Recurrent inguinal hernia in Ile-Ife Nigeria: Characteristics and outcome of management

Abstract

Background: There are very few reports addressing patients' characteristics, patterns, and outcome of treatment of recurrent inguinal hernia irrespective of the method of hernia repair. Purpose: The purpose of this study is to evaluate the patients and disease characteristics, treatment and early outcome of surgery for recurrent inguinal hernia. Patients and Methods: The medical records of patients who had repair of recurrent inguinal hernia at the Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife from January 1, 2004, to December 31, 2013 were reviewed for demographics, number and place of previous repair, technique of repair, intraoperative findings at repair of recurrence, and outcome of this intervention. Data generated were analyzed for frequencies, percentages and Fisher exact test for statistical significance. Results: Forty-one recurrent hernia repairs were done during the period, constituting 3.2% of all hernia repaired. The male:female ratio was 40:1. Mean age was 56.1 ± 17.7 years. Most cases were first-time recurrences 36 (87.8%), reducible 35 (85.4%) and were electively repaired. Six (14.6%) were complicated requiring emergency repair. Recurrence within 1 year of earlier repair was common (36.6%). Relatively, more patients 22 (53.7%) had their primary repair in nonspecialist centers (P < 0.05) while only eight patients had their primary repairs in specialist centers. Lichtenstein and Nylon Darn techniques were common repair methods for recurrent hernia. Overall complication rate was 36.6% (n = 15) with wound hematoma being the most predominant 11 (25.6%). There was no record of re-recurrence over 3–60-month period (mean = 6 months). Conclusion: Place of the previous repair was associated with increased risk for hernia recurrence. Tension-free repair remains pivotal in recurrent hernia repair.