Sir, According to the Danish and the Swedish hernia registry [1, 2] inguinal herniorrhaphy seems to be associated with more recurrencies in women than in men; this is particularly true for femoral hernia. The Danish results have been the subject of much dissenting discussion in this journal [3–5], but without any doubt, both of these registers show the same trend. Therefore, the clinical impact of this trend should now be the subject of due discussion. Female and male hernias can be regarded as partly diVerent entities [3] and, in this context, the clinical classiWcation should be more precise. That is to say, the clinical classiWcation should distinguish between real hernia (with diameter) or broad insuYciency. The femoral canal should also be controlled in any female hernia operation and classiWed. The type of repair should also be discussed. The high proportion of femoral recurrencies in women [1, 2] may also be explained – over and above some cases in which the femoral component of a combined hernia has not been recognized – by the high proportion of Lichtenstein repair, which will not stabilize the femoral ring and, as a result of impairment of the abdominal wall that strengthens the fascia transversalis, weaken the femoral canal. This assumption strongly suggests the use of the preperitoneal plane as the plane of mesh implantation, either through open surgery or by laparoscopy. The same assumption may explain the diVerences in the discussion of Bay-Nielsen and Kehlet versus Bendavid in this journal, which ultimately concluded that the Shouldice repair does not show such a degree of impairment as the mesh implantation in the plane of the inguinal canal. Further analysis of the Danish and Swedish hernia register may resolve this problem.