In advising a patient preoperatively of potential complications of operative treatment of an inguinal hernia, which of the following statement(s) is/are true?

a. Severe symptoms due to sensory nerve entrapment or injury can occur

c. Recurrent hernia after primary groin repair should occur in less than 10% of cases

d. Wound infection increases the risk of recurrent hernia

Many complications can occur with operations to repair an inguinal hernia. Sensory nerve injury may lead to disabling symptoms from neuromas or nerve entrapment during inguinal hernia repair. Although vascular injuries are uncommon in inguinal repair, the proximity of the femoral vein to the structures used in the hernia repair makes injury of this vessel the most frequent vascular injury observed. Hernia recurrence after primary groin hernia repairs should be infrequent and varies in several large series from less than one percent to almost nine percent. The prevalence of recurrent hernia may be higher after repair of recurrent groin hernia. Factors responsible for hernia recurrence include closure under excessive tension, failure to identify and use an adequately strong musculoaponeurotic tissue, and wound infection.