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At least 19 recordsLinked to original sources
PubMed2026

CT-Derived pelvic morphometry for preoperative risk assessment of recurrent unilateral inguinal hernia.

BACKGROUND: Recurrent inguinal hernia remains a significant challenge in abdominal wall surgery despite advances in mesh-based repair techniques and minimally invasive approaches. Although pelvic skeletal morphology has been implicated in inguinal hernia development, its association with recurrent disease remains incompletely understood. This study aimed to evaluate computed tomography (CT)-derived pelvic morphometric parameters and investigate their potential value in preoperative recurrence risk assessment. METHODS: This retrospective study included 251 male patients with preoperative abdominal CT examinations and complete clinical records who underwent elective inguinal hernia repair at a tertiary referral center. After applying the predefined eligibility criteria, 188 patients with unilateral inguinal hernias constituted the primary study cohort, including 162 primary and 26 recurrent unilateral hernias. The Radoievitch angle and Ami's line were measured independently by two blinded radiology residents using a standardized CT-based pelvic morphometric measurement protocol, and the mean values were used for analysis. Multivariable logistic regression and receiver operating characteristic (ROC) curve analyses were performed to evaluate the association between pelvic morphometric parameters and recurrent inguinal hernia. RESULTS: Patients with recurrent unilateral inguinal hernias demonstrated significantly greater affected-side Ami's line measurements (8.27 ± 0.63 vs. 7.90 ± 0.71 cm, p = 0.014) and larger Radoievitch angles (40.68 ± 4.02° vs. 38.80 ± 3.68°, p = 0.018) than patients with primary unilateral hernias. Both the Radoievitch angle (OR 1.14, 95% CI 1.01-1.28, p = 0.033) and Ami's line (OR 2.26, 95% CI 1.14-4.49, p = 0.020) remained independently associated with recurrent inguinal hernia after adjustment for age and body mass index. ROC analysis demonstrated modest discriminatory performance (AUC 0.634 for the Radoievitch angle and 0.633 for Ami's line), while the multivariable model incorporating age, body mass index, and Ami's line showed slightly improved discrimination (AUC 0.655). CONCLUSION: CT-derived pelvic morphometric parameters were independently associated with recurrent unilateral inguinal hernia. Although their individual discriminatory performance was modest, standardized CT-based pelvimetry may serve as an objective adjunctive tool for individualized preoperative recurrence risk assessment in patients who already undergo CT imaging for unrelated clinical indications. Prospective multicenter studies are warranted to validate these findings and determine their clinical applicability.

Humans↗
PubMed1979

[Operative methods and our results in the surgery of inguinal hernias in children].

Inguinal hernias in children are encountered very frequently in the surgical wards. The aim of surgical treatment of such hernias is to close and resect the nonobliterated - opened vaginal process. The distal portion of the vaginal process may left unaltered however, the position of the funiculus must not be changed. The operative procedure used by the authors has yielded excellent results with complications in less than 1% of the cases. A much larger percentage of complications (over 6%) occurs in those cases in which surgical procedures intended for adults are used for children. Testicular atrophy has been seen in 13% of such cases. Keeping in mind the difference in percentage in complications between the two above mentioned surgical approaches, it is obvious that only those procedures that yield the least complications should be used in pediatric hernioplasty. 430 inguinal hernia repairs were performed on children in our clinic and only one recidivism occurred in one child and in another, the testes did not descend completely into the scrotum. No other complications had occurred.

Adolescent↗
PubMed1975

Occult inguinal hernia in the female.

Inguinal hernioplasty was performed in a series of 14 female patients with occult inguinal hernias over a period of five years. During this time 194 herniorrhaphies were performed and thus the incidence of repair for occult hernia was 8%. These patients represent a definite syndrome which has not been sufficiently documented in the surgical literature. The condition is defined and the anatomic pathology documented photographically. The mean age in this series was 20 years with a range of 15-45 years. Thirteen of the 14 cases were followed a mean of 10 months postoperatively. Ten of these were considered excellent results and were symptom-free. The remaining three cases were judged as good results but objective evaluation was less conclusive. There have been no recurrences. The anatomic basis for this syndrome has been documented by others. The absence of an impulse on clinical examination is explained on the basis of size of the hernias and the difference in the anatomy between males and females. Occult inguinal hernia in the female is clinically recognizable on the basis of intermittency, character, and localization of pain and after the exclusion of other pathologic conditions. This syndrome should be entertained in the differential diagnosis of lower abdominal pain in the female. Hernioplasty is safe and effective therapy and returns the patient to normal activity.

Abdomen↗
PubMed1976

[The herniotomy operation in the treatment of congenital inguinal hernia].

--203 cases of congenital inguinal hernia operated with Mitchell-Banks technique have been studied. Just over half the patients were less than 1-year old; 48% were males; right inguinal hernia (53%) predominated, while 13% presented bilateral hernia. Post-operative hospitalization was 1-3 days in 73% of cases. Fever was observed in 86% of the children but it never lasted more than 2 days. 81 patients presented scrotal haematoma. Mortality was nil. Long-term follow-up showed that only 1% had suffered a recurrence. As a result of all these advantages and the low hospitalization (one day surgery), the technique is recommended for the treatment of infant inguinal hernia.

Female↗
PubMed1976

Short-stay surgery (Shouldice technique) for repair of inguinal hernia.

Short-stay surgery for inguinal hernia repair using the Shouldice technique, with local anaesthesia in the great majority of cases, has achieved a recurrence rate of less than 1% in the repair of both primary and recurrent inguinal hernia. A personal series of 14 982 consecutive inguinal herniorrhaphies performed during a 21-year period with an overall recurrence rate of 0.6%, using the Shouldice technique exclusively, is documented and discussed in some detail. The results suggest that the adoption of these methods on a national scale would result in a saving to the economy of many millions of pounds.

Follow-Up Studies↗
PubMed2026

Sequential laparoscopic percutaneous extraperitoneal closure for inguinal hernia during NICU/GCU hospitalization in low birth weight infants.

BACKGROUND: Inguinal hernia is common in low birth weight infants and carries a risk of incarceration. Although laparoscopic percutaneous extraperitoneal closure (LPEC) is widely used in pediatric patients, the safety of sequential LPEC during NICU/GCU hospitalization remains unclear. This study evaluated the safety and feasibility of sequential LPEC during NICU/GCU hospitalization. METHODS: We retrospectively reviewed infants who underwent LPEC between September 2018 and July 2024. Infants aged ≤ 6 months diagnosed with inguinal hernia and treated with sequential LPEC during hospitalization were included. For comparison, infants aged ≤ 6 months with a history of NICU/GCU hospitalization who were diagnosed with inguinal hernia after NICU/GCU discharge and underwent LPEC were identified. RESULTS: Among 302 patients, 13 met the inclusion criteria. One patient required postoperative reintubation, postoperative testicular atrophy occurred in three patients, and no hernia recurrence was observed during a median follow-up of 48 months. Compared with infants diagnosed after NICU/GCU discharge, the sequential LPEC group had significantly lower gestational age, lower birth weight, lower body weight at surgery, and more comorbidities, whereas postoperative outcomes were comparable. CONCLUSION: Sequential LPEC during continuous NICU/GCU hospitalization is feasible and can be safely performed in low birth weight infants with appropriate technical refinements.

Humans↗
PubMed1978

The prevalence of inguinal hernia in adult Ghanaian males.

Indirect inguinal hernia imposes a heavy patient caseload on surgical services in Africa. This study, conducted in rural southern Ghana in 1973, showed a marked increase in prevalence in adult males aged 55 years and older. In contrast, hospitalized patients undergoing herniorrhaphy in Accra were evenly distributed through all age groups. As hospital services expand and rural patients have better access to surgical care, recent innovations such as short stay surgery may be important for coping with rising patient demand.

Adolescent↗
PubMed1976

Inguinal hernia repair. A comparison of the Shouldice and Cooper ligament repair of the posterior inguinal wall.

The basic principle of the Cooper ligament repair is the closure of the deficiency in the posterior inguinal wall effected by suturing the upper margin of the defect, represented by the aponeurosis of the transversus plus its investing fascia, downwards to its insertion on to Copper's ligament along the superior ramus of the pubis lateral to the pubic tubercle. Because of tension, a relaxing incision in the anterior rectus sheath is frequently necessary. The basic principle of the Shouldice repair of the posterior inguinal wall is an overlapping repair utilizing the transversalis fascia, previously divided from internal ring to pubic tubercle. The lateral (or lower) transversalis flap is anchored upwards, underneath the medial (or upper) flap, being attached medially to the edge of the rectus and laterally to the arching fibers of transversus and internal oblique. The medial flap is then attached to the deepest part of the shelving surface of the inguinal ligament. Tension is a less significant factor and a relaxing incision is not used. In two large well-documented series, each using one of these technics exclusively, the recurrence rates are used to compare these two methods of repair. In Halverson and McVay's twenty-two year series of 263 repairs for primary direct inguinal hernia, using the Cooper ligament method throughout, this rate was 4.9 per cent. In my personal twenty-one year series of 4,812 primary direct inguinal hernia repairs using the Shouldice method exclusively, a recurrence rate of 0.7 per cent was achieved. These results suggest that the Shouldice repair is superior.

Abdominal Muscles↗
PubMed1976

A neuromuscular basis for development of indirect inguinal hernia.

Specialized portions of the transversus abdominus muscles act on the internal inguinal rings and produce a closure mechanism during voluntary abdominal muscular activity. Abdominal muscular contractions may have a protective influence against development of indirect inguinal hernia. It follows, therefore, that injury or inactivation of this mechanism may be an etiologic factor in the development of indirect inguinal hernia. One cause of injury to this mechanism is by denervation and regional muscle paralysis occurring during a surgical procedure. Surgical denervation appears to have caused an indirect inguinal hernia in one of the authors.

Adult↗
PubMed1978

Testicular infarction with incarcerated inguinal hernia in infants.

Three male babies presenting with incarcerated inguinal hernias in the first year of life were found to have infarction of the ipselateral testis at operation. This is a well recognised complication of indirect inguinal hernia and a common complication of incarceration.

Hernia, Inguinal↗
PubMed1979

The government and the inguinal hernia.

Our review of the incidence of inguinal hernias in children based on socioeconomic differences and their risk of incarceration with its subsequent complications, was prompted by a governmental decision to disallow elective herniorrhaphy in children over 1 yr of age. The review showed the following: The risk of incarceration, the failure of preoperative reduction and the potential gonadal injury is more than three times as high in the poor child, usually covered by Medicaid. Since operative and postoperative complications increase proportional to the incidence of incarcertain, the denial of an elective herniorrhaphy endangers the life of a child. Since the increased hospitalization after incarceration also increases the financial expenditure, this rule is not only medically but also economically unsound. This review suggests that unilateral governmental health care decisions, especially those aimed at cost containment, should be carefully scrutinized to determine what price not only the society, but the patient has to pay for the "cost containment". We feel that the price of the denial of a herniorrhaphy is too high.

Child↗
PubMed1978

The epidemiology of inguinal hernia. A survey in western Jerusalem.

The epidemiology of inguinal hernia was investigated in a community survey in a neighbourhood of western Jerusalem in 1969-71. The current prevalence rate, excluding operated hernias, was 18 per 100 men aged 25 and over, and the lifetime prevalence, including operated hernias, was 24 per 100. Prevalence rose markedly with age; the lifetime prevalence rate reached 40 per 100 men at the ages of 65-74 and 47 per 100 at 75 and over. The prevalence of hernia was significantly higher in the presence of varicose veins, in men who reported symptoms of prostatic hypertrophy, and, among lean men only, in the presence of haemorrhoids. These associations may reflect the role of increased abdominal pressure. The prevalence of hernia was low in the presence of overweight or adiposity, suggesting that obesity is a protective factor. No significant age-independent associations were found with chronic cough, constipation, physical activity at work, or a number of other variables. Two-thirds of the hernias had not been operated upon. The prevalence of unrepaired hernias rose with age; 13% of all men aged 65-74 and 23% of those aged 75 and over had unoperated groin swellings. One in every five operated hernias showed evidence of recurrence. No significant age-independent associations were found between evidence of occurrence and other characteristics. A comparison of interview responses and examination findings showed that interview data on the presence of hernias were of low validity, mainly because of under-reporting.

Adult↗
PubMed1975

Effects of inguinal hernias upon the bladder and ureters.

The presence of inguinal hernia may be associated with extrinsic defects upon the bladder and ureter in the absence of actual herniation of the urinary structures. The findings are characteristic unless associated with irregularity of the bladder wall or elevation of the bladder floor by prostatic enlargement. In some cases, the possibility of intrinsic bladder pathology is raised, requiring retrograde study for clarification. Ureteral displacements may be either ipsilateral or contralateral, depending upon the segment of bowel involved and the side of the hernia. The bladder findings are best demonstrated when the patient is prone or upright.

Hernia, Inguinal↗
PubMed1976

The incidence of male hermaphroditism in girls with inguinal hernia.

The incidence of male hermaphroditism in girls with inguinal hernias is estimated to be 1.4 per cent. From 1961 to 1972, 340 girls were admitted to the Department of Surgery at St. Josephs Hospital for hernial repair. One hundred and two patients had menstruated prior to the follow-up study. Buccal smears from the remaining patients were examined for Y chromatin-positive cells. We observed a zero per cent rate of male hermaphroditism, which is not significantly different from the aforementioned frequency, p greater than 0.05. Large scale prospective studies must be available before any conclusion can be drawn as to whether or not determination of the genetic gender prior to hernial repair in girls should be conducted as a routine procedure.

Adolescent↗
PubMed1975

Recurrent inguinal hernia. Follow-up study of 100 postoperative patients.

This review of recurrent inguinal hernia evaluates the possible causes of recurrence and the most effective operative procedures for successful repair. Emphasis is placed upon precise dissection technic so that whatever fascia is available after the primary operation may be utilized for the subsequent repair. A detailed study is devoted to the histologic features of fascia, emphasizing its lack of vascularization as the possible reason for its strength and permanency throughout life. In operations for recurrent inguinal hernia, rectus sheath pedunculated grafts should be used more frequently, and in extreme cases cord excision may be required. A follow-up study of one hundred postoperative cases, with a failure rate of 7 per cent, is presented.

Adolescent↗
PubMed1978

Sliding appendiceal inguinal hernia.

Rarely, the mesoappendix forms the sliding component of an inguinal hernia. Appendectomy, in such instances, permits effective repair of the hernia. This was accomplished in 16 patients without wound complication or recurrence of the hernia.

Appendectomy↗
PubMed1976

Ambulatory inguinal hernia repair compared with short-stay surgery.

Two groups of patients operated on for inguinal hernia, one outpatient group and one inpatient group, are compared with respect to subjective distress and immediate postoperative complications. The groups were chosen at random and matched for sex and age. A large number of those who received treatment as outpatients suffered marked distress during the first postoperative days. Some form of intermediary or light nursing should be tried out for the outpatients so that if necessary they can stay the night after operation at the hospital. The number of postoperative complications was equal in the two groups. With suitable patient selection and with a small number of reserve places in a light-care ward, the majority of inguinal hernia operations can be performed on outpatients, resulting in a considerable economic saving and shorter waiting time.

Adult↗