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Contralateral inguinal hernia in childhood and youth: which child will develop a contralateral inguinal hernia?

G Steinau1, G Böhm, P Vaassen

  • 1Rhenish-Westfalian Technical University, Aachen, Germany. gsteinau@ukaachen.de

Hernia : the Journal of Hernias and Abdominal Wall Surgery
|July 3, 2008
PubMed

Insights

Infants under two months with a one-sided inguinal hernia have a high risk of developing a contralateral hernia. Simultaneous bilateral repair is recommended for this age group to prevent further complications.

Area of Science:

  • Pediatric Surgery
  • Neonatal Care

Background:

  • Inguinal hernias are common in infants, with management of unilateral cases often debated regarding contralateral exploration.
  • The incidence and timing of contralateral hernia development in infants with unilateral inguinal hernias require further investigation.

Purpose of the Study:

  • To investigate the incidence of contralateral inguinal hernia development in infants initially presenting with a unilateral inguinal hernia.
  • To identify risk factors, specifically age at initial surgery, associated with the development of a consecutive contralateral hernia.

Main Methods:

  • A prospective study was conducted involving 368 infants diagnosed with a unilateral inguinal hernia.
  • Data collected included patient age at initial operation and the subsequent development of a contralateral hernia.

Main Results:

  • A consecutive contralateral inguinal hernia developed in 6% (22 out of 368) of the studied children.
  • Infants operated on at less than two months of age showed a highly significant accumulation of consecutive hernias (P < 0.0001).
  • Contralateral hernias appeared significantly often within two months post-operation in children aged two months or older at initial surgery (P < 0.0009).

Conclusions:

  • Age at initial surgical repair is a significant risk factor for the development of contralateral inguinal hernias in infants.
  • Routine simultaneous bilateral repair is indicated for infants under two months of age presenting with a unilateral inguinal hernia.

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