Abstract

Abstract Aim To assess if increased serum levels of estradiol is an independent risk factor for occurrence of groin hernia in men. Material and Methods We performed a hospital based case-control study. Men diagnosed with groin hernia were taken as cases and men who did not have groin hernia but were admitted for other elective surgery were taken as controls. Cases were matched to controls based on age and BMI. Morning fasting blood sample was collected from both cases and controls used to measure serum estradiol levels. Results A total of 46 hernia cases and 91 non-hernia controls were included in the study. The mean age and BMI of both cases and controls were not significantly different. The mean serum estradiol level for cases was 53.5 ±7.11 pg/ml. This value was significantly higher (p < 0.001) than for the control group which was 28.3 ± 3.14 pg/ml. A strong positive association was observed between increasing serum estradiol levels and hernia incidence. Men in 4th (highest) quartile of estradiol levels had a relative risk of 2.27 (95% CI:1.33-3.04) compared to men in 2nd quartile. Men in 1st (lowest) quartile didn’t have any hernia cases. Conclusions The knowledge may allow treatment or prevention with novel nonsurgical approaches. Therapy with aromatase inhibitors might prevent recurrence after hernia repair or even help men avoid surgery in the first place. Prevention of hernia will lead to decrease in morbidity and cost burden due to surgical treatment to a long extent.

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