Sex-based differences in inguinal hernia factors.

Adult Male Humans Female Child Hernia, Inguinal / etiology Genetic Predisposition to Disease / etiology Herniorrhaphy / adverse effects Hernia, Femoral / surgery Risk Factors Laparoscopy
Gender studies Inguinal hernia Inguinal hernias in women Risk factors inguinal hernia Sex-based differences

Journal

Surgical endoscopy
ISSN: 1432-2218
Titre abrégé: Surg Endosc
Pays: Germany
ID NLM: 8806653

Informations de publication

Date de publication:
Nov 2023
Historique:
received: 07 04 2023
accepted: 30 07 2023
medline: 1 11 2023
pubmed: 26 8 2023
entrez: 25 8 2023
Statut: ppublish

Résumé

Much of our knowledge about inguinal hernias is based on males. Meanwhile, it is established that women have worse outcomes after inguinal hernia repair, with more chronic pain and higher recurrences. Pediatric literature shows inguinal hernias in females are more likely to be bilateral, incarcerated, and carry a stronger genetic predisposition than males. We aimed to evaluate sex-based differences in inguinal hernia factors in adults, to help supplement the paucity of literature in the adult population. An institutional database of patients undergoing repair of primary inguinal hernias was queried with focus on preoperative risk factors and operative characteristics. Multivariate analysis was performed looking for independent variables associated with a greater number of hernia defects found intraoperatively. Among 494 patients, 202 (40.9%) were female. Number of risk factors among females was significantly higher than males (1.53 vs 1.2, p = 0.003). Females had significantly more constipation, GERD, and asthma and lower BMI than males. Family history of hernias was similar between both sexes. As expected, females had significantly less direct hernias (12.9% vs 32.9%, p < 0.001) and more femoral hernias (38.5% vs 12.2%, p < 0.001) than males. Bilaterality was similar. Females undergoing inguinal hernia repair averaged 1.23 prior deliveries. Regression analysis showed age, sex, BMI, and number of deliveries were not correlated with the number of defects. Females undergoing primary inguinal hernia repair had more preoperative risk factors for inguinal hernia than males. In our population, there was no higher incidence of bilaterality or significant genetic predisposition in females as noted by family history of hernias. Age, sex, BMI and number of deliveries did not correlate with the number of hernia defects found. Our study promotes awareness of inguinal hernias in females and presents new data to quantify sex-based differences and predispositions to inguinal hernias.

Sections du résumé

BACKGROUND BACKGROUND
Much of our knowledge about inguinal hernias is based on males. Meanwhile, it is established that women have worse outcomes after inguinal hernia repair, with more chronic pain and higher recurrences. Pediatric literature shows inguinal hernias in females are more likely to be bilateral, incarcerated, and carry a stronger genetic predisposition than males. We aimed to evaluate sex-based differences in inguinal hernia factors in adults, to help supplement the paucity of literature in the adult population.
METHODS METHODS
An institutional database of patients undergoing repair of primary inguinal hernias was queried with focus on preoperative risk factors and operative characteristics. Multivariate analysis was performed looking for independent variables associated with a greater number of hernia defects found intraoperatively.
RESULTS RESULTS
Among 494 patients, 202 (40.9%) were female. Number of risk factors among females was significantly higher than males (1.53 vs 1.2, p = 0.003). Females had significantly more constipation, GERD, and asthma and lower BMI than males. Family history of hernias was similar between both sexes. As expected, females had significantly less direct hernias (12.9% vs 32.9%, p < 0.001) and more femoral hernias (38.5% vs 12.2%, p < 0.001) than males. Bilaterality was similar. Females undergoing inguinal hernia repair averaged 1.23 prior deliveries. Regression analysis showed age, sex, BMI, and number of deliveries were not correlated with the number of defects.
CONCLUSIONS CONCLUSIONS
Females undergoing primary inguinal hernia repair had more preoperative risk factors for inguinal hernia than males. In our population, there was no higher incidence of bilaterality or significant genetic predisposition in females as noted by family history of hernias. Age, sex, BMI and number of deliveries did not correlate with the number of hernia defects found. Our study promotes awareness of inguinal hernias in females and presents new data to quantify sex-based differences and predispositions to inguinal hernias.

Identifiants

DOI: 10.1007/s00464-023-10367-5 PMID: 37626235
pubmed: 37626235
doi: 10.1007/s00464-023-10367-5
pii: 10.1007/s00464-023-10367-5
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

8841-8845

Informations de copyright

© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.

Références

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Auteurs

Sarah Pivo (S)

Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA.

Desmond Huynh (D)

Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA.

Cherin Oh (C)

Beverly Hills Hernia Center, 450 N. Roxbury Dr., Suite 224, Beverly Hills, CA, 90210, USA.

Shirin Towfigh (S)

Beverly Hills Hernia Center, 450 N. Roxbury Dr., Suite 224, Beverly Hills, CA, 90210, USA. DrTowfigh@BeverlyHillsHerniaCenter.com.
ORCID: 0000-0002-1016-7993

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Classifications MeSH

questionsmedicales.fr › Personnes › Tranches d'âge › Adulte › Sex-based differences in inguinal hernia factors.
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Sex-based differences in inguinal hernia factors.
questionsmedicales.fr › Personnes › Tranches d'âge › Enfant › Sex-based differences in inguinal hernia factors.
questionsmedicales.fr › États, signes et symptômes pathologiques › États anatomopathologiques › Hernie › Hernie abdominale › Hernie inguinale › Sex-based differences in inguinal hernia factors.
questionsmedicales.fr › Phénomènes génétiques › Génotype › Prédisposition génétique à une maladie › Sex-based differences in inguinal hernia factors.
questionsmedicales.fr › Procédures de chirurgie opératoire › Procédures de chirurgie reconstructive › Herniorraphie › Sex-based differences in inguinal hernia factors.
questionsmedicales.fr › États, signes et symptômes pathologiques › États anatomopathologiques › Hernie › Hernie abdominale › Hernie crurale › Sex-based differences in inguinal hernia factors.
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Statistiques comme sujet › Probabilité › Risque › Facteurs de risque › Sex-based differences in inguinal hernia factors.
questionsmedicales.fr › Procédures de chirurgie opératoire › Interventions chirurgicales mini-invasives › Endoscopie › Laparoscopie › Sex-based differences in inguinal hernia factors.