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S26-10
(P)
IMPACT OF CONCOMITTANT INGUINAL HERNIA REPAIR AT THE TIME OF INITIAL
EXSTROPHY REPAIR
Jonathan ELLISON, Richard GRADY, Margarett SHNORHAVORIAN and Paul MERGUERIAN
Seattle Children's Hospital, Pediatric Urology, Seattle, USA
PURPOSE
Patients with classic bladder exstrophy have a reported 81% (male) and 10% (female) incidence of inguinal hernias that
present either during the newborn period or later in life. In 2006, we modified our approach to this condition by
performing concomitant inguinal hernia repair at the time of initial exstrophy repair in the vast majority of patients
undergoing initial surgery at our institution to test the hypothesis that simultaneous inguinal hernia repair will reduce
the later incidence of inguinal hernias in this high risk group.
MATERIAL AND METHODS
We conducted a retrospective chart review comparing patients with bladder exstrophy initially treated with initial
complete primary exstrophy repair (CPRE) alone at our institution from 1990 to 2005 to those undergoing simultaneous
CPRE and inguinal hernia repair between 2006 and 2014 . We excluded patients with incomplete follow-up.
RESULTS
Between 1990 and 2006, 30 patients underwent initial exstrophy repair. Of these patients, 11 presented later for repair
of a symptomatic inguinal hernia or undescended testis at a median age of 19 months. After 2006, 15 patients
underwent simultaneous hernia repair at the time of initial CPRE. None of these patients has presented with a clinically
symptomatic inguinal hernia with a median follow-up of 52 months.
CONCLUSIONS
Simultaneous inguinal hernia repair at the time of initial exstrophy repair appears associated with decreased incidence of
later inguinal hernia in this high-risk patient population.