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Low risk of need for contralateral inguinal hernia repair after unilateral repair

Clinical Question:
What is the risk of requiring a contralateral inguinal hernia repair in adults after unilateral repair?

Bottom Line:
In this study the risk of needing a contralateral inguinal hernia repair in adults after unilateral repair was low (3.8% at 10 years). The true risk is likely to be higher since some of the patients needing a second surgery may have moved or changed insurance carriers. (LOE = 2b-)

Reference:
Clark JJ, Limm W, Wong LL. What is the likelihood of requiring contralateral inguinal hernia repair after unilateral repair? Am J Surgery 2011;202(6):754-758.  [PMID:22000721]

Study Design:
Cohort (retrospective)

Funding:
Unknown/not stated

Setting:
Inpatient (any location) with outpatient follow-up

Synopsis:
These investigators retrospectively analyzed data from a large commercial insurance carrier over a 10-year period from January 1, 1999, to December 31, 2009. Standard CPT codes were used to identify patients who underwent an open or laparoscopic unilateral inguinal hernia repair and then a subsequent contralateral inguinal hernia repair in this period. The authors were unable to report what percent of the original cohort remained with the same commercial insurance carrier. From a total of 7050 patients who underwent an initial unilateral inguinal hernia repair in this period, 272 (3.8%) also underwent a contralateral inguinal hernia repair. Most of the patients requiring a second surgery were male (97.4%) and were significantly older at the time of initial repair compared with those not requiring contralateral repair (mean age = 62.2 years vs 59.6 years, respectively). Fifty percent of the contralateral repairs occurred within 2.5 years.

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