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Contralateral groin exploration is not justified in infants with a unilateral inguinal hernia

  • J Shabbir
  • A Moore
  • JB O’Sullivan
  • PV Delaney
  • J Drumm
  • H Flood
  • PA Grace
Original Paper

Abstract

Background Contralateral groin exploration in children with unilateral inguinal hernia is still controversial, particularly in infants. The patency rate of processus vaginalis is highest in infants but there are few data on the subsequent risk of contralateral hernia development in infants. In this retrospective study, we aimed to find out the incidence of contralateral inguinal hernia following unilateral inguinal herniotomy in infants aged less than one year.

Methods All infants who underwent a unilateral inguinal herniotomy between January 1990 and December 1998 were studied retrospectively. Infants with bilateral hernia (n=7) were excluded from the study.

Results One hundred and one infants (93 boys and 8 girls) were studied. Median age at operation was 23 (range 2–52) weeks. The herniotomy was right-sided in 75% of the infants. Follow-up ranged from three and a half years to 11 years. A contralateral hernia developed in nine infants (9.0%). One of the initial hernias was incarcerated. Median time from operation to occurrence of contralateral hernia was 18 (range 2–60) months. None of the contralateral hernia was incarcerated. Age, sex, incarceration and side of initial hernia did not influence the development of contralateral hernia.

Conclusion The low incidence and benign nature of contralateral hernia development in infants undergoing a unilateral inguinal herniotomy does not justify routine contralateral groin exploration.

Keywords

Inguinal Hernia Hydrocele Bilateral Hernia Contralateral Hernia Contralateral Exploration 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. 1.
    Rowe MI, Clatworthy HW. The other side of the paediatric inguinal hernia.Surg Clin North Am 1971; 51: 1371–6.PubMedGoogle Scholar
  2. 2.
    Gilbert M, Clatworthy HW. Bilateral operation for inguinal hernia and hydrocele in infancy and childhood.Am J Surg 1959; 97: 255–9.PubMedCrossRefGoogle Scholar
  3. 3.
    Hrabovszky Z, Pinter AB. Routine bilateral exploration for inguinal hernia in infancy and childhood.Eur J Pediatr Surg 1995; 5: 152–5.PubMedCrossRefGoogle Scholar
  4. 4.
    Sparkman RS. Bilateral exploration in inguinal hernia in juvenile patients.Surgery 1962; 51: 393–06.PubMedGoogle Scholar
  5. 5.
    Ballantyne A, Jawaheer G, Munro FD. Contralateral groin exploration is not justified in infants with a unilateral inguinal hernia.Br J Surg 2001; 88: 720–23.PubMedCrossRefGoogle Scholar
  6. 6.
    Lym L, Ross JH, Alexander F, Kay R. Risk of contralateral hydrocele or hernia after unilateral hydrocele repair in children.J Urol 1999; 162: 1169–71.PubMedCrossRefGoogle Scholar
  7. 7.
    Tackett LD, Breuer CK, Luks FI et al. Incidence of contralateral inguinal hernia:a prospective analysis.J Pediatr Surg 1999; 34: 684–8.PubMedCrossRefGoogle Scholar
  8. 8.
    Given JP, Rubin SZ. Occurrence of contralateral inguinal hernia following unilateral repair in a paediatric hospital.J Pediatr Surg 1989; 24: 963–5.PubMedCrossRefGoogle Scholar
  9. 9.
    Surana R, Puri P. Is contralateral exploration necessary in infants with unilateral inguinal hernia?J Pediatr Surg 1993; 28: 1026–7.PubMedCrossRefGoogle Scholar
  10. 10.
    Janik JS, Shandling B. The vulnerability of the vas deferens. (ii) The case against routine bilateral inguinal exploration.J Paed Surg 1982; 17: 585–8.CrossRefGoogle Scholar

Copyright information

© Springer London 2003

Authors and Affiliations

  • J Shabbir
    • 1
  • A Moore
    • 1
  • JB O’Sullivan
    • 1
  • PV Delaney
    • 1
  • J Drumm
    • 1
  • H Flood
    • 1
  • PA Grace
    • 1
  1. 1.Department of SurgeryMid-Western Regional HospitalLimerickIreland

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