Contralateral groin exploration is not justified in infants with a unilateral inguinal hernia

Abstract

Background: In children undergoing a unilateral inguinal herniotomy, the contralateral groin is often explored on the basis of a high incidence of patency of the processus vaginalis. The patency rate is highest in infants but there are no data on the subsequent risk of contralateral hernia development purely in this population. This was a study of the incidence of contralateral inguinal hernia following unilateral inguinal herniotomy in infancy (aged less than 1 year). Methods: All infants who underwent a unilateral inguinal herniotomy between January 1986 and December 1991 were studied retrospectively. Results: One hundred and eighty-one infants (165 boys and 16 girls) were studied. Median gestational age was 37 (range 25-42) weeks and median age at operation was 87 (range 1-365) days. The herniotomy was right sided in 82.9 per cent of infants. Follow-up ranged from 5 to 10 years. A contralateral hernia/hydrocele developed in 14 infants (7.7 per cent). None of the hernias was incarcerated. Median time from operation to occurrence of the contralateral hernia was 18 (2-67) months. Gestational age, sex and the side of the hernia did not influence the incidence of contralateral hernia development. Conclusion: The low incidence of contralateral hernia development in infants undergoing a unilateral inguinal herniotomy does not justify routine contralateral groin exploration.