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The pediatric inguinal hernia: is contralateral exploration justified?

H L Lugo Vicente1

  • 1Department of Surgery, Universidad Central del Caribe, School of Medicine, San Juan, PR 00922-0426.

Boletin De La Asociacion Medica De Puerto Rico
|January 1, 1995
PubMed
Summary

Contralateral inguinal hernia exploration in children is justified, especially in females and infants under two months. Routine exploration helps detect patent processus vaginalis, preventing future hernias without significant complications.

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Area of Science:

  • Pediatric Surgery
  • Surgical Outcomes

Background:

  • Inguinal hernias are common in infants, with potential for contralateral involvement.
  • Bilateral repair is often considered to address this risk.

Purpose of the Study:

  • To evaluate the justification for contralateral inguinal hernia exploration in pediatric patients.
  • To identify factors influencing positive contralateral findings.

Main Methods:

  • Retrospective review of 161 pediatric patients undergoing bilateral inguinal hernia repair.
  • Analysis of intraoperative findings, including patent processus vaginalis.
  • Six-year follow-up for complications like testicular issues or recurrence.

Main Results:

  • Positive contralateral findings (hernial sac or patent processus vaginalis) were observed in 74% of right-sided and 72% of left-sided hernias.

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  • Females and infants younger than two months showed a higher probability of positive contralateral findings.
  • No significant complications such as testicular edema, atrophy, vas deferens injury, or recurrence were reported.

    • Conclusions:

    • Routine contralateral exploration is beneficial for identifying and addressing patent processus vaginalis in pediatric inguinal hernias.
    • Specific criteria, including surgeon experience and minimizing operative time, support routine contralateral exploration.