichtenstein technique. Preoperative pain, existing risk factors, larger defects, a higher body mass index, higher American Society of Anesthesiologists classification and postoperative complications were the relevant risk factors for occurrence of perioperative complications, recurrences, and chronic pain. They noted a negative correlation of higher age with postoperative complications and positive association with pain rates. As per these findings, they recommend performing female groin hernia repair with the TEP or TAPP laparo-endoscopic technique, or, alternatively, with the Shouldice technique, if there is no evidence of a femoral hernia.