Impact of pelvic osteotomy on the incidence of inguinal hernias in classic bladder exstrophy

Garjae Lavien, Heather N. Di Carlo, Bhavik B. Shah, John Eifler, Eric Massanyi, Andrew Stec, Paul D. Sponseller, John P. Gearhart

Research output: Contribution to journalArticle

Abstract

Background/purpose The high prevalence of inguinal hernias in the bladder exstrophy population is well documented. The authors' aim is to determine whether pelvic osteotomy reduces the incidence of primary and recurrent inguinal hernias in patients with classic bladder exstrophy.

Methods Using an institutionally-approved database, patients who underwent immediate or delayed primary bladder closure between 1974 and 2012 were identified and stratified by the use of pelvic osteotomy at the time of closure. Data were analyzed using Fisher's exact test and multivariate logistic regression analysis.

Results One hundred thirty-six patients were identified with a median follow up of 8 years. The incidence of inguinal hernias following closure was 25% in the osteotomy group versus 46% in the non-osteotomy group (p = 0.017). Osteotomy was associated with a significant decrease in recurrence of inguinal hernias amongst patients who underwent previous repair (17% versus 47%, osteotomy versus non-osteotomy, p = 0.027) and the development of primary inguinal hernias in whom initial groin exploration was negative (20% versus 39%, p = 0.029). Osteotomy and female sex were associated with a decreased rate of inguinal hernia development after bladder closure while age at closure was not.

Conclusions Pelvic osteotomy at the time of exstrophy closure decreases the likelihood of primary or recurrent inguinal hernia development.

Original languageEnglish (US)
Pages (from-to)1496-1499
Number of pages4
JournalJournal of pediatric surgery
Volume49
Issue number10
DOIs
StatePublished - Oct 1 2014

Keywords

  • Bladder exstrophy
  • Inguinal hernia
  • Pelvic osteotomy
  • words

ASJC Scopus subject areas

  • Surgery
  • Pediatrics, Perinatology, and Child Health

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