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Contralateral patent processus vaginalis repair in boys: a single-center retrospective study
Liu Jinxiang1, Cao Qingwei2, Qiu Shenghua2
1Master of Medicine, Linyi Central Hospital, Linyi, Shandong, China. 461900909@qq.com.
Insights
Contralateral patent processus vaginalis (CPPV) is common in children with inguinal hernias (IHs), with higher incidence in boys. Routine contralateral exploration may prevent future hernias.
Area of Science:
- Pediatric Surgery
- Surgical Outcomes
- Hernia Repair
Background:
- The processus vaginalis typically obliterates after birth but can remain patent.
- A patent processus vaginalis is a precursor to inguinal hernias.
- Understanding contralateral patent processus vaginalis (CPPV) prevalence is crucial for surgical management.
Purpose of the Study:
- To determine the prevalence of CPPV in male patients undergoing inguinal hernia (IH) repair.
- To analyze the trends of CPPV prevalence across different age groups.
- To evaluate the clinical significance of CPPV for treatment strategies.
Main Methods:
- Retrospective review of 3243 male patients with IH from 2014-2018.
- Analysis of hernia side, age, and presence of CPPV.
- Comparison of CPPV prevalence and recurrence rates between pediatric and adult groups.
Main Results:
- CPPV was identified in 1124 of 2386 children (47.1%) with unilateral IH, versus 12 of 267 adults (4.5%).
- The incidence of IH was significantly higher in boys than men, declining rapidly with age.
- No significant difference in recurrence rates was observed among pediatric subgroups.
Conclusions:
- CPPV is highly prevalent in pediatric patients with IH, suggesting routine contralateral exploration may be beneficial.
- The high incidence of CPPV in children underscores the importance of considering prophylactic contralateral repair.
- Age-related decline in IH incidence and CPPV prevalence highlights developmental changes in the processus vaginalis.
Abstract:
To ascertain the prevalence of contralateral patent processus vaginalis (CPPV) in life and the significance of the prevalence trends for treatment. We performed a retrospective review of all inguinal hernias (IHs) that underwent repair in our hospital from 2014 to 2018. We analyzed the frequency of occurrence and treatment in boys. We assessed and compared the history, initial sides of hernia, CPPV and prognoses in different age groups. We assessed all IH cases repaired in our hospital and selected male patients of a variety of ages, including boys and men. Recurrent cases were not enrolled. A total of 3243 cases were enrolled: 2489 [right-sided IH 1411 (56.69%) vs. left-sided IH 975 (39.17%), bilateral IH 103 (4.14%)] in children and 754 [right-sided IH 485 (64.32%) vs. left-sided IH 236 (31.30%), bilateral IH 33 (4.38%)] in adults. A total of 1124 CPPVs were identified in children with unilateral IH (2386), and 12 were identified in adults (267) (p < 0.0001). There were no significant differences in recurrence rate between different subgroups of children (p > 0.05). The incidence of IH in boys was significantly higher than that in men. The number of incident cases declines rapidly with age in boys. The processus vaginalis is normally obliterated and involuted but may instead remain patent for a long period before closure; routine exploration on the contralateral side may eliminate the possibility of spontaneous PPV closure.
