VOLUMETRIC CLASSIFICATION OF INGUINOSCROTAL SWELLINGS

External hernias and scrotal swellings are diverse in presentation and are described in many subjective ways.

To create an objective classification of inguinoscrotal swellings in the rural setting.

It was a prospective study on the measurement of inguinoscrotal swellings volume/contents in a cohort of surgical patients in a provincial general hospital in the north of Sierra Leone over a three-year period. For inguinal hernias and other scrotal swellings, the volume ranges of 0- 500ml were used in the classification; for femoral and other external hernias which generally do not reach 'huge' sizes, the volume ranges of 0-100 ml were used.

A total of 962 external hernias and hydroceles were classified over a 3- year period. Most, 610 (63.4%) were inguino-scrotal hernias, others were hydroceles, 303 (31.0%) and femoral hernias, 42 (4.3%). The remaining small number consisted of umbilical (4) and epigastric (3) hernias. For the common conditions of hydroceles, inguinal and femoral hernias, about 50% were 'small', more than 40% were 'large', the rest were giant. The same findings were true for epigastric and umbilical hernias.

Using the scale that we adopted, majority of the groin hernias and hydroceles were in the small and large categories with a few giant varieties. Volumetric-based classification of hernias and hydroceles can help surgeons communicate more clearly based on standard rather than arbitrary ascription of descriptive terminologies to these very common surgical entities.