Abstract
Background/aim
Closure of the processus vaginalis (PV) is considered as the last step of testicular descent. Therefore, patent processus vaginalis (PV), and inguinal hernias are linked to cryptorchidism. As the National Australian incidence of orchidopexy has decreased over the previous 20 years, we aimed to explore the incidence of inguinal herniotomy (including hydrocele) over time in Australia.
Methods
The National Department of Human Services (DHS) database, and Bureau of Statistics database were obtained for the years 1998–2017. The numbers of inguinal herniotomies in patients aged 0–4, 5–14 and 15–24 yearswere examined with ethical approval.
Results
Over the 20-year period, over 87,000 inguinal herniotomy procedures were performed in males. The incidence per year in males decreased across all ages over the 20-year period, but was most pronounced in infants and toddlers. Similar to males, the incidence in females decreased over time, with the ratio of procedures per head of population decreasing in children under 5 years of age. The ratio of male: females varied according to ages, and was between 2.8 and 6.2 males: 1 female.
Conclusion
This study suggests that fewer 0–4-year olds are undergoing inguinal herniotomy, compared with 20 years ago. This is likely due to a change in practice for the management of unilateral symptomatic hernias, from routine bilateral herniotomies, to unilateral surgery. As well as less aggressive surgical intervention for hydroceles in boys.
Level of evidence
III.
Similar content being viewed by others
References
Pham SB, Hong MK, Teague JA et al (2005) Is the testis intraperitoneal? Pediatr Surg Int 21(4):231–239
Hutson JM, Southwell BR, Li R et al (2013) The regulation of testicular descent and the effects of cryptorchidism. Endocr Rev 134(5):725–752
Ein S, Njere I, Ein A (2006) Six thousand three hundred sixty-one pediatric inguinal hernias: a 35-year review. J Pediatr Surg 41(5):980–986
Palmer LS (2013) Hernias and hydroceles. Pediatr Rev 34(10):457–464
Clarnette TD, Hutson JM (1999) The development and closure of the processus vaginalis. Hernia 3:97–102
Clarnette TD, Rowe D, Hasthorpe S et al (1997) Incomplete disappearance of the processus vaginalis as a cause of ascending testis. J Urol 157:1889–1891
Vikraman J, Donath S, Hutson J (2017) Undescended testes: diagnosis and timely treatment in Australia (1995–2014). Aus Fam Physician 46(3):152–158
Hutson JM, O’Brien M, Beasley S et al (2015) Jones’ clinical paediatric surgery, 7th edn. Singapore, Markono Print Media Pte Ltd., p 180
Jobson M, Hall NJ (2017) Current practice regarding timing of patent processus vaginalis ligation for idiopathic hydrocele in young boys: a survey of UK surgeons. Pediatr Surg Int 33(6):677–681
Sözübir S, Ekingen G, Senel U et al (2006) A continuous debate on contralateral processus vaginalis: evaluation technique and approach to patency. Hernia 10(1):74–78
Klin B, Efrati Y, Abu-Kishk I et al (2010) The contribution of intraoperative transinguinal laparoscropic examination of the contralateral side to the repair of inguinal hernias in children. World J Pediatr 6(2):119–124
Funding
This research did not receive any specific grant from funding agencies in the public, commercial or not-for-profit sectors.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
None of the authors have any financial or personal interests to disclose.
Ethical approval
Human ethical approval was obtained prior to undertaking the study via The Royal Children’s Hospital (Melbourne), HREC No. 38122A.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Vikraman, J., Donath, S. & Hutson, J.M. Frequency of inguinal herniotomy in Australia (1998–2017). Pediatr Surg Int 35, 759–763 (2019). https://doi.org/10.1007/s00383-019-04483-4
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00383-019-04483-4