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Prevalence and repair of inguinal hernias in children with bladder exstrophy

J A Connolly1, D S Peppas, R D Jeffs

  • 1Division of Pediatric Urology, James Buchanan Brady Urological Institute, Johns Hopkins Hospital, Johns Hopkins University School of Medicine, Baltimore, Maryland 21287-2101, USA.

The Journal of Urology
|November 1, 1995
PubMed

Insights

Children with bladder exstrophy have a high incidence of inguinal hernias, particularly boys. Early detection and careful preperitoneal repair focusing on the internal ring are crucial to minimize recurrence.

Area of Science:

  • Pediatric Surgery
  • Urology
  • Congenital Abnormalities

Background:

  • Bladder exstrophy is a complex congenital condition.
  • Inguinal hernias are a common co-occurrence in this population.
  • Understanding hernia characteristics is vital for management.

Purpose of the Study:

  • To determine the prevalence and recurrence rates of inguinal hernias in children with bladder exstrophy.
  • To identify optimal treatment strategies for these hernias.

Main Methods:

  • Retrospective review of 181 children with exstrophy.
  • Analysis of hernia development, surgical repair methods, and recurrence.
  • Evaluation of internal ring defects and processus vaginalis patency.

Main Results:

  • Inguinal hernias developed in 66.8% of the cohort.
  • Prevalence was significantly higher in boys (81.8%) than girls (10.5%).
  • Overall recurrence rate was 8.3%, with 81.8% bilaterality.

Conclusions:

  • Routine screening for inguinal hernias is recommended before bladder closure in exstrophy patients.
  • Contralateral exploration is advised for unilateral hernias.
  • Preperitoneal repair emphasizing internal ring closure is the preferred method.
Abstract

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