Risk factors for inguinal hernia in adult male Nigerians: a case control study

We sought to evaluate selected risk factors for development of inguinal hernia in adult male Nigerians in a hospital based case control study. The aim was to identify the risks for this condition in our population. This may assist in instituting appropriate preventive measures towards early detection and treatment.

All male patients aged 18 years and above who presented with primary inguinal hernia at the General Surgical clinic of Ikorodu General Hospital between April 2009 and March 2011 were enrolled into the study as cases. Control subjects were selected randomly from the general out-patient clinic. Participants were interviewed during their first clinic attendance using a standardised questionnaire to record their bio-data and the presence or absence of the risk factors. All study cases had hernia repair and the type of hernia, whether indirect or direct was determined and documented. SPSS version 15.0 was used in the statistical analysis and the risk factors among the cases and controls were compared using univariate and multivariate logistic regression analysis.

A total number of 404 male patients were interviewed. Two hundred and two were the cases while the remaining 202 were the controls. Significant risk factors for inguinal hernia were positive family history of inguinal hernia (p < 0.001 and strenuous work activities (p < 0.001). Among the cases, 132 (65.3%) had indirect hernia while the remaining 70 (34.7%) had direct hernia. Positive family history (p = 0.011) and straining during urination or defecation (p = 0.047) were the factors significantly associated with the type of hernia.

Family history of inguinal hernia and strenuous work activity are the significant risk factors for this condition in our setting. Public health initiatives targeting those at higher risk of hernia development may help early detection and treatment; thereby reducing morbidity and mortality from this condition.