Prevalence and repair of inguinal hernias in children with bladder exstrophy.

Abstract

We delineated the prevalence, recurrence rates and optimal treatment of inguinal hernia in the exstrophy population. Of 181 children with exstrophy followed at our hospital inguinal hernias developed in 121 (66.8%). In a 12-year period inguinal hernias developed in 81.8% of the boys and 10.5% of the girls. In 18.2% of the cases the hernia was repaired via a preperitoneal approach at the same time as exstrophy closure. The remaining patients underwent an inguinal operation. Most patients had a wide defect at the internal ring in addition to a patent processus vaginalis. The overall recurrence rate was 8.3%. The incidence of synchronous or asynchronous bilaterality was 81.8%. Children with bladder exstrophy should be carefully examined for inguinal hernias before bladder closure. If a unilateral hernia is present, the contralateral side should be explored. Careful preperitoneal repair should emphasize repair of the internal ring.