Asymptomatic patent processus vaginalis is a risk for developing external inguinal hernia in adults: A prospective cohort study

Abstract

Background Inguinal hernia repair is common for children and adults across the world, but the mechanism behind hernia onset still requires elucidation. This prospective study aims to determine whether patent processus vaginalis (PPV) is a factor in the development of external inguinal hernias. Method We enrolled 1008 patients who underwent laparoscopic surgery and in whom the inguinal region was observed. If processus vaginalis existed, we measured the diameter and length. Patients were followed for three years after surgery to investigate the incidence of external inguinal hernias. Result No significant differences were found between age groups. Furthermore, no difference could be recognized in length or opening diameter of the PPVs between age groups. Three-year follow up was possible for 765 of 1008 patients enrolled in this study (76%), eight of whom, all male, developed external inguinal hernia during this period. Multivariate analysis for onset of inguinal hernia onset in male patients showed that PPV and length of the right PPV were independent risk factors for development of external inguinal hernia. Conclusion The patency rate, length, and diameter of the processus vaginalis do not differ according to age. The patency of the processus vaginalis in male patients is an independent risk factor for development of external inguinal hernia in adults.

Worldwide magnitude of inguinal hernia: Systematic review and meta-analysis of population-based studies

“…30 Some other factors like persistent processes vaginalis ameliorate the prevalence of IH in males. 32,33 In the subgroup analysis, the highest and lowest prevalence of IH was observed in Asia and America, respectively. This result may not be conclusive regarding regional prevalence of IH because the studies conducted in America and Asia are only two for each and the studies are heterogeneous.…”

Sex-specific genetic variants associated with adult-onset inguinal hernia in a Taiwanese population

“…The rate of recurrent inguinal hernia was reported to range from 0.5 to 15 percent, depending upon the type of repair, hernia site, and the clinical circumstances. [4] Multiple risk factors for the formation of inguinal hernia have been recognized, including older age, male sex, [5] lower body mass index, [6] patent processus vaginalis, [7] matrix metalloproteinase (MMP) abnormalities, [1] chronic obstructive pulmonary disease, [8] and history of prostatectomy. [9] Greater body height and rural residence were also reported to be associated with direct inguinal hernia in females.…”