IDENTIFYING RISK FACTORS OF RECURRENTAND SCROTAL-INGUINAL HERNIAS

Abstract

Introduction. Recurrent inguinal hernias are the actual problem of surgery. However, the causes of
recurrence have not been studied at all. This is a reason that doesn’t allow to carry out effective
preventive measures and develop non-recurrent methods of primary operation of inguinal hernias. It is
impossible to investigate all risk factors of inguinal hernia.
Objective: To determine risk factors of recurrent and scrotal-inguinal hernias, and choice plastic
method for recurrent inguinal hernias.

Methods and Materials: Between 2008 and 2013 years in Medical Center of Semey State Medical
University, 519 patient were operated on inguinal hernia, 64 (12.3%) of them on recurrent inguinal
hernia, and retrospective analysis was conducted based on case histories. Those patients suffered from
hernia form 1 to 20 years. By analyzing case histories, 8,7% (approximately every tenth) of all patients
suffered from inguinal hernia more than 10 years. Average age of patients underwent operation, was
53,6(±12,5). Right-sided inguinal hernia occurred in 342 (64,89%) patients, left-sided in 171 (32,94%)
patients and both-sided inguinal hernia was found in 6 (1,15%) patients.
Results: By analyzing surveys and causes of inguinal hernia recurrence of patients, we have
distinguished 5 types of inguinal hernia recurrence. We focused on their location, condition of the
structures of the inguinal canal, that form hernial ring of recurrent hernia, that can point on additional
technical mistakes during first operation, and also scar that repeats the direction of inguinal canal.
Conclusion: Thus, the main risk factors of inguinal hernia recurrence are inadequate plastics
(pastics of anterior wall of inguinal canal), tension of tissues, stitching inhomogeneous tissues, defects
of the inguinal canal, age-related changes of tissues that form inguinal canal. The main types of inguinal
hernia recurrence are lateral, median, medial, total and false hernas.