FEATURES OF CONTRALATERAL MANIFESTATIONS AFTER THE REPAIR OF UNILATERAL INGUINAL-HERNIA

Background/Purpose: Routine contralateral exploration in infants and c hildren with unilateral clinical inguinal hernia is performed by many surgeons in a selected population of patients based on a presumed high incidence of patent processus vaginalis. Our purpose is to report the actual incidence of contralateral manifestations in infants and child ren after the repair of unilateral inguinal hernia. Methods: From July 1985 through December 1995, 1,052 infants and children with unilatera l inguinal hernia or hydrocele were treated in our hospital without co ntralateral exploration. Among them, 1,001 patients (95.2%) were follo wed up for 1 to 11 years to determine if contralateral hernia develope d after unilateral inguinal herniorrhaphy. Results: The overall incide nce of contralateral hernia was 11.6% (116 of 1,001). In boys, the inc idence was 13.1%, 13.7%, and 11.7% in those under 1 year, under 2 year s of age, and in total, respectively. In girls, the incidence was 9.6% , 13.9%, 11.3%, in those under 1 year, under 5 years of age, and in to tal, respectively. The side of the initial repair did not influence th e subsequent development of contralateral inguinal hernia. In children with hydrocele, the incidence of contralateral hernias was lower (7.6 %). In girls with sliding hernias the contralateral occurrence was 12. 5%. Conclusion: Given this low incidence of contralateral hernia after unilateral inguinal herniorrhaphy, the authors do not recommend contr alateral exploration for infants and children with unilateral inguinal hernia. J Pediatr Surg 33:1099-1703. Copyright (C) 1998 by W.B. Saund ers Company.