Abstract
Introduction: Hernia developing in the contralateral groin in children presenting with unilateral inguinal hernia is a recognized problem. There is no consensus regarding the need for exploration of the contralateral groin in children presenting with a unilateral hernia. Objectives: To study the incidence of metachronous inguinal hernia and to assess the justifiability of not exploring the contralateral groin. Methods: All children operated for unilateral inguinal hernia in our unit between April 1995 and April 1998 were asked to present themselves for review in April 2000. Results: Hundred and forty six of the 247 children operated turned up for review. There were 96 (66%) boys and 50 (34%) girls. The ages ranged from 54 days to 11 years. Eight of the 50 girls (16%) and 14 of the 96 boys (15%) developed metachronous inguinal hernias. Metachronous hernias developed in 5 of the 42 children (12%) who had their first operation at the age of 2 years or earlier. Conclusion: Routine exploration of the contralateral groin of all children cannot be justified as only 15% developed metachronous hernias. Some surgeons are selective and explore the contralateral groins of all girls and in boys under 2 years. This policy also could not be justified as the incidence of metachronous hernia was equal in both sexes and was not higher in children of 2 years or younger. We recommend exploring the symptomatic groin only.
Highlights
Hernia developing in the contralat eral groin in children presenting with unilateral inguinal hernia is a recognized problem
Routine exploration of the contralat eral groin of all children cannot be justified as only 15% developed metachronous hernias
Some sur geons are selective and explore the contralateral groins of all girls and in boys under 2 years. This policy could not be justified as the incidence of metachronous hernia was equal in both sexes and was not higher in children of 2 years or younger
Summary
Hernia developing in the contralat eral groin in children presenting with unilateral inguinal hernia is a recognized problem. There is no consensus regarding the need for exploration of the contralateral groin in children presenting with a unilateral hernia. Many current surgeons advocate a selective rather than a routine exploration of the contralateral groin. It has been our policy and of some others to operate on the symptomatic groin only. The objectives of our study were to evaluate the incidence of a contralateral inguinal hernia (metachronoushemia) developing in the children we had operated on for a unilateral hernia and to assess the justifiability of not exploring the contralateral groin
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