2008 Volume 44 Issue 5 Pages 667-671
Purpose: To investigate the effectiveness of ultrasound scan (US) for detecting contralateral patent processus vaginalis (CPPV) in pediatric patients with unilateral inguinal hernia. Moreover, we performed a preventive operation against subsequent contralateral occurrence and investigated whether the operation reduces the incidence of contralateral hernia. Methods: Between August 1998 and December 2002, among 348 patients with unilateral inguinal hernia, 74 patients were diagnosed with CPPV by US, and they underwent bilateral surgery. The remaining 274 patients were classified as the Operation group. Between January 2003 and December 2005, among 245 patients with unilateral inguinal hernia, 53 patients were diagnosed with CPPV by US, but they did not undergo contralateral operation. All 245 patients were classified as the Observation group. The incidence of subsequent contralateral occurrence was compared between the two groups. Results: Among the 274 patients in the Operation group, 3 (1.1%) presented with contralateral hernia. Among the 245 patients in the Observation group, 22 (9.0%) presented with contralateral hernia. There was a significant difference between the two groups (p<0.0001). Among the 22 patients with contralateral hernia in the Observation group, 19 patients were diagnosed with CPPV by preoperative US. The incidence of contralateral occurrence in the CPPV-negative patients in the Observation group was 1.6% (3/192) , and the overall incidence of CPPV-negative patients in both the Operation and Observation groups was 1.3% (6/462). Conclusions: Preoperative evaluation of contralateral side by US in pediatric patients with unilateral inguinal hernias reduces the incidence of subsequent contralateral occurrence.
