Herniographic appearance of contralateral inguinal hernia

In 303 adults (185 men, 118 women) with unilateral groin pain and a normal physical examination, positive contrast herniography was performed. In 32 per cent of the patients a symptomatic hernia (ipsilateral) and in 18 per cent an asymptomatic hernia (contralateral) were found. The type of hernia was indirect, direct, femoral or obturator. Indirect and direct inguinal hernias were significantly more frequent on the ipsilateral side compared with the contralateral in men with right-sided groin pain. In women with left-side groin pain femoral hernias were significantly more frequent on the ipsilateral side compared with the contralateral. The size alone could not discriminate between ipsi- and contralateral hernias. The results indicate that in most patients there is no specific radiographic appearance which can discriminate between symptomatic and asymptomatic hernias.