Abstract
BackgroundTo identify the rate of and risk factors for contralateral inguinal hernia (CIH) after unilateral inguinal hernia repair in adult male patients.MethodsThis retrospective cohort study identified from the Taiwan National Health Insurance Research Database (NHIRD). Information on all adult patients who underwent primary unilateral inguinal hernia repair without any other operation was collected using ICD-9 diagnostic and procedure codes. The exclusion criteria were laparoscopic hernia repair, non-primary repair, complicated hernia, other combined procedures, female and undetermined gender.ResultsA total of 170,492 adult male patients were included, with a median follow-up of 87 months. The overall CIH rate was 10.5%, with a median time of 48 months to a subsequent hernia operation. The 1-year, 2-year, 3-year and 5-year-recurrent rate was 2.6, 3, 4.3, and 6.7% respectively. Further, 3.7% patients who underwent CIH repair had a complicated inguinal hernia. Multivariate analysis demonstrated that age > 45 y, direct hernia, cirrhosis (HR = 1.564), severe liver disease (HR = 1.663), prostate disease (HR = 1.178), congestive heart failure (HR = 1.138), and history of malignancy (HR = 1.116) had a significantly higher risk of CIH repair.ConclusionsAmong adult male patients undergoing long-term follow-up, we identified several significant risk factors for CIH repair. If these risk factors are presented, the surgeon should inform the following risk of CIH repair to patients so that it can be repaired as soon as possible.
Highlights
To identify the rate of and risk factors for contralateral inguinal hernia (CIH) after unilateral inguinal hernia repair in adult male patients
We excluded 22,003 patients who underwent other operations during the same admission: 10,948 patients underwent an operation for a complicated inguinal hernia; 1518 patients underwent a laparoscopic procedure, and 16,841 female patients and 1503 patients were of undeterminated gender
The cumulative incidence of CIH repair, which was demonstrated by Kaplan–Meier analysis, gradually increased without abrupt fluctuations (Fig. 2)
Summary
To identify the rate of and risk factors for contralateral inguinal hernia (CIH) after unilateral inguinal hernia repair in adult male patients. After unilateral inguinal hernia repair, some patients experience a contralateral inguinal hernia (CIH) and require subsequent surgical repair. Previous reports have shown that ≤30% patients develop CIH [1]. In the era of conventional hernia repair, few studies have researched the risk factors of CIH repair. To date, reports on adults have seldom discussed the risk factors for CIH repair. The risk factors associated with and results of CIH repair have been widely discussed [4, 5]. One study used a non-Medicare claims database to analyze the risk factors for treatment of CIH and showed that an older age and prostate disease were risk factors [6]
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