The degree to which the size and side of an inguinal hernia is predictive of a hernia on the other side

Abstract

It is not possible to predict reliably which patients who present with a unilateral hernia would benefit from bilateral exploration, although the size of the hernia has a positive correlation with the size of the contralateral processus vaginalis/hernial sac. Those with "massive" hernias on the presenting side were more likely to have "large" contralateral hernial sacs, but how many of these would subsequently become symptomatic remains uncertain.

Predictors of recurrence after inguinal herniotomy in boys

“…Larger hernias were more likely to recur, with ''massive'' ones recurring earlier than smaller hernias. Large hernial sacs more often occurred in small infants [13] and may be technically more difficult to repair. Thus, ''large'' and ''massive'' sacs were more likely to be opened during dissection, and those are seen predominantly in the youngest children.…”

Metachronous contralateral pediatric inguinal hernia

“…1 The incidence of the development of a metachronous hernia varies from 2.1 to 31% in the literature. 2,3 The routine exploration of the asymptomatic side in a unilateral inguinal herniotomy is therefore controversial. Benefits include prevention of a further anesthetic in the future, any complications associated with an untreated inguinal hernia such as incarceration, and the risks associated with another procedure.…”

“…4 The prospective trials demonstrated a large range of MCIH incidence (2.3%-9.3%), as did the retrospective trials (2.1%-7.1%). 2,[5][6][7][8][9][10][11][12] When this evidence was combined in a new systematic review, an incidence of 6.4% in 31,164 pediatric patients was revealed (Table 1).…”