Impact of pelvic osteotomy on the incidence of inguinal hernias in classic bladder exstrophy
| Autor: | Eric Z. Massanyi, John P. Gearhart, Paul D. Sponseller, John Eifler, Heather N. Di Carlo, Garjae Lavien, Bhavik B. Shah, Andrew A. Stec |
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| Rok vydání: | 2014 |
| Předmět: |
Male
medicine.medical_specialty medicine.medical_treatment Urinary Bladder Population Hernia Inguinal Osteotomy Recurrence Median follow-up Humans Medicine Pelvic Bones education education.field_of_study Groin business.industry Incidence Incidence (epidemiology) Bladder Exstrophy General Medicine medicine.disease Surgery Bladder exstrophy Inguinal hernia Exact test medicine.anatomical_structure Pediatrics Perinatology and Child Health Urologic Surgical Procedures Female business |
| Zdroj: | Journal of Pediatric Surgery. 49:1496-1499 |
| ISSN: | 0022-3468 |
| Popis: | 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 8years. 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. |
| Databáze: | OpenAIRE |
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