Prevalence and Repair of Inguinal Hernias in Children with Bladder Exstrophy

Purpose: We delineated the prevalence, recurrence rates and optimal treatment of inguinal hernia in the exstrophy population. Materials and Methods: Of 181 children with exstrophy followed at our hospital inguinal hernias developed in 121 (66.8 percent). Results: In a 12-year period inguinal hernias developed in 81.8 percent of the boys and 10.5 percent of the girls. In 18.2 percent of the cases the hernia was repaired via a preperitoneal approach at the same time as exstrophy closure. The remaining patients underwent an inguinal operation. Most patients had a wide defect at the internal ring in addition to a patent processus vaginalis. The overall recurrence rate was 8.3 percent. The incidence of synchronous or asynchronous bilaterality was 81.8 percent. Conclusions: Children with bladder exstrophy should be carefully examined for inguinal hernias before bladder closure. If a unilateral hernia is present, the contralateral side should be explored. Careful preperitoneal repair should emphasize repair of the internal ring.