Association of Low-lying Pubic Tubercle in Patients with Inguinal Hernia

Abstract

A low-lying pubic tubercle is one of the commonly implicated anatomical factors associated with indirect inguinal hernias. Even though many studies have addressed this topic, we found that they had major lacunae that are addressed in this article. The purpose of this study was to compare the incidence of low-lying pubic tubercle in a direct and indirect inguinal hernia, the accuracy of radiological measurement with clinical measurement for low-lying pubic tubercle, and to establish a mean cutoff value for low-lying pubic tubercle in our patient population. This was a case series analysis conducted at a tertiary care hospital. Forty Indian men patients with uncomplicated inguinal hernia between the age group of 22 and 60 years and the same number of matched healthy individuals (age, height, and body mass index–matched) without inguinal hernia as controls were studied. Three measurements, namely, distance between two anterior superior iliac spines (SS), the vertical distance from the pubic tubercle to the interspinal line (ST), and mid-inguinal point to pubic tubercle (MIP to PT) were taken clinically and radiologically by X-ray pelvis. The mean cutoff value for the ST segment measured clinically and radiologically was 8.10 and 8.15 cm, respectively. In our study, the ST line which measures the length of pubic tubercle was significantly longer in patients with indirect inguinal hernia, clinically and radiologically (9.56 SD 0.84 and 9.45 SD 1.02, respectively). The mean SS, MIP to PT was also significantly longer (p 25) individuals. Based on the results of our study, it can be concluded that low-lying pubic tubercle is associated with the development of an indirect inguinal hernia.