Inguinal hernia repair timing in bladder exstrophy: A systematic review.

Area of Science:

• Pediatric Surgery
• Urology
• Congenital Anomalies

Background:

• Bladder exstrophy (BE) is a rare congenital anomaly with a high incidence of associated inguinal hernias, particularly in males.
• The optimal timing for inguinal hernia repair in BE patients remains a subject of debate.
• Current approaches include repair during primary bladder closure or delayed symptomatic repair.

Purpose of the Study:

• To systematically evaluate the optimal timing for inguinal hernia repair in patients with bladder exstrophy.
• To synthesize current literature regarding surgical approaches and outcomes for inguinal hernias in BE.

Main Methods:

• A systematic review was conducted following PRISMA guidelines.
• Searches were performed in PubMed, Web of Science, and Scopus.
• Fourteen studies involving 1042 BE patients were included.

Main Results:

• 537 out of 1042 BE patients (84% male) underwent inguinal hernia repair.
• Concomitant inguinal hernia repair (CIH) was performed in 38% of cases, with 67% requiring bilateral repair.
• Heterogeneity in study design and surgical techniques limited direct comparisons.

Conclusions:

• Concurrent bilateral groin exploration with selective hernia repair during primary exstrophy surgery may reduce procedural burden.
• Further research is necessary to refine surgical techniques and optimize patient selection due to study design limitations and recurrence rates.
• Optimizing the timing and approach for inguinal hernia repair in BE is crucial for improved patient outcomes.