Skip to main content
Log in

Female pediatric inguinal hernia: uterine deviation toward the hernia side

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

Abstract

Purpose

We aimed to clarify the frequency and the clinical significance of deviation of the uterus in female pediatric inguinal hernia.

Methods

We retrospectively evaluated the data of 94 female pediatric inguinal hernia cases that were treated by laparoscopic percutaneous extraperitoneal closure. We assessed for correlations between uterine deviation and age, body weight, the size of the hernia orifice, and the presence of contralateral processus vaginalis (PV) patency.

Results

Eighty-four of 94 cases were diagnosed with unilateral inguinal hernia. A total of 62 (73.8%) of these had uterine deviation to the hernia side (Group D); 22 (26.2%) had no deviation to the hernia side (Group N) (P < 0.001). Group D cases were significantly younger than those in Group N (P = 0.0351). There was no difference in body weight, size of the hernia orifice, or contralateral PV patency between the two groups.

Conclusion

The incidence of uterine deviation toward the hernia side was statistically significant. It is important to recognize that female pediatric inguinal hernia repair carries an increased risk of ovarian and fallopian tube damage, because these appendages are close to the hernia orifice as a result of the uterine deviation.

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

Access this article

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

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Rowe MI, Copelson LW, Clatworthy HW (1969) The patent processus vaginalis and the inguinal hernia. J Pediatr Surg 4:102–107. https://doi.org/10.1016/0022-3468(69)90189-4

    Article  PubMed  CAS  Google Scholar 

  2. Takehara H, Ishibashi H, Sato H (2000) Laparoscopic surgery for inguinal lesions of pediatric patients. In: Proceedings of 7th world congress endoscopic surgery, Singapore, pp 537–541

  3. Shono T, Izaki T, Nakahori R, Yoshimaru K (2015) Testicular ascent after laparoscopic percutaneous extraperitoneal closure for inguinal hernias. Eur J Pediatr Surg 25:105–108. https://doi.org/10.1055/s-0034-1387938

    Article  PubMed  Google Scholar 

  4. Harjai MM (2014) Uncommon content in congenial inguinal hernia. J Indian Assoc Pediatr Surg 19:244–245. https://doi.org/10.4103/0971-9261.142023

    Article  PubMed  PubMed Central  Google Scholar 

  5. Prodromidou A, Machairas N, Garoufalia Z, Kostakis ID, Kyriakidis AV, Spartalis E, Sotiropoulos GC (2020) Ovarian inguinal hernia. Ann R Coll Surg Engl 102:75–83. https://doi.org/10.1308/rcsann.2019.0137

    Article  PubMed  CAS  Google Scholar 

  6. Jafari R, Javanbakht M, Dehghanpoor F (2020) Inguinal herniation of left ovary, fallopian tube and rudimentary left horn of bicornuate uterus associated with type 2 Mayer-Rakitansky-Kuster-Hauser (MRKH) syndrome in a teenage girl: a case report and literature review. Eur J Radiol Open 7:100215. https://doi.org/10.1016/j.ejro.2020.01.004

    Article  PubMed  PubMed Central  Google Scholar 

  7. Kuyama H, Uemura S, Yoshida A, Yamamoto M (2019) Close relationship between the short round ligament and the ovarian prolapsed inguinal hernia in female infants. Pediatr Surg Int 35:625–629. https://doi.org/10.1007/s00383-019-04465-6

    Article  PubMed  Google Scholar 

  8. Shadbolt CL, Heinze SB, Dietrich RB (2001) Imaging of groin masses: inguinal anatomy and pathologic conditions revisited. Radiographics 21:s261-271. https://doi.org/10.1148/radiographics.21.suppl_1.g01oc17s261

    Article  PubMed  Google Scholar 

  9. Acien P, del Campo FS, Mayol MJ, Acien M (2011) The female gubernaculum: role in the embryology and development of the genital tract in the possible genesis of malformations. Eur J Obstet Gynecol Reprod Biol 159:426–432. https://doi.org/10.1016/j.ejogrb.2011.07.040

    Article  PubMed  Google Scholar 

  10. Attah AA, Hutson JM (1991) The anatomy of the female gubernaculum is different from the male. Aust N Z J Surg 61:380–384. https://doi.org/10.1111/j.1445-2197.1991.tb00239.x

    Article  PubMed  CAS  Google Scholar 

  11. Hutson JM, Kearsey I (2016) Is the ovary in an inguinal hernia ‘descended’ like a testis or not? J Pediatr Surg 51:1197–1200. https://doi.org/10.1016/j.jpedsurg.2015.09.014

    Article  PubMed  Google Scholar 

  12. Hutson JM (2019) Commentary to: Close relationship between the short round ligament and the ovarian prolapsed inguinal hernia in female infants-H Kuyama, S Uemura, A Yoshida, M Yamamoto, PSI (2019) 35:625–629. Pediatr Surg Int 35:1163. https://doi.org/10.1007/s00383-019-04528-8

    Article  PubMed  Google Scholar 

  13. Laing FC, Townsend BA, Rodriguez JR (2007) Ovary containing hernia in a premature infant: sonographic diagnosis. J Ultrasound Med 26:985–987. https://doi.org/10.7863/jum.2007.26.7.985

    Article  PubMed  Google Scholar 

  14. Cam C, Celik C, Sancak A, Iskender C, Karateke A (2009) Inguinal herniorrhaphy in childhood may result in tubal damage and future infertility. Arch Gynecol Obstet 279:175–176. https://doi.org/10.1007/s00404-008-0654-z

    Article  PubMed  Google Scholar 

  15. Hirabayashi T, Sakoda A, Kawano T (2012) Ventrally dislocated attachment of the ovarian suspensory ligament, a risk factor for tubal occlusion as a postoperative complication of inguinal hernia repair: efficacy of laparoscopic inguinal hernia repair for preventing tubal damage. Pediatr Surg Int 28:1089–1094. https://doi.org/10.1007/s00383-012-3171-x

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Yuki Muta.

Ethics declarations

Conflict of interest

The authors declare no conflicts of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Declaration of Helsinki and its later amendments. The approval for this study was obtained from the Research Ethics Committee of Saitama Medical Center, Saitama Medical University (no. 2270).

Informed consent

The need for informed consent was waived in view of the retrospective and observational nature of the study. We obtained consent in an opt-out manner on our institute website.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Muta, Y., Odaka, A., Inoue, S. et al. Female pediatric inguinal hernia: uterine deviation toward the hernia side. Pediatr Surg Int 37, 1569–1574 (2021). https://doi.org/10.1007/s00383-021-04982-3

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00383-021-04982-3

Keywords

Navigation