Epidemiology of Inguinal Hernia: A Useful Aid for Adequate Surgical Decisions

  • Alejandro Weber
  • Denzil Garteiz
  • Salvador Valencia


Hernias of the abdominal wall constitute an important public health problem and often pose a surgical dilemma even for the most skilled surgeon.1 In most countries, hernioplasty and cholecystectomy are the most common forms of elective surgery. In the United States alone, between 500,000 and 750,000 patients are operated on for inguinal hernia each year.2 Yet, in spite of its great incidence, precise epidemiological data about inguinal hernia are difficult to obtain.


Hernia Repair Inguinal Hernia Inguinal Hernia Repair Femoral Hernia Groin Hernia 
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.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Wexler MJ. Herniorrafia inguinal laparoscópica. In: American College of Surgeons’ Scientific American Cirugía. New York: Scientific American; 1995; Sup.5:1–3.Google Scholar
  2. 2.
    Rutkow I. Epidemiologic, economic, and sociologic aspects of hernia surgery in the United States in the 1990s. Surg Clin North Am. 1998; 78:941–951.PubMedCrossRefGoogle Scholar
  3. 3.
    Rutkow IM, Robbins AW. Demographic, classificatory, and socioeconomic aspects of hernia repair in the United States. Surg Clin North Am. 1993;73:413–426.PubMedGoogle Scholar
  4. 4.
    Ralphs DNL, Brain AJL, Grundy DJ, Hobsley M. How accurately can direct and indirect inguinal hernias be distinguished? Br Med J. 1980; 280;1039–1040.PubMedCrossRefGoogle Scholar
  5. 5.
    Malgaigne J: Leçons cliniques sur les hernies. Paris: Baillière; 1841:19, 174.Google Scholar
  6. 6.
    Iason A. The incidence of hernia in man. In: Hernia. Philadelphia: Blakiston; 1941:156–179.Google Scholar
  7. 7.
    el-Qaderi S, Aligharaibeh KI, Hani IB, et al. Hernia in northern Jordan. Some epidemiological considerations. Trop Geogr Med. 1992;44: 281–283.PubMedGoogle Scholar
  8. 8.
    Wantz GE. Abdominal wall hernias. In: Schwartz SI, Shires GT, Spencer FC, et al., eds. Principles of surgery. New York: McGraw-Hill, Inc.; 1999: 1585–1611.Google Scholar
  9. 9.
    Primatesta P, Goldcare MJ. Inguinal hernia repair: incidence of elective and emergency surgery, readmission and mortality. Int J Epidemiol. 1996;25:835–839.PubMedCrossRefGoogle Scholar
  10. 10.
    Ponka JL. Hernias of the abdominal wall. Philadelphia: W.B. Saunders; 1980:82–89.Google Scholar
  11. 11.
    Bronsther B, Abrams MW, Elboim C. Inguinal hernias in children. A study of 1000 cases and review of the literature. J Am Med Worn Assoc. 1972;27:522–535.Google Scholar
  12. 12.
    Snyder WH, Greany EM. Inguinal hernia. In: Mustard WT, Ravitch MM, Snyder WH, et al., eds: Pediatric surgery, 2nd ed. Chicago: Medical Year Book; 1969:692.Google Scholar
  13. 13.
    Chin T, et al. The morphology of the contralateral internal inguinal rings is age-dependent in children with unilateral inguinal hernia. J Pediatr Surg. 1995;30:1663–1665.PubMedCrossRefGoogle Scholar
  14. 14.
    Miltenburg DM, et al. Laparoscopic evaluation of the pediatric inguinal hernia—a meta-analysis. J Pediatr Surg. 1998;33:874–879.PubMedCrossRefGoogle Scholar
  15. 15.
    Powell TG, Hallows JA, Cooke RWI, et al. Why do so many small infants develop an inguinal hernia? Arch Dis Child. 1986;61:991–995.PubMedCrossRefGoogle Scholar
  16. 16.
    Akin ML, Karakaya M, Batkin A, et al. Prevalence of inguinal hernia in otherwise healthy males of 20 to 22 years of age. J R Army Med Corps. 1997;143:101–102.PubMedGoogle Scholar
  17. 17.
    Abramson JH, Gofin J, Hopp C, et al. The epidemiology of inguinal hernia. A survey in western Jerusalem. J Epidemiol Community Health. 1978;32:59–67.PubMedCrossRefGoogle Scholar
  18. 18.
    Cox JA. Inguinal hernia of childhood. Surg Clin North Am. 1985;65: 1331–1342.PubMedGoogle Scholar
  19. 19.
    Rescorla FJ, Grosfeld JL. Inguinal hernia repair in the perinatal period and early infancy: clinical considerations. J Pediatr Surg. 1984;19: 832–837.PubMedCrossRefGoogle Scholar
  20. 20.
    Rodriguez RI, Flores PLC, Domínguez GFJ, et al. Hernia inguinal unilateral: ¿exploratión quirúrgica contralateral sistemática? Cir Gen. 1993;15:2–5.Google Scholar
  21. 21.
    Holcomb GW 3rd, et al. Laparoscopic evaluation for a contralateral patent processus vaginalis. J Pediatr Surg. 1994;29:970–973.PubMedCrossRefGoogle Scholar
  22. 22.
    Miltenburg DM, Nüchtern J, Jaksic T, et al. Meta-analysis of the risk of metachronous hernia in infants and children. Am J Surg. 1997;174:741–744.PubMedCrossRefGoogle Scholar
  23. 23.
    Moss RL, Hatch EI. Inguinal hernia repair in early infancy. Am J Surg. 1991;161:596–599.PubMedCrossRefGoogle Scholar
  24. 24.
    Christianson RE. The relationship between maternal smoking and the incidence of congenital anomalies. Am J Epidemiol. 1980;112:684–695.PubMedGoogle Scholar
  25. 25.
    Ekberg O, Lasson A, et al. Ipsilateral multiple groin hernias. Surgery 1994;115:557–561.PubMedGoogle Scholar
  26. 26.
    Weber A, Garteiz D, Cueto J. Stoppa-type laparoscopic repair of complex groin defects. Surg Laparosc Endosc. 1999;9:14–16.PubMedCrossRefGoogle Scholar
  27. 27.
    Tetik C, Arregui ME, Dulucq JL, et al. Complications and recurrences associated with laparoscopic repair of groin hernias. A multi-institutional retrospective analysis. Surg Endosc. 1994;8:1316–1323.PubMedCrossRefGoogle Scholar
  28. 28.
    Phillips EH, Arregui M, Carroll BJ, et al. Incidence of complications following laparoscopic surgery. Surg Endosc. 1995;9:16–21.PubMedGoogle Scholar
  29. 29.
    Woodward AM, Choe EU, Flint LM, et al. The incidence of secondary hernias diagnosed during laparoscopic total extraperitoneal inguinal herniorrhaphy. J Laparoendosc Adv Surg Tech A. 1998;8:33–38.PubMedCrossRefGoogle Scholar
  30. 30.
    Felix EL, Michas CA, González MH. Laparoscopic hernioplasty: why does it work? Surg Endosc. 1997;11:36–41.PubMedCrossRefGoogle Scholar
  31. 31.
    Schapp HM, Van de Pavoordt HD, Bast TJ. The preperitoneal approach in the repair of recurrent inguinal hernias. Surg Gynecol Obstet. 1992;174:460–464.Google Scholar
  32. 32.
    Ijzermans J, Wilt H, Hop W, et al. Recurrent inguinal hernia treated by classical hernioplasty. Arch Surg. 1991;126:1097–1100.PubMedCrossRefGoogle Scholar
  33. 33.
    Marsden AJ. Recurrent inguinal hernia—a personal study. Br J Surg. 1988;75:263–266.PubMedCrossRefGoogle Scholar
  34. 34.
    Rutledge R. Cooper’s ligament repair: a 25-year experience with a single technique for all groin hernias in adults. Surgery. 1988;103:1–10.PubMedGoogle Scholar
  35. 35.
    Posdethwait RW. Causes of recurrence after inguinal herniorrhaphy. Surgery. 1971;69:772–775.Google Scholar
  36. 36.
    Halverson K, McVay CV Inguinal and femoral hernioplasty: a 22-year study of the author’s method. Arch Surg. 1970;11:127–135.CrossRefGoogle Scholar
  37. 37.
    Thieme ET. Recurrent inguinal hernia. Arch Surg. 1971;13:238–241.CrossRefGoogle Scholar
  38. 38.
    Peacock EE, Madden JW. Studies on the biology and treatment of recurrent inguinal hernia: II. Morphological changes. Ann Surg. 1974; 179:567–571.PubMedCrossRefGoogle Scholar
  39. 39.
    Read RC. Attenuation of the rectus sheath in inguinal herniation. Am J Surg. 1970;120:610.PubMedCrossRefGoogle Scholar
  40. 40.
    Schumpelick V, Treutner K-H, Arlt G. Inguinal hernia repair in adults. Lancet. 1994;344:375–378.PubMedCrossRefGoogle Scholar
  41. 41.
    Rai S, Chandra SS, Smile SR. A study of the risk of strangulation and obstruction in groin hernias. Aust N Z J Surg. 1998;68:650–654.PubMedCrossRefGoogle Scholar
  42. 42.
    Gallegos NC, Dawson J, Jarvis M, et al. Risk of strangulation in groin hernia. Br J Surg. 1991;78:1171–1173.PubMedCrossRefGoogle Scholar
  43. 43.
    Liem MS, van der Graaf Y, Zwart RC, et al. Risk factors for inguinal hernia in women: a case-control study. The Coala trial group. Am J Epidemiol. 1997;146:721–726.PubMedCrossRefGoogle Scholar
  44. 44.
    Flich J, Alfonso JL, Delgado F, et al. Inguinal hernia and certain risk factors. Eur J Epidemiol. 1992;8:277–282.PubMedCrossRefGoogle Scholar
  45. 45.
    Cannon DJ, Read RC. Metastatic emphysema. A mechanism for acquiring inguinal herniation. Ann Surg. 1981;194:270–273.PubMedCrossRefGoogle Scholar
  46. 46.
    Cannon DJ, Casteel L, Read RC. Abdominal aortic aneurysm, Leriche’s syndrome, inguinal herniation, and smoking. Arch Surg. 1984;119:387–389.PubMedCrossRefGoogle Scholar
  47. 47.
    Jorgensen LN, Kallehave F, Christensen E, et al. Less collagen production in smokers. Surgery. 1998;123:450–455.PubMedCrossRefGoogle Scholar
  48. 48.
    Read RC. Cigarette smoking, herniation, and recurrence. Surgery. 1998;124:942.PubMedCrossRefGoogle Scholar
  49. 49.
    Kindon JA. On the causes of hernia. Roy Med Chir Trans Lond. 1864; 47:295–321.Google Scholar
  50. 50.
    Ashley M. A case of familial inheritance of oblique inguinal hernia. J Hered. 1942;33:355.Google Scholar
  51. 51.
    Mayo C. Congenital hernia in three boys of the same family. Proc Staff Meet Mayo Clin. 1930;5:103.Google Scholar
  52. 52.
    Warren LF, Atleson F. Inheritance of hernia in a family of Holstein-Friesian cattle. J Hered. 1931;22:345.Google Scholar
  53. 53.
    Smith MP, Sparkes RS. Familial inguinal hernia. Surgery. 1968;57: 809–812.Google Scholar
  54. 54.
    Jones ME, Swerdlow AJ, Griffith M, et al. Risk of congenital inguinal hernia in siblings: a record linkage study. Paediatr Perinat Epidemiol. 1998;12:288–296.PubMedCrossRefGoogle Scholar
  55. 55.
    Gong Y, Shao C, Sun Q, et al. Genetic study of indirect inguinal hernia. J Med Genet. 1994;31:187–192.PubMedCrossRefGoogle Scholar
  56. 56.
    Hippocrates. Quoted by Selye, H. Lathyrism. Can Biol. 1957; 16:1.Google Scholar
  57. 57.
    Harrison PW. Inguinal hernia: a study of the principles involved in the surgical treatment. Arch Surg. 1922;4:680–689.CrossRefGoogle Scholar
  58. 58.
    Wagh PV, Read RC. Collagen deficiency in rectus sheath of patients with inguinal herniation. Proc Soc Exp Biol Med. 1971;137:382.Google Scholar
  59. 59.
    Wagh PV, Read RC. Defective collagen synthesis in inguinal herniation. Am J Surg. 1972;124:819–822.PubMedCrossRefGoogle Scholar
  60. 60.
    Wagh PV, Leverich AP, Sun CN, et al. Direct inguinal herniation in men: a disease of collagen. J Surg Res. 1974;17:425–433.PubMedCrossRefGoogle Scholar
  61. 61.
    Bellon JM, Bujan J, Honduvilla NG, et al. Study of biochemical substrate and role of metalloproteinases in fascia transversalis from hernial processes. Eur J Clin Invest. 1997;27(6):510–516.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2001

Authors and Affiliations

  • Alejandro Weber
    • 1
  • Denzil Garteiz
    • 2
  • Salvador Valencia
    • 3
  1. 1.Department of General SurgeryHospital Angeles de las LomasHuixquilucanMexico
  2. 2.Department of General SurgeryHospital Angeles de las LomasHuixquilucanMexico
  3. 3.Department of General SurgeryHospital Angeles de las LomasHuixquilucanMexico

Personalised recommendations