Skip to main content
SpringerLink
Log in

Age-related probability of contralateral processus vaginalis patency in children with unilateral inguinal hernia

  • Original Article
  • Published:
Pediatric Surgery International Aims and scope Submit manuscript

Abstract

Purpose

Contralateral groin exploration with closure of a patent processus vaginalis (PPV) in children with a unilateral inguinal hernia remains controversial. We aimed to generate precise, age-related probabilities of patency of the contralateral processus vaginalis (PV) in infants with a unilateral inguinal hernia to guide practice.

Methods

Retrospective review of all unilateral laparoscopic inguinal hernia repairs in 5 years to determine patency of contralateral PV. Using logistic binomial regression, age-adjusted odds ratio (OR), probability of contralateral PPV and number needed to explore (NNE) in order to close all PPVs were estimated.

Results

Data from 331 children [262 male, median 3.8 months corrected gestational age (CGA)] were analysed; 160 (48 %) had a contralateral PPV. In the regression model, CGA is linearly related to log[OR] such that for each month increase in CGA, the log[OR] of having a contralateral PPV decreased by 0.017 ± 0.006 (mean ± SEM; p = 0.005). Gender and side of hernia had no significant effect. The probability of contralateral PPV is 50 % (NNE = 2) at 8 m CGA, 33 % (NNE = 3) at 49 m and 25 % (NNE = 4) at 72 m.

Conclusions

These data contribute to our knowledge of the natural history of the PV and may help guide the need for contralateral groin exploration in infants with inguinal hernia.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Antonoff MB, Kreykes NS, Saltzman DA, Acton RD (2005) American academy of pediatrics section on surgery hernia survey revisited. J Pediatr Surg 40:1009–1014

    Article  PubMed  Google Scholar 

  2. Martin RS Jr (1961) The case for bilateral exploration of inguinal canals in pediatric patients presenting unilateral inguinal hernias. Am Surg 27:182–185

    PubMed  Google Scholar 

  3. Ron O, Eaton S, Pierro A (2007) Systematic review of the risk of developing a metachronous contralateral inguinal hernia in children. Br J Surg 94:804–811

    Article  PubMed  CAS  Google Scholar 

  4. Surana R, Puri P (1993) Is contralateral exploration necessary in infants with unilateral inguinal hernia? J Pediatr Surg 28:1026–1027

    Article  PubMed  CAS  Google Scholar 

  5. Wiener ES, Touloukian RJ, Rodgers BM et al (1996) Hernia survey of the section on surgery of the American Academy of Pediatrics. J Pediatr Surg 31:1166–1169

    Article  PubMed  CAS  Google Scholar 

  6. Ein SH, Njere I, Ein A (2006) Six thousand three hundred sixty-one pediatric inguinal hernias: a 35-year review. J Pediatr Surg 41:980–986

    Article  PubMed  Google Scholar 

  7. Manoharan S, Samarakkody U, Kulkarni M, Blakelock R, Brown S (2005) Evidence-based change of practice in the management of unilateral inguinal hernia. J Pediatr Surg 40:1163–1166

    Article  PubMed  Google Scholar 

  8. Bhatia AM, Gow KW, Heiss KF, Barr G, Wulkan ML (2004) Is the use of laparoscopy to determine presence of contralateral patent processus vaginalis justified in children greater than 2 years of age? J Pediatr Surg 39:778–781

    Article  PubMed  Google Scholar 

  9. Saad S, Mansson J, Saad A, Goldfarb MA (2011) Ten-year review of groin laparoscopy in 1001 pediatric patients with clinical unilateral inguinal hernia: an improved technique with transhernia multiple-channel scope. J Pediatr Surg 46:1011–1014

    Article  PubMed  Google Scholar 

  10. Klin B, Efrati Y, Abu-Kishk I, Stolero S, Lotan G (2010) The contribution of intraoperative transinguinal laparoscopic examination of the contralateral side to the repair of inguinal hernias in children. World J Pediatr 6:119–124

    Article  PubMed  Google Scholar 

  11. Golka T, Holschneider AM, Fischer R, Blessing MH (1989) Pathogenicity of the open processus vaginalis peritonei. Z Kinderchir 44:88–90

    PubMed  CAS  Google Scholar 

  12. Toufique EM, Ng AT, Chung PH, Chan KL, Wong KK, Tam PK (2009) Laparoscopic hernioplasties in children: the implication on contralateral groin exploration for unilateral inguinal hernias. Pediatr Surg Int 25:759–762

    Article  Google Scholar 

  13. Koivusalo AI, Korpela R, Wirtavuori K, Piiparinen S, Rintala RJ, Pakarinen MP (2009) A single-blinded, randomized comparison of laparoscopic versus open hernia repair in children. Pediatrics 123:332–337

    Article  PubMed  Google Scholar 

Download references

Conflict of interest

None.

Author information

Authors and Affiliations

  1. Surgery Unit, Department of Paediatric Surgery, UCL Institute of Child Health, 30 Guilford Street, London, WC1N 1EH, UK

    Nigel J. Hall, Wonyong Choi, Agostino Pierro & Simon Eaton

Authors
  1. Nigel J. Hall
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Wonyong Choi
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Agostino Pierro
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Simon Eaton
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Nigel J. Hall.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Hall, N.J., Choi, W., Pierro, A. et al. Age-related probability of contralateral processus vaginalis patency in children with unilateral inguinal hernia. Pediatr Surg Int 28, 1085–1088 (2012). https://doi.org/10.1007/s00383-012-3174-7

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00383-012-3174-7

Keywords

Search

Navigation