Risk Factors of Inguinal Hernia in Urban South Africa

Abstract Background: One million inguinal hernia repairs are performed annually in the USA. Although there are reports on the prevalence of inguinal hernias from sub-Sahara Africa, similar reports and guidelines are lacking for the South African population. The aim of this study was to address the epidemiology of inguinal hernias in a South African population. Methods: A retrospective review of all adult patients admitted with inguinal hernias to a public health facility in Johannesburg, was performed using a retrospective review of hospital patient records from August 2019 to May 2020. The patient records were analysed to identify the risk factors associated with inguinal hernias in this population. Results: Of the 125 patients, 91 were male (73%, mean age 50) and 34 were female (27%, mean age 47). Eighty-seven patients self-identified as Black African, 31 as White, four as Indian and three as mixed race. The right side predominated. Twenty patients had bilateral hernias. The mean BMI of males was 25, and 29 for females (p=0.002). Seventy-five patients were never-smokers, seven patients suffered from chronic obstructive pulmonary disease, and six had a family history of hernia. Fifteen patients indicated lifting heavy weights. Conclusion: Based on the study population, women had a nine-fold higher risk for developing an inguinal hernia, compared with women in Western countries. Further studies of inguinal hernia in women on the African continent are strongly advised.