Contralateral exploration is not mandatory in unilateral inguinal hernia in children: a prospective 6-year study

Contralateral exploration (CE) in children with a unilateral inguinal hernia (IH) is still controversial. To define the necessity of CE in unilaterally-presenting IH, all patients who had been operated upon unilaterally in a 6-year period and were followed for 4-10 years had annual evaluations for a contra-lateral IH. Comparison of the frequency of different variables was done by chi-square test. Of 650 patients aged 1 month-12 years, 521 (3.6%) developed a contralateral IH. There was no significant difference in occurrence in the different sex and age groups. There was a significant difference in the side of presentation: patients who presented with a left-sided hernia had a greater chance of developing a contralateral IH (P = 0.006). The finding of a patent processus vaginalis (PPV) in the literature is usually present in over 35% of cases, while the occurrence of a contralateral hernia is usually seen in less than 15% of cases. In our study this rate was also very low (3.6%). Therefore, it seems that most PPVs will close or remain asymptomatic and only a few will lead to IHs, so that routine CE does not seem justified.